PMR or migraine

[Pinkpepper]

I’ve had a pain right across the back of my skull for five days with nausea and feeling not quite with it. Doctor says PMR doesn’t normally cause neck pain and thinks it’s either neck muscle strain or an ongoing migraine. Any ideas, many thanks.

[Soraya_PMR]

Well my PMR caused/causes neck pain! In fact waking up with a stiff painful neck was early days stuff prior to shoulders, hips and thighs and groins.

It’s very common for us to hunch our shoulder though, I describe it as wearing my shoulders as earrings. And this will shorten the neck muscles over time and make things very uncomfortable in the neck area. Some gentle stretches might help: my chiro said point your nose towards your armpit, then using your hand apply pressure to the head to stretch those muscles. Also looking in a mirror to ensure you’re vertical, try to get your head to left and right shoulders, also applying some pressure with your hand. If the muscles in your shoulders and upper back are taught, you’re almost guaranteed to get a nasty tension headache.

Are you diagnosed with migraines? And if yes, is this the same pain?

[Pinkpepper in reply to Soraya_PMR]

No I'm not but wondered if the nausea was migraine based. Have taken paracetamol today to see if it shifts the headache as I understand it wouldn't touch PMP pain. Thanks for replying.

[YuliK in reply to Soraya_PMR]

Soraya your post made me smile.

"Wearing my shoulders as earrings. "😂

👌

It's exactly how I felt when I first started with pmr pains. Neck and nausea..

[SnazzyD]

Hello. The GP is incorrect about GCA and neck pain, as people often describe base of skull pain, me included. However, the nausea doesn’t come up as a typical feature. My daughter gets humdinger postural headaches that are like migraine, with skull/neck origin that causes nausea too. If it’s bad, Paracetamol only means it works a bit but takes the edge off. Base of skull pain can also be refered pain from the sinuses.

[Pinkpepper in reply to SnazzyD]

Thanks for your advice, much appreciated

[PMRpro Ambassador]

Well your doctor isn't entirely correct - I also had neck pain due to the state of the back and shoulder muscles! My diagnosis is PMR although I probably did have something more though not florid GCA.

However, more concerning is that occipital headache is a common occurrence in GCA and sometimes PMR progresses to GCA. There is no time limit, it can happen soon or after months or even years. Although Snazzy mentions nausea being unusual - I know a few GCA patients who presented with nausea and headache at the back of the head. And whose doctors didn't know that GCA doesn't always present the way the textbooks suggest.

[Pinkpepper in reply to PMRpro]

Saw my GP

Saw GP last night, she checked me over and said I’ve strained muscles in my neck. Didn’t think it was either PMR or GCA related.

[piglette]

Your doctor may not get neck pains if he/she ever gets PMR, but I certainly do. I wonder where they come across this rubbish. Perhaps they just make it up.

[GOOD_GRIEF]

Migraines don't last 5 days.

At this point, I'd be heading for the emergency room.

Something isn't right.

[Louisepenygraig]

I also have neck pains with PMR. It's not uncommon for a migraine to last 3 days - mine usually do but 5 days sounds too long. I agree with others here you should get it checked out

[Yellowbluebell]

I have had migraines for years on and off and only one lasted more than a few days. You really should be going back to your gp or A&E.

[PMRnewbie2017]

Google the symptoms of occipital neuralgia too. The more info you have the better.

[PMRpro Ambassador in reply to PMRnewbie2017]

Bearing in mind that occipital neuralgia can be caused by GCA ...

[PMRnewbie2017 in reply to PMRpro]

Absolutely! This is the problem isn't it. So many symptoms overlap with other conditions. It really is a minefield and to be honest I do have a lot of sympathy with the medics because to an extent they are relying on the patient's description of their symptoms.

[PMRpro Ambassador in reply to PMRnewbie2017]

Oh yes - I do have some sympathy, it is a minefield! But only someone stupid believes that all patients will present the same and respond to treatment the same. And the denial of certain things being typical when a 30 second google would bring up medical references showing how wrong they are... The headache at the back of the head in a patients who already has a PMR diagnosis must be a red flag - but several doctors have been heard to say "it's the wrong sort of headache", in that it is in the wrong place! GCA is quite keen on that area of the brain...

[PMRnewbie2017 in reply to PMRpro]

Why do think I retired early!! Pharmacists have no teeth in contrast to our nursing colleagues. It used to frustrate the hell out of me when I "knew" patients were not being treated properly and I could do little about it. So many Consultants are so arrogant...