Occipital pains/headaches
 

My TOS symptoms are under control now and my major issue is occipital neck pains and headaches.
I wonder if anyone can suggest something.

I had headaches for 20+ years since college which progressively got worse and 10 years or so ago the neck pains started. At first these would come and go, but now I have them more or less daily. Muscle spasms on the back of the neck seem to be the cause of the pain.

Regular stretches and trigger point massage are somewhat helpful, but sometimes trigger really bad headaches and don't have any lasting effect.

The doctors only suggested over-the-counter painkillers which do help with the headaches although after taking them for many years I developed stomach problems (from NSAIDs) and tylenol addiction so I stopped taking them all unless I happen to have an unusually bad headache.
The really bad ones put me out of commission for one or two days. I get sensitive to light and sounds, nauseated etc. Thankfully, these only happen once every few months.

I was hoping regular posture exercises will bring some relief, but I am yet to see any improvement. Sometimes symptoms get better, but then flare up again. So I don't know how to proceed.

Any success resolving the neck/headache issues?

Upper cervical chiropractic?
Regular chiro that does soft tissue work along with adjusting?
Ultrasound, IF stim, low level laser??
acupressure/acupuncture?

The chiropractor I saw basically did trigger point massage on the back of the neck. This only had short-term effect.
This is something I continued doing on my own for the past year or so. Probably it is not as efficient doing it myself, but I can do it multiple times a day.
Still I only get short-term effect (or sometimes a flare-up, presumably when I irritate a nerve).
I was hoping to see some gradual improvement over time, but no luck so far.

Acupuncture and ultrasound had no effect (with 3 different PTs and 3 different acupuncturists over the years).

Did not try the laser thing - not sure I understand how it is supposed to work.

The neck pain usually gets worse at night and then gets better during the day. I spent many years trying to change the way I sleep, experimenting with different pillows etc. At best, I get some relief for a few days and then the pain comes back.
Anyone had issues with neck pains at night?

So sorry to hear about the cervical headaches. I suffer similarly. Often the weather is all it takes to set off a pain event.

Have you considered a muscle relaxer at bedtime? That might help calm down the muscles enough to let nerves repair. I take a Flexaril 10mg at night - and plan to do nothing for a solid 12 hours - they make me loopy.

Ice, Ice, Ice. That helps me a lot when Im aching.

And if those things fail, an Alieve for swelling OR a Percocet (not both at the same time!!)

Thats how I'm living with TOS. Best of luck and speedy healing to you!
Anne

Thanks astern.

I tried all the muscle relaxers for my TOS-like symptoms which had little effect.
Can't say if they helped with the headaches as my shoulder area pain at the time was 10 times worse than headaches. Maybe something I could try again.

Never tried ice for headaches. How do you use it? Ice bag on your head?

Excedrin helps quite well for my headaches, better than aleve/naproxen.
But I am afraid to take it unless I really have to - rebound headaches and gastritis is what I got in the past due to overuse.

I remember you were doing bent over rows.. try stopping those. They recruit the neck musculature extensively..basically, if your neck is bent or not straight on your spine, stop any shoulder strengthening as it will stretch your neck muscles.. which may be still healing.

Yes, this is a good suggestion.
I was wondering if some of the exercises I do were problematic for the neck
(and others problematic for the low back :) ).
I don't do a lot of these and will probably replace them with rubber bands or something similar.

Thanks Hiker. If you must do shoulder exercises, your neck must be supported all times. Some exercises show the person with lying on their stomach, or bent over and neck free. All these will recruit neck muscles.

I learnt what I told you about bent over rows when i did them - my shoulderblades would burn because the overactive neck muscles would go hyper. However, if i squeezed my blade back and down, while standing up, the same pain wouldn't occur to the same degree.

About your low back. If your low back is heavily arched, then don't do extension exercises, they will merely put the muscles under further strain. Also, rotating while extended is a firm no. That's how i injured my lower back.

Ice: I have a neck wrap that I keep in the freezer. A travel neck-pillow with natural contents is good - it can live in the freezer ( or be put in a microwave for heat ). I've also used small plastic cups with frozen water inside. All these can be applied to your pain over clothing or thin towel if using ice, when pain is getting you down. Experiment to see what location feels best - trigger points can be different for everyone. Sometimes for me, putting ice on my head where it hurts helps. But it can also help to ice my neck, shoulders, scapulae, even upper arms.

Heat: my Dr says use whatever feels best at the moment - heat or ice. Just a comment on heat, it causes tissue to swell a bit. Swelling/inflamation = not good. :winky: so use in limited amounts.

Anne

Took a break from exercises which stress the neck. Replaced prone covras with rubber bands. No change in two months.
The neck is in near constant low-grade pain. Worse at night and after computer work.

Also doing a lot of self massage on the trigger points in the neck. There are many tender areas in SCM, occipitals, traps and scalenes, Not seeing much effect.
Often pressing on of one of these triggers a headache so I can't be too agressive with this.

Will continue for a coupule months before trying something else.

I suspect you are one of those folks whose upper traps are taking a beating each time you do shoulder depressions and activating lower traps. And that's yanking on your UT & causing them to spasm and causing the Suboccipital headaches. Since you already broke out of your pain-nerve cycle, worth dropping these exercises and seeing what happens

have you had a neurologist do the 30 seconds hands on clinical diagnosis of occipitial neuralgia?

a trial of prescriptions and neck injected nerve blockers may rule out if you may be a candidate for? occipital nerve surgery. It has helped many with headaches due to the occipital nerve being inflamed.

any exercise that works the traps, or neck muscles may inflame that nerve due to the nearby muscles around that neck being involved.

slowly...tilting your head up or down, left or right, twisting left or right...if it can increase chances of headaches...can also be a possible indicator.

I can not do upright rows, overhead presses, and other certain neck movements without my occipital starting to flare up. (me not yet a candidate for the occipital nerve surgery)

gl

Akash, yes, I think may be right. Upper traps are definitely contributing to the headaches though I don't know if they are the primary cause. I don't have regular pain in the traps themselves and can't tell if they are spasming.
But if I compress the UT muscle in the area where the neck meets the body, I get referred pain in the back of the neck. Have been doing self-massage of these areas for a while hoping to resolve trigger points, but with no effect so far.
It is possible that lower trap exercises are messing with the upper traps too so I was doing less of those recently. Again without much effect one way or the other.

Pedalspinner, no I was never diagnosed with occipitial neuralgia.
My GP told me I don't have it though he did not do any tests. The neurologists I saw never tested me for it either.
You are right that certain neck movements and positions trigger pain.
Thankfully my headaches are not too bad to consider a surgery.

anything that works your neck muscles or traps is likely to cause more occipital area inflamation. for me, no more bent over lateral raises, standing lateral raises, over head presses, upright rows, etc. I have proven this out...one by one...even time on my indoor cycle trainer requires upright position (and still feels weird)

An update.
After a 3 week vacation from computer work and regular upper trap TP self-massage for a few months the headaches and back-of-the-neck pains have subsided.
I also have been avoiding any neck-straining exercises.
Still have a bit of neck pain when I wake up in the morning, but nothing too bad.

Unfortunately I am back working on computer all day so we'll see how long this lasts...