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Suggest Treatment For Tension Headaches

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Posted on Tue, 18 Jul 2017
Twitter Tue, 18 Jul 2017 Answered on
Twitter Tue, 8 Aug 2017 Last reviewed on
Question : Hi, my mother is 87 years old and suffers from sever arthritis. about a month ago, in addition the her regular headaches, she started having migraine type headaches. as of four day ago, she's experiencing sever pain on the right side of her head behind her ear. when we apply heat to the area it seams to reside for some time but comes back. an MRI was completed about four weeks ago with negative results. just this past Friday, I had to take her to the emergency room because the pain was so bed. blood work turned out ok. attending doctor believes its a tension headache. i'm not sure, please help, very desperate!
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Answered by Dr. Olsi Taka (2 hours later)
Brief Answer:
Read below

Detailed Answer:
I read your question carefully and I understand your concern.

It seems the doctors are not that convinced about the nature of the pain either, Lorazepam is not commonly used for tension type headache, nor are steroid shots.

Since the MRI was normal than brain lesions can be excluded. Conditions like temporal arteritis should have been excluded as well (it can be done through a routine blood test like erythrocyte sedimentation rate, I am assuming it was among her test).

Given the fact that you describe it to be shooting up her arm, as well as being relieved by heat I would say that neck issues are more likely. Neck pain commonly irradiates in the head, shoulder and upper arm. The history of arthritis makes her someone at risk of developing arthritis of the neck as well. So I would say that the pain is more likely due to inflammation and muscle spasms in the neck. Improvement can take some time, but in the meanwhile an over the counter anti-inflammatory drug like Ibuprofen, a muscle relaxant like Flexeril are advised. Medication for chronic pain like Duloxetin or Gabapentin may also be considered.

I remain at your disposal for other questions.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Olsi Taka

Neurologist

Practicing since :2004

Answered : 3672 Questions

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Suggest Treatment For Tension Headaches

Brief Answer: Read below Detailed Answer: I read your question carefully and I understand your concern. It seems the doctors are not that convinced about the nature of the pain either, Lorazepam is not commonly used for tension type headache, nor are steroid shots. Since the MRI was normal than brain lesions can be excluded. Conditions like temporal arteritis should have been excluded as well (it can be done through a routine blood test like erythrocyte sedimentation rate, I am assuming it was among her test). Given the fact that you describe it to be shooting up her arm, as well as being relieved by heat I would say that neck issues are more likely. Neck pain commonly irradiates in the head, shoulder and upper arm. The history of arthritis makes her someone at risk of developing arthritis of the neck as well. So I would say that the pain is more likely due to inflammation and muscle spasms in the neck. Improvement can take some time, but in the meanwhile an over the counter anti-inflammatory drug like Ibuprofen, a muscle relaxant like Flexeril are advised. Medication for chronic pain like Duloxetin or Gabapentin may also be considered. I remain at your disposal for other questions.