Question: I have had daily headaches since high school in 1967. Took a LOT of Excedrin every day that helped back then and over the years. Then headaches got worse as I got older- very bad about 8 years ago, and got put on Hydrocodone that helped some, but beneficial effect of has lessened and now trying to get off of it. I am now down to just 1/4 of a 325 mg. tablet every four hours except at night when I finally can get to sleep. Not noticing withdrawal effects other than that I am in a LOT more pain and just can hardly function, and my life is in the toilet, because I cannot work or do much of anything.
May not be related, but I began intense weightlifting about the time I began having the headaches in high school in about '67. Also, I have a sway back condition and do not have good posture, leaning forward that likely makes my neck and trap muscles tighten and remain that way when standing or walking. Most days I do not wake up with a headache now, and don't have until I get up and walk around for about 10 to 15 minutes when the headache comes on, especially bad if I do things that require bending over. Only thing that helps and has helped over the years is to lay down on my back in bed for a long time. Since none of the many doctors and neurologists have been able to determine the cause of the daily chronic headaches (which I am sure were aggravated by over the counter meds and the Hydrocodone, giving me rebound headaches) as I am otherwise in good health at age 64, it caught my attention reading the info here, that poor posture can cause muscle contraction headaches, and the headaches are ALL through my head, with a dull sensation and a feeling of squeezing all thru my head to include my temples as the day goes on, and then the pain becomes sharper and intolerable. Always have gotten worse as the day goes on. Years ago the pain was sharper and on the top of my scalp. Now everywhere in my head, to include feeling deep down inside my head.
Also, I have lost the natural curve to my neck and have bad arthritis in by neck. Have seen many chiropractors- one for daily treatments for 6 months who did curvature stretching to my neck with weights with no benefit, tried neck muscle stretching myself etc. with no change to headaches. Thought for a long time my neck was the problem, but now think it is not. Think the muscle contraction due to poor posture makes since, cents the headaches only start after I get up out of bed. I can lay there in bed for some time and the headaches don't start now that I am not taking over the counter meds or much Hydrocodone, that gave me rebound headaches. But again, in MUCH pain all day long, and gets so bad in late afternoon that all I can do is to just lay in bed on my back.
One time not too long ago, I stood in the shower for about 15 min. running very hot water over my neck and traps until the hot water heater ran out of hot water, and the headache left altogether for about 30 to 40 minutes. Tried again later, but not as long and it didn't help. That was the first time I had EVER had the headache leave in the daytime. Again, it does go away when I sleep at night. (Can't fall asleep in the daytime.)
Also, at times I notice that I contract my scalp and facial muscles when I am trying to be aware of that, and think I do so all the more when my headache gets bad and I am subconsciously trying to "fight" it.
REALLY hope you can help me. My name is XXXXXXX 509-760-0222 cell. email- YYYY@YYYY

Thank you so much, Dr. for responding. While I have thought that my neck was the problem many years ago, first thinking that I had tight neck muscles giving me tension headaches (but deep massage didn't help), then later the neck vertebrae themselves, since a chiropractor's X-ray about 8 or 9 years ago showed that there are indeed bone spur's there, and the arthritis has nearly fused the vertebrae together- I just don't know. For one, I have never and still don't experience any pain whatsoever in my neck. I was told that I don't have full range of motion when turning sided to side, but my neck doesn't feel exceptionally stiff. Secondly, about a year ago I had a specialist give me two nerve blocks on each side on the back of my neck, who was confident that he hit the nerves since I really felt it especially on one side. The treatment immediately after and for that day and others, there was no change to the nature or intensity of my chronic headaches. The specialist told me that since the nerve blocks didn't work, that the source of the headaches was not my neck. So........? I did recently buy an over the door home neck stretching device, but have only used it a couple of times with the water bag about 1/2 full. Is this like something a physical therapist would use, and would you recommend me using it daily? It pulls my chin upward to elongated the neck vertebrae. Again, I had a chiro use his device for every day for nearly 6 months back in '97. I laid on a bench on my back, and the strap over my neck bent my head backwards in an effort to get more curve back in my neck. He used waaay more weight on me than anyone before and for a longer period of time as well. Didn't change the curve and did not help with the headaches. Not questioning your response- just providing you with a bit more info. I am much anticipating your reply. Thanks much, Dave

Dr. Saha, I think that you may well be- actually, ARE right in your diagnoses, and will be more helpful, if not a literal life- saver for me than the numerous doctors and specialists that I have seen all over the state, and spent/wasted so much money on. Last evening I did some light stretching of my neck muscles and then laid on my back on my bed with a big firm pillow under my shoulders and back allowing my head to tilt further back than normal. Not sure why, just wanted to see if it would help. Well, the combination of those things gave me the sharpest most intense headache ever, and it did not let up or go away until I finally got to sleep from taking various things. I woke up today with the headache gone until after I got up and had been up for 20 minutes or so. Point being that I must have been aggravating the vertebrae in my neck as you say. So I will be taking all of your advise immediately, putting my confidence in you that I have lost in all my other doctors and specialists.

I had even asked the chiro that told me about 9 years ago that the x-ray showed that I had serious arthritis in my neck if that could be the cause of my headaches, and was told that it probably was not.

I do wonder tho as to why that I don't have any pain in my neck. I noticed today that my side to side rotation is much more limited than I thought, and more so to the right. Also, you might think this to be a bit weird, but I slept with silicone ear plugs in my ears last night, and before I took them out this morning, I bent my head forward and back a bit very slowly and in so doing I could hear a LOT of cracking and crunching of the neck vertebrae, apparently due to the arthritis causing the vertebrae to be nearly fused together. Also, today I noticed that when I turn my head to the left I feel almost dizzy, which I have not felt like that before, and think due to what I did with my neck last night.

About the time that my headaches got so VERY bad about 9 years ago- like 3 times as bad as before, when I started seeing a doctor and got put on hydrocodone, I had started losing my teeth due to osteoporosis or arthritis (tho didn't find out the reason for the deteriorating teeth until 1 yr. ago), and also got arthritis in my lower back that pinched a nerve, giving me symptoms similar to sciatica. I am thinking that prior to that, my headaches were largely due to tension, muscular contraction and muscle memory due to tension especially in my traps, neck muscles, and also in my scalp and facial muscles (as even now I notice that I inadvertently tighten those muscles up since paying attention to them in the past few days) since high school in the late 60's (as I am a high strung, tense person); that plus the rebound effect of taking so many over the counter pain relievers to include caffeine that made them more effective, but likely gave me caffeine rebound effect as well. Would you agree?

One thing that I didn't tell you earlier is that every so often my headache pain is very sharp and similar to last night altho not as severe, while most days are more a duller squeezing sensation that gets into my temples by late afternoon that can make me sort of feeling like I could almost pass out if it got much worse. More recently the headache then gets sharper in the evenings all the time, and has been REALLY intense through the evening even while lying down all late aft. and eve., no doubt largely due to me cutting back on the Hydrocodones over the last several weeks.

Think I did tell you before that any bending over activities that I do after getting up in the AM brings the headache right on almost if not immediately.

Should I use only heat pads on the back of my neck or a combination of heat and ice? Ok to use my home over the door neck stretching device since it pulls on my neck pretty much straight up? When I had the chiro use his neck stretcher some time back that bent my neck back, I initially left there with more of a sharp headache sensation, and it never helped one bit. And after last night, I do not want to experiment with bending my neck back again.

I did ask my local doctor about a month ago if it would be useful to get a more up to date x-ray of my neck. He told me that it would not be useful since it would not show any nerves (that could be pinched) and we already know that there is serious arthritis there. I have next to no money left after seeing so many doctors and also not being able to work while having these debilitating headaches and being on straight commission, so can do only a limited number of things, and need to know what you think is most important- thinking seeing a physical therapist would be one of them, and maybe not a chiro, since they have never helped just cracking my neck from side to side (and I think that that could well make the pain worse, which right now I can NOT handle, being down to taking 1/4 Hydro every 4 hours. Your thoughts?

Finally, do you think that steroid injections into my neck is something that I should be pursuing right away, or only if traction and heat do not seem to help?

REALLY would appreciate you taking the time to address these last questions for me, in the hopes that I can at least in part, get some of my life back.

Regards,

Dave XXXXXXX YYYY@YYYY