Chronic tension headache diagnosis and long term management

[Lost_Girl]

Hi I suffer from chronic pain. I have a bone shard impacting a nerve root at c8 being treated with cortisone. I have pain at c5 and c6 that is manageable without anything. However I have a constant headache and pressure in my ears that I have had for pretty much every waking moment for the last 7 months. As a result I have become depressed and I have insomnia.

After a trip to a neurologist I have been advised to cease sleeping medication and strong pain killers. I am now only on antidepressants.

A visit to my psychologist today has alerted me that depression does not cause headaches.   

Has anyone been treated for chronic pain with ONLY antidepressants and did it work?

I havr a referral now to a psychiatrist to check but it not until May. While I see if I can find something earlier I sm keen to hear if this has worked for anyone.

Thanks,

Carol

[JessF]

Hello Carol, starting with the disclaimer that I'm not a doctor, and none of us are here of course, but there's a two way street with physical symptoms.  Long term pain can make you depressed.  Can depression cause physical pain?  Well, we know that anxiety attacks can mimic the physical symptoms that go with feeling like you're having a heart attack, so the answer in general terms is probably yes. 

I would say that the neurologist is the best expert on how to manage the pain associated with your injury. If you're not happy with that, and the pain is still  unbearable (which is sounds like it is) then I would look for a second opinion. 

Psychologists have no licence to prescribe medicine so I wouldn't take their word on what the best possible medical intervention is for you.  The psychiatrist would be better in this area but as you say two months is a long wait.

[Lost_Girl]

Hi JessF and thank you for the reply.

I am aware, and not seeking medical advice but I am glad of the reminder here for responders as well. I had my old GP question my current GP that I have been seeing  as well in regard to a referral to a psychiatrist when he chatted tobme impromptu at the drs having raised a friendly concern that i did not seem myself. I figure it can't hurt to get a second opinikn relating to the medication.

What I was hoping to get from the feed was success stories (if any) from others who may have been treated for chronic pain with only antidepressants.  I am keen to understand if anyone has experienced relief without any other medication types. I know it takes time for antidepressants to work but I am struggling with the pain and insomnia and it impacting my ability to function and am not the most patient person.  Just hoping someone else has experienced something similar and can advise.

I had an assessment done at the psychiatrist office today in prep for the May appointment and they have put me as a priority on the wait list for cancellations.

Kind regards,

Carol

[Neil_1]

Dear Carol,

I’m really sorry to hear of the amount of pain that you’re in and it’s not good that you’re having to wait until May for your next appointment.

With regard to your question, while I haven’t been in this particular boat, I would have to say that every time I’ve had extreme injuries or have been recovering from surgery, my medication has always been pain-killers.  The strong kind.

I’ve never had suggested to me ever that to help with your pain, I’ll write you out a script for these … they’re anti-depressants.

I’m just wondering if you could possibly either get back to your neurologist and to let them know the exact full extent of your pain and symptoms or at the very least, to your GP.

I can see no reason why you shouldn’t be on strong pain-killers to help you.  No-one should have to suffer this kind of pain, when options are available.

I do hope you can keep us posted with how you get on?

Kind regards

Neil

[romantic_thi3f]

Hi Lost Girl,

Just a little disclaimer: this is my own experience/opinion.  As you know we can't give specific advice here.

I have been put on anti-depressants for chronic pain.  This was because of the pain, even though I was depressed at the time.  I was told the medication increases neurotransmitters in the spinal cord which helps reduce pain signals.  The medication didn't help with the pain and it didn't help with my depression and I got awful side effects from it. 

One resource that might be worth looking at for more information is the NPS Medicine Wise.  They are part of Australian Government and they are my go-to resource for all things medication related.  They also have a number that you can call for advice which might be helpful.

Also, I haven't specifically heard of headaches relating to depression, however I do know that when people are in pain (especially chronic pain) there flight/fight response is easily triggered, so as part of the stress response to pain that could be why you're getting headaches or why it's been suggested.  Also, people with chronic pain can experience more headaches simply because it's harder to focus/concentrate and also that they are forgetting to drink and becoming dehydrated.

Hope this helps. Fingers crossed that you can get in sooner than May.

[Lost_Girl]

Hi Neil,

Thanks so much for your reply.

I intend to see my GP again on the weekend. I am trying to get all my thoughts together clearly before I go. I have never questioned medical advice from a GP or specialist before but my gut instinct is telling me this is wrong.

I ununderstand why they have prescribed the antidepressants as I was in a bad state at the point they were given. However my concern is that all the focus is on the depression and not the root cause of the pain.  Up until a few days ago I thought the depression must cause the headaches but I have had them long before I started not coping or feeling depressed so it doesn't make sense.

I will let you know how I go. I haven't slept now for 2 days 2 nights so things are getting tough.

Cheers,

Carol

[Lost_Girl]

Hi romantic_thi3f,

Thanks for sharing your experience.  The information and resource are great too.  I am putting together a mind map on paper of my problems, symptoms and treatment for each so I have a visual record to help explain to the GP how I feel about what's being treated.  

My emotions are very much under control at the moment so I am in a much better position to start questioning and understanding their treatment plan for me.

I'lI record the resources too including that provided by my psychologist and discuss with my GP prior to taking any further action.

I really appreciate your response and support.

Cheers,

Carol

[Lost_Girl]

I was able to talk through everything with the GP today without crying so that was a positive. However, GP hasn't received a report from the neurologist and is reluctant to give any sort of pain relief.   GP has asked me to try and get an earlier appointment with the neurologist. 

Here's hoping I can get an appointment.

In the meantime I am in pain, hardly get any sleep and I'm struggling. About to stop getting paid through work too so that's not helping.

Feeling very frustrated with the process. I truly feel like I am back where I started 7 months ago and it's hard not to feel hopeless.

Carol

[Guest_1055]

Hello Carol.....

I am sorry you are experiencing all this, it must be so challenging to go through it all . And you must be exhausted. I am guessing you may be feeling fed up from the whole situation. I can definitely send out a hug to you, but it doesn't seem enough.

May I ask a question?  Is there some operation you could have to actually remove the bone shard? Like maybe that is the root cause of all the pain. Sorry if I sound ignorant Carol, it is just I care about you. And I hate the thought of you hurting in any way. 

I hope it all gets sorted out soon, and you will start to feel better. 

Hugs

Shell xx

[Guest_5218]

Hi Carol,

An appointment with your GP on a Sunday?  Gosh thats novel.

I'm so sorry the appointment wasnt more constructive.  I know any specialist is really hard to get an appointment with.  That is really disappointing.  You must feel very let down.........

So all you are getting by on now is what - over the counter standard paracetamol?  Or is an over the counter anti-inflamatory perhaps of slightly more benefit?

Your discussion on this thread is with regards to anti-depressants and whether they can assist with pain management.  Well in short, yes there are studies that indicate that some anti-anxiety or anti-depressant meds can assist with nerve pain.  Which I think in your case (bone fragment impacting on nerve root) is highly relevant.  So I would not discount the possible benefits of some anti-depression meds for your injury itself.

However, I've not heard that they are of any benefit for your continuous headache.  That seems to be a newie to me.  And if that is what they are suggesting you take it for, then I would definitely question them on that one.  Ask for as much information on it as you can.  Obviously you dont want to take meds unnecessarily or for something for which there is absolutely no benefit.

Regardless, I would have thought that you would have been given some other sort of assistance by way of instant pain relief as well, at least in the acute stages of your injury.  I think anti-dep would only be of benefit in the chronic stages of your injury.  From what you have said, your injury sounds as though it may still be in the acute stages, or has reverted back to an acute level?  As you know, an acute injury such as yours can become chronic, often persisting to some degree for life.  It is therefore very important that you receive adequate care when you need it.

The sooner you are able to see your neuro specialist the better.  You shouldnt have to continue to go through this as you are.  Your pain is certainly having a major affect on your overall mental health.  Which is totally understandable.  Especially when you also have the added burden of your work situation, and the knowledge that your income from that source will soon cease.

Gosh Carol, I really wish there was something I could say that would help.  However there just isnt.  No wonder you feel so hopeless.  I really feel for you right now.  But dont give up, and dont stop asking questions.  

Love and hugs to you Carol.  I am hurting for you.  ( - :

Sherie xx