mrsD -
Did you ever find out what your condition is? I was googling "headache all night every night" and saw your post for years ago. I also get right temple headaches every night starting at 9 p.m. that last until I stand up in the morning. They are accompanied simultaneously at night by a throbbing front shoulder pain that is now allowing me to sleep. Occasionally during the day I get mostly the shoulder pain with a bit of nystagmus happening as well...the headaches do not happen so much during the day. When it first presented, it started with the headaches, then the shoulder pain came along. I've been trying figure out what this is since January...six months. I've been to the neuro who had me on Gabapentin with no relief. After a couple of other meds, I'm currently on Cymbalta (60 mg/day) and Tramadol (50 mg x 2 or 3 at night only). This doesn't seem to help anymore. I simply cannot sleep. I've fallen into a routine of taking Tramadol at bedtime, and then when I invariably wake up at 1 a.m. or 2, I take 2 Benadryl, another Tramadol and try to get another hour or two. It's just miserable. I dread bedtime. I've got a prescription for Ambien, but am too afraid to use it too much. Every three days or so, I'll take it and get 5 hours in a row.
I saw your post and it seemed as though you had some similar symptoms. I'm desperate! I do have MS, so I think the neuro thinks that's what it is. I'm thinking it might be Lyme's. I have a lumbar puncture scheduled for Monday with IV antibiotics for a month.
I've tried accupuncture, chiropractic and am currently doing PT. The PT may be helping a little, but the "no-sleep" situation is what's doing me in.

Did you have resolution of your headaches and shoulder pain? I'm worried that taking Tramadol every night is giving me rebound symptoms...but wouldn't I get some symptoms during the day? I only take it at night and usually tough it out during the day if I get the shoulder pain...it's usually not that severe during the day. Last night I couldn't take it and took two extra-strength Tylenol at 2 a.m. and both the headache and shoulder pain went away. I don't take the Tylenol very often for fear of rebound pain, but find it odd that Tylenol helped and two Tramadol didn't.

Any insights are very much appreciated...so sorry for the length of this post.

Yes, over time, it has improved.

Mine appears to be arthritis plus some muscle spasms.

I use a lotion on my neck there, called Morton Epsom lotion, and
this relaxes the spasming muscles. For really bad times which are not everyday, I have Flexeril.

I had shingles in my upper neck and down my right arm, and I find taking a gram or 2 of lysine also helpful, so I guess there is a viral trigger in there as well. (Herpes Zoster).

I don't have everyday pain, and I consider myself lucky.

Tramadol has to be activated to its active metabolite to work. This can take up to 2 hrs from when you take it.
Also some people don't have the enzyme that does this, so for them Tramadol apparently doesn't work at all.

So the delay in onset gives the impression of not working, and then you take Tylenol on top of it, and that works, so when the Tramadol kicks in, it is concealed by the Tylenol.