| Headaches can occur occasionally as a result of | | | | problem worse. The solution: try to avoid the cycle of |
| osteoarthritis in the neck. Typically, these headaches | | | | medication- discontinuation of medication- rebound. |
| go up the back of the head. The pain may be more | | | | Patients with fibromyalgia, a diffuse pain syndrome, |
| apparent on one side than the other. The pain then | | | | may also have severe headaches as part of their |
| radiates to the crown of the head. | | | | disease. A treatment plan incorporating exercise, |
| Rarely, the pain will radiate to the temples. | | | | analgesics, and antidepressant types of medicines |
| The pain sometimes is aggravated by movement of | | | | may help. |
| the head or possibly if the head is held in one position | | | | Finally, a potentially serious type of headache can |
| for too long a period of time. | | | | occur as a result of giant cell arteritis (GCA). This is |
| Patients will often comment that it feels "like sand" or | | | | also known as temporal arteritis. GCA is an |
| "crunchy" when they turn their head. | | | | autoimmune disease that causes inflammation of blood |
| Sometimes the pain will be felt in the back of the | | | | vessels, particularly the ones in the head. Typically a |
| shoulder and along the inside of the shoulder blade. | | | | patient will have pain in the temples, tenderness of the |
| The diagnosis is made through a careful history, | | | | scalp, and pain in the jaw with chewing. If not |
| physical examination, and imaging studies such as | | | | diagnosed and treated aggressively with high dose |
| x-ray and magnetic resonance imaging (MRI). | | | | steroids, this condition can lead to blindness. |
| Once the diagnosis is confirmed treatment with | | | | The diagnosis is suspected if the patient has an |
| medication, physical therapy, traction, and different | | | | abnormally elevated erythrocyte sedimentation rate in |
| types of injections are often successful in relieving the | | | | their blood and a biopsy of the temporal artery can |
| pain. A soft cervical collar and neck support pillow may | | | | help confirm the diagnosis. While the biopsy may be |
| also be useful. | | | | negative even in cases where GCA is present, the |
| Sometimes patients who have arthritis take pain | | | | presence of a positive biopsy clinches the diagnosis. |
| relievers. If they stop taking them they can get | | | | Unfortunately, a negative biopsy should not dissuade |
| rebound headaches. This often prompts the patient to | | | | one from making the diagnosis since it can be negative |
| take more pain relievers and therefore may make the | | | | in a significant percentage of cases. |