Headaches

[Diet-well]

I have had pains in my head for over 2 weeks. I was sent to hospital for blood test and CT scan. All normal and was told it could be Neuralgia.

I am taking codene and Ibuprofen which helps but not curing it. The pain is intense and is throbbing and my head also hurts to the touch,

Any advice would be appreciated,

[Hidden]

your pharmacist might advise?

[Blearyeyed]

Codeine can cause rebound pain to occur in the head and ears as the dose reduces , it's important to be aware of that. It has a powerful withdrawal effects even after a few doses , which is why codeine medication has the potential of becoming addictive. Odd , I know , but the remedy for the headache can also be the cause of the next one.Personally I wouldn't take codeine and ibuprofen together because of the potential side effects and stomach issues they cause.

They are also not the best medications to help with Migraines or various types of Neuralgia.

Paracetamol is a safer option until you know the cause of the headaches or what type of head pain or Neuralgia you might have.

If they aren't making much difference anyway you will need to get back to your GP.

Did the CT scan you had look at the temporal arteries ( at the sides of the head) ?

What area is your headache and do you have other symptoms?

On a scale of 1-10 what level is the pain and does it get worse at certain times of the day or when you are doing certain things?

Does it get worse after taking your cardiac medication or is it worse many hours after your cardiac medication when the dose level in the blood may have reduced?

Do you also have high blood pressure or a high heart rate when you have the head pain ?

This is all information your GP could do with writing down in a notebook and telling to the GP at an urgent appointment.

You should ask your GP if they can assess you for Giant Cell Arteritis ( GCA) and Vascular Migraines as well as possibly giving help by prescribing a first line migraine medication or nerve relaxant.

If it turns out to be Migraine or Neuralgia various medications might need to be tried to help , like Sumitriptan, Candesartan or low dose Pregabalin might help.

Did you have inflammatory marker blood tests?

If not , you should have them to help establish if the head pain is inflammatory or not.

You should also go to the optician to get your eyes checked as vision changes or changes in the eye can cause constant head pain, eye screening by an optical specialist can pick up things that a CT checked at AandE can miss.

When getting tested ask them to look out for signs of GCA.

If it's GCA or that is suspected you need to have temporal ultrasound or other GCA tests done to see if that is the cause. This is a condition that usually only responds to steroids medication and also causes eye pain and symptoms and jaw pain particularly when eating or drinking.

Have you had a cough or cold recently?

Another common cause of chronic headaches is pressure from your sinus which can happen for weeks after you are over the main symptoms of an infection.

Having your temples checked and testing for possible TMJ by having them check your jaw and having x-rays at the dentist to look for TMJ or other possible jaw issues also rules out other potential causes of constant head pain and neuralgia,

Anaemia and B vitamins deficiency/ Insufficiency can also cause chronic headaches and neuralgia , so if you weren't checked for these with your hospital blood tests that is another thing to rule out.

Whilst you have more checks consider changing your pain medications , drink the recommended fluids each day particularly drink a generous amount of water first thing in the day, protect your head , eyes and face from the cold or wind, try deep breathing exercises while outdoors, and limit your use of screens and devices to half an hour at a time.

If the GP options and initial tests don't help you will need to ask to be referred to the Pain Management Clinic or to Neurology for tests which should help to assess between Severe Chronic Migraine and other causes.

Let's us know when you finally find out the cause, take care , Bee