Could this be Occipital Neuralgia

Hi There,

I've been suffering from HA for about 8 years now. But recently my concerns have focused on my head. I've been suffering from headaches for about 3 months now. Sometimes they feel like I'm wearing a very tight swimming hat and sometimes the pain seems to be regionalised. I keep getting a pain that seems to stem from the base of my neck and runs up the back of my head and over to the side. Sometimes the pain is like a sharp stabbing pain sometimes its more of a constant pressure. It feels like my head is grazed and my scalp is slightly tender to touch.

The only time the pain goes is at night and strangely enough when I'm at the gym.

I've been to see my doctor who explained that this is a common complaint and is probably due to tight muscles in my neck and shoulders, he also said that the pain could be a neuralgia type pain again caused by the tight muscles constricting the nerves.

I've been prescribed muscle relaxants, which have made no difference so of course I have convinced myself that it's not what the doctor told me and that its something much worse.

My question is does what I've described sound like neuralgia rather than something more sinister?

Any advice greatly received.

Thanks

Bx

Okay, initially I need some clarification. You state in your posting that you've experienced headaches for about 8 years and follow that comment by stating you've had headaches for about 3 months. My presumption here is that you've experienced headaches for the past 8 years, but for the past 3 months, the quality and nature of the headaches has changed and represents different symptoms from what you've normally encountered. If this assumption is incorrect, please clarify.

Occipital headaches are typically the result of stress due to musculo-skeletal tension, which can extend both upward across the scalp in a variety of patterns as well as downward most commonly across the scapulae. I would not suggest neuralgia in this instance because the symptoms don't quite fit the picture.

It's important for you to realize the nature of headaches relative to "something more sinister" because many patients find themselves with increasing apprehension regarding chronic pain. The type of pain that we associate with sinister processes, namely neoplasms in the brain more commonly characterized as "tumors" are of a quality and nature that presents itself with a great deal of recognition. Pain in such instances is typically the latter stage of such processes, virtually always proceeded by symptoms that can include nausea and vomiting, instability with a history of falls and gross incoordination, marked changes in vision, disturbances in personality, altered sensory experiences. Any range of symptoms is possible, depending upon the particular location of the insult and it's frank imposition upon brain tissues both direct and proximal.

The pain is also quite aggressive and does not relent, but rather only grows worse due to it's furthered compression upon the limited space within the dura of the brain.

Indeed, your symptoms more have the ring of familiarity as being consistent with either migrainous headaches, tension headaches, or a combination.

The fact that you can experience relief at night, as well as at the gym, both instances wherein stress has a broader opportunity for escape, lends itself quite well to your inquiry. Sinister processes don't relent under such circumstances.

As I've stated to many patients who frequent the clinics with similar complaints; You can take all the medications you wish in the search for relief, but if environmental conditions are the underlying mechanism which represents the underlying cause for high stress, then it will rarely be abated by the effects of the medications. Hence, the reason you see little results from muscle relaxants. They can ultimately produce the desired effect, but the side-effects are costly and reduce quality of life to near constant somnelescence.

I naturally haven't the privilege of examining you directly, but my impression here is that we're dealing with a musculo-skeletal condition as a consequence of tension-related stress. Many things can bring such a chronic condition to bear upon your quality of life, such as divorce or other marital discord, loss of loved ones, financial crisis, change of a job or loss of a job, and other such life-altering events. It's important to try and identify possible causes and work to reduce their impact.

Finally, if the nature of the headaches change further within the coming weeks and begin including other physical symptoms, then it's always a good idea to undergo screening to simply rule out other causes, but for now I think we're safely within the corridor of tension headache or migrainous variant.

You'll be fine.

Hi RLR,

Thank you for your reply. I'm sorry for the confusion in the opening sentence of my original posting. When I said that I have had HA for 8 years I meant Health Anxiety (sorry my fault for not speaking english properly :-)) I've suffered from headaches on a off for most of my life but recently they seem to be more constant, I'm not sure if it because I've been worrying about them more that's made them worse. They started a few weeks before I had to go on a trip to the US with work, flying is another one of my phobias so initially I just put them down to stress and worry. I don't have any other symptoms at the moment just an annoying headache that doesn't seem to go.

Becki