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What Causes Chronic Pain In The Upper Neck, Back Of The Head And Behind The Eyes?

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Posted on Thu, 23 Apr 2015
Question: I have been suffering form migraines since 13 years old. I have been on numerous medications throughout my life and thought by now at age 61 I would out grow them. (All family members parents and my kidshave had them as well. With that said, I am very well versed on Migraines but, I have developed a severe pain (to the touch and on and off. It is nothing like I have ever had. It is in the area of my head in back of my right ear about an inch or two up the head. It will come and go with automatic pain out of the blue. I also have just had a cold and virus and have been on Pac. Please help! Thank you :)
Sharp pain unbearable at times
doctor
Answered by Dr. Olsi Taka (30 minutes later)
Brief Answer:
Possible occipital neuralgia.

Detailed Answer:
I read your query carefully and I understand your concern.

Judging from that pain distribution, in the back of the head, behind the ear and the stabbing description a possible diagnosis is occipital neuralgia, caused by irritation or entrapment of the occipital nerve, usually in the setting of degenerative spine conditions. Pain can be triggered or exacerbated by touch.

Therapy apart from painkillers, when frequent, consists in preventive treatment with antidepressants (amitriptyline) or anticonvulsants (gabapentin, pregabalin). At times nerve blocks through injections are used as well.

Another possible cause are primary stabbing headaches, or as they are at times called ice pick headache, a headache with no primary cause, but usually have a more anterior localization.

I remain at your disposal for other questions.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Olsi Taka (17 hours later)
I will consult a Dr. if my symptoms do persist.I would just like to explain a little further. I am aware of all types of Headaches being a long time sufferer.This is a different pain.It is a shooting pain now and then and painful to the touch.The pain is in one specific spot around the size of a quarter.The area is the right side of my head about 2"above my ear.Worst case scenario? No other synptoms.

Thank you,
doctor
Answered by Dr. Olsi Taka (1 hour later)
Brief Answer:
Read below

Detailed Answer:
Thank you for bringing more info. Both occipital neuralgia and primary stabbing headache are shooting pains like you describe it. Now that you say it to be over the ear (previously it seemed behind), and the size of the area involved, I would put primary stabbing headache as more likely for that localization. While it's not the same as migraine headache and occurs separately, it has been noted to be more frequent in migrainous patients.

Of course a Dr consult is always advised. However regarding the worst case scenario I don't think you should be worried. Bothersome as it may be it is not typical at all for serious conditions like a brain tumor and stroke. In patients over the age of 60 the diagnosis of temporal arteritis should be considered for that location, but pain is usually throbbing and continuous not the way you describe it. So I don't really see any serious scenario.

I hope to have been of help.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Olsi Taka

Neurologist

Practicing since :2004

Answered : 3672 Questions

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What Causes Chronic Pain In The Upper Neck, Back Of The Head And Behind The Eyes?

Brief Answer: Possible occipital neuralgia. Detailed Answer: I read your query carefully and I understand your concern. Judging from that pain distribution, in the back of the head, behind the ear and the stabbing description a possible diagnosis is occipital neuralgia, caused by irritation or entrapment of the occipital nerve, usually in the setting of degenerative spine conditions. Pain can be triggered or exacerbated by touch. Therapy apart from painkillers, when frequent, consists in preventive treatment with antidepressants (amitriptyline) or anticonvulsants (gabapentin, pregabalin). At times nerve blocks through injections are used as well. Another possible cause are primary stabbing headaches, or as they are at times called ice pick headache, a headache with no primary cause, but usually have a more anterior localization. I remain at your disposal for other questions.