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Ask Coachrobmd Your Own Question
Coachrobmd
Coachrobmd, Doctor (non-eye specialty)
Category: Eye
Satisfied Customers: 1785
Experience:  Medical Internist
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ra-jdp

Customer Question

Had a shot to Left occipital lobe Headache follows nerve up left side over the head to eye templa and ear. Taking Robaxin, Vicadin. Dr wants to do major dose of steroid taper. Already take 6.5 mg for about 11 years. Should I so a modified taper. Can't deal with this unrelenting dull throb from back of head to ear to temple to eye. Please help?
Submitted: 4 years ago.
Category: Eye
Expert:  Coachrobmd replied 4 years ago.

Coachrobmd :

This info is not intended to replace a doctor visit. If this is an emergency, stop and go to an ER near you. This information is not meant to diagnose, treat or cure any disease.

Coachrobmd :

When you say "shot" I take it to mean a hit or trauma, and not an injection?

Coachrobmd :

If you had an injection, I'm not sure why that was given there.

Coachrobmd :

If you have been on prednisone for over 10 years, you will have a difficult time getting off of it.

Coachrobmd :

You are on two narcotics for this pain, which is a fair amount.

Coachrobmd :

It sounds as if you have trigeminal neuralgia, and the shot was given into the ganglion to relieve it?

Coachrobmd :

I am not clear on the diagnosis.

Coachrobmd :

TGN is difficult to treat if that is what you have.

Coachrobmd :

Nerve blocks can be tried, and are often successful.

Coachrobmd :

Steroids are used as well, so I believe that must be the diagnosis even though it was not listed.

Coachrobmd :

I'm not sure why you would want to do a taper of the medication if you're not improving.

Coachrobmd :

You need a neurologist to assess your options.

Coachrobmd :

Meds that are used now include pregabalin and gabapentin.

Coachrobmd :

These often succeed where narcotics fail.

Coachrobmd :

Are you there? Hello?

Coachrobmd :

I don't believe I can give you any more guideance without

Coachrobmd :

1. a diagnosis for why you're on these three medications

Coachrobmd :

2. where the injection was

Coachrobmd :

3. why you desire a steroid taper

Coachrobmd :

(I know why most people want to taper them, but not why YOU want to taper it).

Coachrobmd :

Any other information you can supply will be helpful to me.

Coachrobmd :

Write back when you can. I'll be here for another 3 hours.

Coachrobmd :

Hope to hear back.

Customer: replied 4 years ago.

I had a headache, given a injection to occipital area. Needle hit bone, DX occipital neuralgia. Did not improve.


ANother Dr. prescribed muscle relaxers and a prdenisone taper to break the headache tight neck cycle this is temporary as I take Prednisone 6.5 for 11 years


originally for vasculiitis and now am adrenal insufficient.


My question was Will the Steroids at a higher dose


help break up this headache left side aching.


Thank you.


Maureen Whiting

Expert:  Coachrobmd replied 4 years ago.
No, I'm afraid not. Steroids will not help with trauma from an injection.

As I said, after so many years, you're dependent upon prednisone. I don't know if the adrenal disease was FROM the steroids, or are being TREATED by it.

Either way, you're on them and increasing them will not help with this if it was due to a needle into the bone.

in fact, you may now have the start of bone infection called osteomyelitis. I'm not saying you DO have that, but it is possible.

Steroids at higher doses in that case will not help and may harm as it prevents healing in this situation.

To break the grip, flexeril or Soma are far better choices. Baclofen can be used in some rare cases as well.

But I see no role of steroids in your treatment induced pain. None at all.

does this help? I hope so.
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Expert:  Coachrobmd replied 4 years ago.
I noticed you never rated my response. Was that an oversight, or did you click GOOD/EXCELLENT SERVICE and it simply did not process properly (the site is having severe technical issues and this is a common problem)?

If it did NOT process, can you PLEASE come back and simply write that you tried, and it will get processed manually?

If you did NOT rate it favorably, then if there was something ELSE you wanted from me OTHER than a diagnosis/treatment without testing, a clinic visit with me, etc., would you mind posting it so that I can have a better idea how I can help you better? My goal is to answer your questions to your complete satisfaction (e.g. a GOOD or EXCELLENT SERVICE rating). Thank you!