Question: I have head pains on the right side of my head. Below is a narrative listing the major highlights of what has occurred over the last four years. The pain has caused me to a lot of discomfort and I have had to make a lot of lifestyle changes including limited workouts, no jogging, no golf, sleeping issues etc. I am looking for any assistance either in the way of guidance, a referral to a Doctor who might specialize in this area, or a Clinic or Hospital that would have a department familiar with disorders such as this. Attached are scan results and a diagram showing the areas of pain referenced in the dialog below.
I am a 64-year-old male in relatively good health. I am 5’11” tall, 192 lbs. I work out regularly (although my workouts have been limited due to my ongoing issues discussed below to walking and elliptical workouts, but I do exercise almost daily.

I am currently taking the following medications and supplements:
Prescribed Medications     Notes
No     Drug     Dose     How often     Prescribing Doctor     Notes
1     Losartan     100mg     1/day at bedtime     Internist     For high blood pressure
2     Propranolol ER     20mg     Preventative as needed     Neurologist     For tremors
3     Topiramate     25mg     2/day      Neurologist     For tremors
4     Indomethacin     25mg     Up to 6/day     Neurologist     For head pain
Prescribed Medications No Longer Taking     Reason
1     Duloxetine     30mg     1/day in morning     Neurologist     Problems with urination
2     Duloxetine HCL     60mg     1/day in morning     Neurologist     Problems with urination
3     Zonisamide     100mg     2/day at bed time     Neurologist     Caused sleep issues
4     Propranolol     20mg     3/day     Neurologist     Caused weight gain which lead to high blood pressure (gained 18 lbs.)


                         
OTC Medications
No     Drug     Dose     How often     Notes
1     Gliacin - Boswellia Serrata     375mg     2 caps/ 3 times a day     Taking on recommendation of Neurologist, for Head Pain
2     Allegra or Zyrtec     180mg     1/day at bedtime as needed     For allergies
                         
Supplements          
No     Name     Dose     How often          
1     Trunature Prostrate Health Complex - Saw palmetto with zinc, lycopene & pumpkin seed           1/day          
4     Nature's Bounty Advanced Probiotic 10           1/day          
5     Vitamin D3     1000 iu     1/day          
6     Gingko Biloba     60 mg     1/day          
7     Ocuvite 50+           1/day          
8     One-a-day 50+ Multi-vitamin           1/day          
9     Quinol CoQ10     100 mg     1/day          
10     Melatonin     5 mg     1/day          

Problem: Pains are only on the right side of my head. They can be categorized in four (4) main categories and three (3) other associated areas of pains (Listed in order of pain severity):
1.     Bend-Over Pain: Pain over right ear when bending over or moving head suddenly. Usually only occurs when head is lowed past waist but somedays even the slightest tilt sets it off. I can feel pressure in this area every time I bend over even if no pain is felt but once pain occurs, for the rest of the day, it happens every time I bend over even slightly.
2.     Pressure or Stress Pain: Pain is located behind and around right ear. Pain occurs when I do anything that causes my body to stress. Like lifting, coughing, sneezing, etc.
3.     Back of Head Pain: Pain in back of head feels much like a traditional head ache but only on the right side. Just comes and goes.
4.     Behind the Eye Pain: A pulsating pain behind my right eye. Also, just comes and goes.
5.     Tenderness on Back of Head: This is a pain/tenderness that is associated with both the Bend-Over Pain and the Stress Pain. Ice packs sometimes help relieve this pain.
6.     Back of the Neck Pain: Pain up the back of the neck. This usually precedes both the Bend-Over and Stress Pain. I can feel the pain moving up the back of my neck. I also often wake up with a stiffness in this area that leads to shooting pains in area 5 as shown on diagram, but the subside after a few minutes.
7.     Lower Neck Pain: Pain at the lower neck middle of shoulder blades accompanies the Bend-Over pain and the Stress Pain. It aches and has recently been making cracking noises when my head is moved.
(The time frame of events has been collapsed for brevity)
The problem first appeared in January of 2014. I had just recovered from a two-week flu like illness and had a recurring moderate pain over my right ear (Area 1 on diagram). The pain presented itself most mornings around 9:00 AM and went away on its own around 1:00 (without any medication). I thought it might be sinus related so I went to my Internist and after he examined me he assured me it was not sinus related but thought it might be due to teeth grinding. So, I made an appointment with my Dentist and after her examination she did not see any evidence of grinding but did see a slight indication of some clenching. Just to be safe she made a night guard which I wore regularly for three months with no relief. I returned to the Dentist and had a day appliance made, which I wore for an additional three months, again this provided no relief.
By this time the head pains had become more intense and more regular, but still came on around 9:00 AM and went away by itself around 1:00 or 2:00 PM. OTC pain relievers had absolutely no effect on the pain.
At the recommendation of my Dentist I went to see a TMJ specialist, but he did not believe this was a TMJ related problem. So, my Internist sent me to a ENT who examined me and had a CT Sinus done which was negative. He could not find anything that he believed would be causing this type of pain.
After the ENT, my Internist sent me to a Neurologist. The Neurologist treated me from 2014 through 2016. During the time I was under her care, she prescribed Indomethacin 25mg which I could take up to 6 caps a day. The Indomethacin did help relieve the pain, not completely, but made it more tolerable. In the ensuing years, the pain increased and spread. The other pains as described above developed and became persistent. My neurologist decided that I should have a Spinal Tap and a Cisternogram. The procedures revealed a possible leak at the T10. After seeing the results, the Neurologist and Neurosurgeon decided to performed a Blood Patch at T10. The procedure resulted in no change in my condition. The Neurologist decided to try again and have Blood Patches done at the T10 region and the Lumbar Region.
When I checked into the hospital the same surgeon who had performed the first blood patch came in for the pre-surgery consult and said that he had reviewed the file and felt that the blood patch was unnecessary and would not solve my problem. Of course, I was concerned and confused and asked him to call my Neurologist. After consulting her he performed the two additional blood patches, one at T10 and one in the lumbar region. Unfortunately, both procedures had no effect on my head pains.
In late 2016 a friend recommend that I see another Neurologist who was a Certified Headache Specialist. This Doctor started me on a treatment of Duloxetine 30 mg once a day and a OTC neuron enhancer called Gliacin. After about two months of treatment the Behind the Eye pains and the Back of the Head Pains became minimal, the Stress or Pressure Pains also we less intense and the Bend-Over Pain was gone completely. I still had some residual head pains but they were much more tolerable.
But one day I was working on an under-cabinet kitchen light, I bent over and leaned in without problem, I couldn’t quite see the light socket so I had to look up to my left and just as I turned my head upward, a pain shot up the right side of my neck and the right side of my head felt like it was going to explode. The pain was so intense that I staggered and almost fainted. My head pounded and just like that all the pains that had gone away were back in full force. The Neurologist increased the dosage of Duloxetine to 60 mg, but I had a negative reaction (urination issues) and he had to reduce it back to 30 mg which did not work and the urination issues continued so I have stopped taking it completely and resumed taking the Indomethacin. The Doctor also tried a series of nerve block shots which were totally ineffective.

Other Information that may or may not be pertinent:
In December 2013, I had a traumatic incident. While running a CAT 5 cable in my attic I stepped in a hole that was not boarded and fell through the attic floor up to my hip. I had a contusion on my left thigh just below my hip, my leg swelled up to the point I could not put a pair of regular slacks on. X-rays were negative for broken bones, but the injury took many months to completely heal and there is still a small lump on my left side where I hit.
In 2014 I had two root canals preformed on the upper right side. In both cases when the dentist numbed my upper jaw to perform the procedure all my head pains ceased for two days after the root canal was performed.

Both of the neurologists I have consulted had raised the possibility of using botox but for reasons that I can not recall both decided that botox would not be an effective solution to my problem. I realize that both Doctors had the advantage of hands on examination, I can only assume there is something they both saw that lead to that conclusion

.