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Question
Posted by: Lindy | 2012/05/30

occipital neuralgia

i was diagnosed with occipital neuralgia at the end of jan this year, after having these terrible headaches for over a year. my docotr put me on non invasive therapy. i was on it for 2 months and it did not seem to help at all, i used meds and also went to the physio twice a week. the physio even tried dry needling and i was also injected with steroids and muscle relaxents. please note that the muscles did not cause the neuralgia as i only started getting spasms after i was diagnosed. the spasms started early in feb and has not gone at all. they are chronic and hard as a rock, recently the muscles spasms spread to my back and now my right arm is affected. my physio said that if muscles stay in spasm for a really long time (been 3 months now) it starts affecting the surrounding tissues, she said there is nothing more she can do for me and that i should go back to the neuro surgeon and he will probably do an mri(already had a ct scan done). the neuro surgeon was booked for 3 months in advance so i am due to see him in june, the problem is i lost my job because the headaches affected my ability to concentrate and all sorts of stuff. i want to know what is happening to me, the pain is unbearable and the pain killers don''t work. what tests will be done now and how will they treat me from here ?

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Our expert says:
Expert ImageHeadache expert

Dear Lindy,

I can’t say what tests your doctors are going to do, as each doctor has different knowledge and there are different approaches to diagnosis. My recommendation is that to get to the root of the problem, you need what is called a “multidisciplinary assessment”, which should include a neurological examination to rule out any serious underlying condition. 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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Our users say:
Posted by: Headache expert | 2012/05/30

Dear Lindy,

I can’t say what tests your doctors are going to do, as each doctor has different knowledge and there are different approaches to diagnosis. My recommendation is that to get to the root of the problem, you need what is called a “multidisciplinary assessment”, which should include a neurological examination to rule out any serious underlying condition. 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.

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