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Question
Posted by: Anonymous | 2009-05-21

2 years of pain

I have had headaches for the past 2 years increasing in pain and frecency. Painkillers do not work for me anymore the only goal by taking them will be to sleep and not feel the pain. Doctors have given me Tripiline (cluster headache) that still does not take the pain away the only upside is that I will fall asleep within an hour of taking it. I have done alot of reading and from what I can gather it sounds like it is something between hormonal and cluster headaches. I have been to the gyne and numerous Gp'  s... What is the next step? I have no more quality of life as I am permanently in pain. My headaches allways occur on the right hand side of my head, sometimes affecting my eye sight. Should I be tesing my hormone levels and or go to a neurologist? Please advise

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Our expert says:
Expert ImageHeadache expert

Dear Anonymous.

One of the main problems with taking painkillers for headaches is that it often leads to Medication Overuse Headache (MOH). MOH is a problem that occurs in headache sufferers who have to take painkillers on a regular basis - the headaches become more frequent and more severe! Because of this, the patient increases the dosage and takes the drugs more often, and a vicious circle is set up, making the headaches worse and worse. It sounds as though you now have MOH on top of your original headaches.

The answer therefore is not to rely on medication or painkillers! The correct way to deal with the problem is to have a proper diagnosis of the causes of the headache. If the causes are treated, the headaches no longer occur, and it is no longer necessary to rely on potentially harmful “rescue” medication.

Testing your hormone levels is probably not indicated, unless your cycle is irregular. If your cycle is regular then your hormones are normal. Your body is just reacting abnormally to the normal hormone fluctuations that occur during the cycle. Seeing a neurologist is essential, but not in isolation. The neurologist must be part of a multidisciplinary team because to get to the root of the problem, you need what is called a “multidisciplinary assessment”. There are so many different structures in the head and neck, all of which can be involved in the headache process, that no single specialist can have all the knowledge necessary to make a comprehensive assessment and diagnosis. For instance, a neurologist will examine the brain and nervous system, a physiotherapist will look at the muscles, a dentist will examine the teeth etc. For this reason, the “multidisciplinary assessment” combines and integrates the expertise of different specialists who would normally treat headache patients in isolation, into a single more comprehensive body of knowledge. This enables the different members of the team to provide a co-ordinated treatment plan, so that all the contributing factors are addressed.

This assessment must include a thorough examination of the head and neck muscles to determine the presence of abnormal tension, and of the external carotid vasculature to determine whether there is an arterial element to the pain.

Headache sufferers often have a poor Quality of Life due to the constant pain and associated symptoms. For a free assessment of how your headaches are affecting your Quality of Life, click on http://www.headacheclinic.co.za/

This information has been supplied and checked by the multidisciplinary team of specialists at The Headache Clinic, in association with The International Headache Society and the South African Institute of Headache and Migraine Science. For consultation with these specialists, call The Headache Clinic (Cape Town, Durban, Johannesburg) on 0861 678 911.

The information provided does not constitute a diagnosis of your condition. You should consult a medical practitioner or other appropriate health care professional for a physical exmanication, diagnosis and formal advice. Health24 and the expert accept no responsibility or liability for any damage or personal harm you may suffer resulting from making use of this content.

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