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Dr. Bob
Dr. Bob, Neurologist (MD)
Category: Neurology
Satisfied Customers: 5189
Experience:  Neurology & Int Medicine (US Trained): 20 yrs experience
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I am a 44 y/o female, I work as a dental hygienist, I quit

Customer Question

Hello, I am a 44 y/o female, I work as a dental hygienist, I quit smoking 6 months ago, I am an occasional drinker. I suffer with constant daily headaches, sometimes worse than others, some are migraines. I wake up with a headache I go to bed with them, it is always there. I have been dealing with them for years now, maybe 4 years. I am currently taking meds that my MD has given for them Verapamil, Topamax and Imitrex PRN, I also take Prestiq for depression. I have been to a chiropractor had my eyes checked I don't know what to do anymore, it is disrupting my life. What should I do?
Submitted: 1 year ago.
Category: Neurology
Expert:  Dr. Bob replied 1 year ago.

Hi there. Sorry to hear about your headaches. This is a very distressing condition to have and, unfortunately, is far too common. Usually though the cause, or at least exacerbating factors, can be identified and a measure of relief can be attained with the proper care. Many neurologists are headache specialists. Have you seen one yet?

Customer: replied 1 year ago.
I have not been to a neurologist yet, I have a call in to get an appointment scheduled with a group at IU Neurology group.
Expert:  Dr. Bob replied 1 year ago.

That's a good start, and the right thing to do. In the meantime, have you talked to your dentist (colleagues) about the possibility of TMJ disorder? Do you grind your teeth at night? What about your wisdom teeth? Do you still have them? They can cause bilateral headaches, particularly if they are impacted. It's a fairly common cause of otherwise unexplained daily headaches, and is often overlooked by doctors.

Customer: replied 1 year ago.
I don't have wisdom teeth and I wear a lower mouth guard and maxillary retainer every night. I have tried everything. The pain is in the back at the base of my skull and works around to my temples as it gets worse.
Expert:  Dr. Bob replied 1 year ago.

I see. It could be a combination of factors (i.e. a compound headache) but if you think it centers on the base of the skull there is a very good chance it is mechanical in nature. In other words, these headaches could be cervicogenic in nature. The base of the skull is where the upper trapezius muscles attach to the skull. This is a common site for pain, irritation, spasm and headaches in those whose work involves leaning forward and concentrating on fine motor tasks. The head is heavy and wants to fall forward so the upper traps have to work very hard to keep the head up during work like yours. This puts strain on the muscle fibers and tendinous insertion points that add up slowly over time.

Customer: replied 1 year ago.
That's why I was going to a chiropractor but it didn't help much. I may have lessened the pain but didn't take it away completely. I guess I will just have to wait to see what happens when I get an appointment to see the neurologist at IU.
Expert:  Dr. Bob replied 1 year ago.

In the meantime, see if you can get a referral to a good physical therapist who has training in ergonomics. This is the study of workplace factors and how they impact the body. There may be some simple changes you can make in your work environment, or your computer workstation, for example, that could make a big difference over time. Also, consider wearing a soft cervical collar for a few hours at night after you get home from work to rest the upper traps and relieve some of the muscle fatigue that is likely leading to or making your symptoms worse.

Customer: replied 1 year ago.
OK, I will look in to that as well.
Expert:  Dr. Bob replied 1 year ago.

Hope all works out for the best for you. Let me know if there is anything else I can help you with.

Expert:  Dr. Bob replied 1 year ago.

Hello...just checking in to see if you had any additional questions. Were you able to arrange an appointment with a neurologist?

If so, be sure to ask him or her about cervicogenic headaches, or whether you be suffering from occipital neuralgia.

If so, the occipital nerves (at the back of the head near the base) can be injected, often with lasting relief.