Navigating Chronic Pain: A Journey with Migraines and Nerve Pain
Hello everyone! I'm glad to have this space to share. I’m a 32-year-old female grappling with chronic pain, and I often feel overwhelmed and powerless. **In short:** For the past five years, I have been battling chronic migraines alongside pain in my face, neck, jaw, and head. I find myself struggling to voice my needs effectively. The migraines tend to shift around my head and neck. Some days, it manifests as tension; other times, the throbbing is concentrated behind my eyes or sinuses, and occasionally, the discomfort seems to blanket my entire head accompanied by waves of nausea. There are months when I suffer from four migraine days, while other periods find me grappling with discomfort on more than half the days. I also experience sharp, stabbing sensations in my head and sometimes throughout my body, or running down my arms. There are moments where catches on my neck feel like a tight grip, resembling someone applying pressure with pliers, plus jaw pain that has sent me to multiple dental check-ups, which always yield normal results. I find myself unusually sensitive to light, sound, smells, motion, and temperature changes. Episodes have been triggered following cold air exposure during hikes, windy walks, intense workouts, or while lifting heavy objects. Is it due to exertion? My nerves? Tight muscles pinching nerves? It’s frustrating. Another concern is the tightness in my upper back. I know it's common, but could this suggest a problem with neuropathy? After years of pleading for a referral, I finally secured an appointment with a neurologist, but it took four years of persistent requests, often in tears, at my GP’s office. I appreciate my doctor, yet the frequent responses have defaulted to questioning whether I could be dehydrated or experiencing stress. Allow me to explain my treatment journey over the years. **Diagnostics:** I’ve undergone two MRIs and one MRA, all of which returned normal results. **Initial Treatment:** My experiences with chiropractic therapy provided temporary relief for about a day before the pain returned. Over-the-counter pain relievers and occasional naps can help marginally, although, as you might guess, I can’t always find time for rest. 1. **Nortriptyline:** My previous doctor suggested it might address TMJ issues. It lessened facial pain and reduced headache frequency slightly, but I gained a significant amount of weight and it upset my stomach, which eventually prompted me to stop—after all, debilitating stomach aches seemed worse than fewer headaches. Additionally, I was referred to counseling, which didn’t yield any useful help. Stress wasn’t the issue; a suggestion to meditate felt insurmountable, especially with my ADHD. 2. **Amitriptyline:** This was comparable to Nortriptyline, along with a referral to physical therapy. While physical therapy allowed me to strengthen my shoulder and neck, I began experiencing headaches post-exercise—sometimes immediately after or even the following day. It wasn't until later that I started connecting these dots, and I ultimately discontinued this treatment after a year. 3. **Gabapentin:** I began with a low dose of 300 mg. My doctor advised limiting NSAID use to less than ten days monthly to prevent medication-overuse headaches, a concept I hadn’t previously encountered. Initially, Gabapentin helped with facial and jaw discomfort, yet my migraines persisted. After several months, my tolerance increased, and the pain returned, which is when I finally got that neuro referral. 4. **Neurologist Appointment:** During a telehealth visit (is this really an adequate way to diagnose?), the neurologist suggested neuropathy but ruled out Trigeminal Neuralgia as my symptoms didn't quite align. They increased my Gabapentin dosage to 600 mg, which provided minor relief, but once again, I find myself where I started, enduring recurrent migraines and sporadic sharp pains. 4.5. I've felt bereft of both energy and hope, leading to the addition of low-dose antidepressants to support my mood. I’m currently attempting to secure an in-person consultation with my neurologist. I recognize that diagnosing migraines can be complex, but what else could be factoring into my pain? What steps can I take for my well-being? How can I communicate that living with this pain is not the future I want? What further testing should I request? I’m hesitant about further increasing the Gabapentin, as it has made waking in the mornings more challenging and intensified my bouts of brain fog. Sometimes, verbal instructions come across to me as unintelligible. **Note:** I will not consider Botox injections; having researched it, the potential risks seem to outweigh any possible advantages, and my background as a chef raises additional red flags regarding safety. **Postscript:** Toradol has offered some temporary relief but only lasting a few hours, and the long wait at our ER means this isn’t a viable option for regular trips.
Answers (1)
3/21/2025, 4:50:49 PM
OpenHealth AI
Main Points Summary: You've been experiencing chronic migraines, facial pain, and sharp nerve sensations for several years. While you’ve pursued various treatments and diagnostics, it's clear you are still struggling and are seeking answers for better management of your pain and symptoms.
Explanation: Chronic migraines can be accompanied by other forms of pain, like neuropathic pain, which may explain your sensations of sharp, stabbing pain and symptoms like tightness in your neck and jaws. It’s insightful that you’ve noted the variety of triggers, which could be physical (like exertion), sensory (light, sound), or related to muscle tension. Your experiences make clear that finding an effective treatment has been frustrating, especially with overlapping conditions like TMJ, which can contribute to headaches and facial pain.
Given the complexity of your symptoms and past treatment attempts, it’s vital to prioritize pain management strategies that can provide relief while evaluating the best way forward with your healthcare provider.
Next Steps:
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Keep a Symptom Diary: Track your headaches, their intensity, duration, and any associated symptoms (like nausea), alongside possible triggers. This can help paint a clearer picture for your healthcare provider and assist in tailoring your treatment.
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Request Further Testing or Evaluations:
- Ask about tests that evaluate nerve function, like nerve conduction studies, which could clarify if neuropathy is a contributor.
- Discuss the possibility of imaging for any potential muscle or structural issues affecting your neck or jaw.
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Consider a Headache Specialist: Inquire if your neurologist can refer you to a headache specialist who has specific expertise in managing chronic migraines and related pain.
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Explore Non-Pharmacological Treatments:
- Gentle yoga or tailored exercise routines focusing on relaxation and strengthening might help reduce tension over time.
- Cognitive Behavioral Therapy (CBT) could be beneficial for managing the emotional toll of chronic pain without focusing on meditation if that feels overwhelming.
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Communicate Your Needs Clearly: Consider writing down how your pain impacts your daily life, including emotional and physical aspects. This can help convey the seriousness of your condition when discussing it with health professionals.
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Review Current Medications: With your experiences of tolerance to Gabapentin and concerns with morning drowsiness, discuss possible alternatives or adjunctive therapies with your doctor to support mood and pain management without increasing side effects.
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Explore Support Networks: Connecting with support groups, either in-person or online, for people with chronic pain conditions can provide emotional support and coping strategies from those who understand similar experiences.
It’s understandable to feel overwhelmed, but by taking these steps, you can work towards a more manageable future regarding your chronic pain. Remember, you are not alone in this journey, and with the right approach, improvements in your quality of life are possible.
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