Solving my Headache Mystery

It started a year or two ago. It's a deep pain originating where my neck met the base of my skull. This one-sided sharp pain often radiates to the front of my head around the temple area. Its not as painful as my worst migraine but disrupts my day and keeps me up at night. My abortives had no effect, but NSAIDs sometimes do. I have none of my migraine symptoms like photophobia, fatigue, brain fog, worsening pain with movement, or prodome and postdrome.

Does this sound like a migraine to you?

They happen about once or twice a month. I've started to catch on that these piercing headaches don’t seem like my usual migraines. I had a particularly bad one that kept me up at night, continuing into the next day when I had to help several customers at once at work, my head splitting and their questions coming at me simultaneously.

I felt that since I probably wasn't dealing with a migraine, I should seek an answer.

The first doctors I saw didn't have a diagnosis, but they did have a treatment plan. My primary care doctor recommended massage. I've been focusing on self-massage techniques for budget/time purposes. My chiro said he thought it might be a kind of headache that stems from my neck, and he did some helpful spinal adjustments and instructed me further on self-massage techniques and exercises.

I had an appointment with my headache specialist coming up, and I decided to bring this headache up to get a firm diagnosis.

After asking me about my pain and examining me, my headache specialist had a possible name for the pain I was experiencing: occipital neuralgia. The pain follows the pattern of the occipital nerve which starts at the base of my neck up over my head to my temple. It can be caused by a damaged or inflamed nerve. It’s not surprising to hear a nerve in my neck is unhappy. I constantly have a “crick” in my neck and have been to PT and chiro for neck pain over the years. So for me it's likely a product of my chronic neck tension, but for some there can be more serious causes including post-injury inflammation or compression or even tumors.

Now that I have hopefully identified the problem, I have a new treatment plan that is different than my migraine treatment.

I will continue with the chiropractic treatments and self-massage and may splurge on a real massage at some point. I know that heat can help, unlike the ice I use for my migraines. I also can try a muscle relaxant, and my doctor told me if I was unsure if it was a migraine that it was ok to take my abortive. Some people with more frequent or severe occipital neuralgia can try nerve blocks, preventive medications, and even surgery.

I have a new respect for other headache disorders, and I believe trying to compare other types of headaches to migraines is like comparing apples and oranges.

It was good for me to learn that other types of headaches can be pretty painful, and just because it’s a one-sided headache doesn’t mean it’s a migraine. I’m thankful my headache specialist is helping me sort it out.

Now I want to hear from you.

Have you ever had a new symptom or issue that you wrote off as migraines, only to find out it was something different? Do you have trouble figuring out if a headache is a migraine or another type of headache?

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