Neurologist doubts neck pain from migraine

roseann4z, I am so sorry you are battling this. Praying for you.

Here is my take on this. I was diagnosed with arthritis in the spine a few years back. My migraines changed
significantly with the arthritis. I use to have the migraine on the left side of my head, but, now if my spine
is flared up, I will often get a migraine. I hurt from my spine all the way up the back of my head and in my
neck and skull.

It is not a tension headache. It's a migraine. I use Voltaren Gel on my spine and I take Maxal. , I put a heatpack down both sides of my spine and lie down and try to sleep it off. It's a migraine and I believe it is arthritis
induced. Weather change usually is the culprit to get this all flared up.....a migraine can be flared up the
same way. If it is not a migraine, the triptans simply will not work at all. I can have these several days
in a row. I do find sometimes, I can get relief from Flexeril 5 mg (Muscle Relaxant)
and Tylenol if I take it immediately. That will keep me from taking the Maxalt.

A massage helps greatly when I do not have a migraine going on to relax the muscles from the migraine & spine
pain. I could not tolerate going to a Chiropractor for my spine, but, it may work for you.

Ubrelvy worked the best for me when I saw a Neurologist, BUT, the med made me nauseated.

Prayers & Blessings to you....

Thank you so much for sharing your experiences. It is very helpful. I do have arthritis in my spine/neck and some very similar experiences. My neurologist also suggested Voltaire’s and I am going to add that to my treatments. Thank you again. Wishing you peace and all the best!

I have chronic migraine as well as significant neck arthritis. I have both head pain and neck pain and over the many years I have had migraine it has morphed in location and some of that I suspect is related to the development of the arthritis. This is just some background as an FYI for you.

I was on cyclobenzaprine (Flexeril), a muscle relaxer, for a number of years. I took it every night and it helped with sleep, decreased muscle spasm and pain in my neck and shoulders (the shoulder spasm was related to the neck per my doctor). I developed some side effects (chillblains which I have a tendency towards anyway but it made it much worse) or I would still be taking it. This med is helpful in a lot of chronic pain conditions and is used in fibromyalgia too. Unlike some muscle relaxers, it has an effect in the central nervous system, ie/brain. I don't know if that is the one your doc was thinking of or if it is right for you, that is for you to discuss with them as they know your full medical history.

I would say a really good test is what makes the pain at the base of your skull go away? Do you have an acute med for migraine that does work like a triptan? If that makes the skull pain go away it is probably migraine.

It is VERY difficult to parse out neck pain and migraine. The nerves from the upper neck are part of the migraine circuit of nerves--they all connect! So migraine can cause pain in the neck, and pain in the neck can cause migraine!! And it can be so hard to tell.....just when I thought I have it figured out, I don't! I think that some days it is the head, other days the neck, that is the trigger. I have found that the best way to deal with it is to address both. Anything that helps the neck is likely to help the head, and vice versa.

I have tried acupuncture and it didn't help me. I don't think I went to the right provider. It has good evidence behind it and is reasonable to try. Ask your doctor or other folks you know in your area if they have a good acupuncturist they can recommend.

Chiropractor, might be best to avoid. At least anyone who does traditional adjustments, the abrupt movements of the neck. They are not recommended by most doctors, especially neurologists, for the neck. Usually they are ok with people seeing them for their back, but not their neck. Those types of adjustments that move the neck abruptly can cause injury to the vertebral arteries that are right along the spine in the neck. These are 2 of the major arteries to the brain and while this is a rare complication, it can lead to stroke. I know someone who it happened to. Fortunately for him, it was a small stroke. However, I am not your expert, please talk it over with your neurologist or other physician caring for you.

Good luck, let us know how it goes!

I have had shots in freeze nerves in my neck before determining if it would be useful to have them cauterized. It didn't help. I get extremely stiff neck along with frontal headaches and I notice are connected to physical and environmental stimulation. I get a mild attack after eating. No meds really help and lying down / sleeping is the best cure. They wanted to do surgery on my neck but given they were wrong with the first diagnosis treatment I am reluctant. I think it is neurological because when it's bad I also get strong light auras. I have a neurologist who referred me to a pain specialist who pursued the neck. Think I'd rather find a neurologist who will focus more on the brain / neurological system.

roseann4z, Can you soak in the tub in Epsom salt? It helps me a lot too. Blessings....

Thank you so much for all this information, incredibly helpful to hear real experiences from people who have experienced it. I feel I have a combination of neurological and muscle pain and have to do more research into causes & what works when. I will keep my mind more open to the muscle relaxer idea. I truly appreciate your sharing and will keep you posted.

Thank you so much for sharing. It is truly helpful and gives me information I can use it to help me make decisions. Be well.

@roseann4z
Have you had a MRI of your cervical spine and head? I had migraine with aura which was triggered by hormones plus I have compression of my spinal cord/nerve roots.

You should see if your neurologist would get you a MRI of your cervical spine to see if you have bone spurs/osteophytes, disc herniations, etc. that is compressing/flattening your spinal cord/nerve roots. Once I had ACDF surgery on my c5-c6 in 2022, my daily headaches and neck/shoulder pain/knots in shoulder blades, etc. improved.

Thank you, I had an MRI last year when I went to a pain management practice. Showed some arthritis and compression. The neurologist doesn’t seem to have too many suggestions other than drugs. I am thinking of getting another opinion.

@roseann4z
It is good to get a 2nd and 3rd opinion, if needed.

I went to my neurologist and he kept testing me and only offered medication (amitriptyline and muscle relaxer) that I couldn’t take as it made me too sleepy. I couldn't function. It was a waste of time and money. He had me get MRIs but missed the spinal cord flattening in my cervical spine which was causing central nervous system neurological symptoms and injury. You would think a neurologist would see this and refer me to an orthopedic spine specialist/surgeon. He didn’t. He is the reason I was not properly or diagnosed sooner with degenerative cervical myelopathy spinal cord injury.

It took me seeing my 4th surgeon to finally get a correct diagnosis and surgery. Don’t give up advocating for yourself to get properly diagnosed and treated.