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Headache Pain that Affects the Rest of the Body

Program: Effective Treatments for Headache and Migraine
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Andrew Schorr:

Okay. Let's continue now. Who's been waiting? Roger in Seattle has been there. Roger, welcome to Patient Power. Thanks for calling in. What's happening with you and headache?

Caller:

Well, I have a headache that hits the top of my head, the front of my head where my eyes are and of course the back of my head, my neck. And then I have pain going through my whole body, jumping around all day long.

Andrew Schorr:

What do you do for it?

Caller:

They have me on pain pills. And it doesn't do any good because I load myself up on Tylenol and pain pills, and I'm just taking so many of them. And I'm not a pill taker at all. I don't like taking pills. But anyway they had me on nasal spray for my headache, but that doesn't help at all. I mean it's been going on now for, what, three months that they've had me on all these pills, and it's just not doing a darn bit of good. And I of course have an appointment this month, again. This is the end of my third month, and I have another appointment. But it's just I'm just not sure the doctor--he claims he doesn't understand all these pains jumping around. Well, it started with my headache and now it's in my legs, my feet, everywhere, my back, my shoulders, everywhere.

Andrew Schorr:

Now, is the doctor you go to a neurologist?

Caller:

Actually I go to Harborview, and I've been to see at least four doctors, and a neurologist was one of them but he doesn't know. And he sent me back to my doctor, and my doctor sent me to see a therapist, and of course she sent me back to him. And I mean it's just not going anywhere because they say it's really a medical thing.

Andrew Schorr:

Roger, I don't mean to cut you short but what we'll do, let's hear from Dr. Lucas on this. We all hear the pain in your voice and how frustrating it is, and how do you get to the goal line of some relief. So we're going to talk about that. I want you to listen off the air, but thank you for calling. I hope we can give you some guidance here, okay?

Caller:

All right.

Andrew Schorr:

Thank you. How frustrating. Dr. Lucas, so he's got doctors on the team and the pain is moving around. So what do you do in that sort of complicated situation?

Dr. Lucas:

I know Roger's been through a lot of this, so what I say he may have already tried. But typically if someone like Roger came into my office one of the things we try to do is to make sure he didn't have apples and oranges, that is, you know, headache but some other underlying reason to cause the pain all over the body. So that may involve a few tests. Blood tests, maybe imaging like a CAT scan or an MRI.

The second thing is that the medicines that some of the doctors are treating Roger with could be causing pain all over his body. And one of the things that a lot of people don't appreciate is sometimes pain medications, particularly if they have narcotics in them, might actually decrease your threshold to pain. It's a very unusual idea because most of us think that taking something like codeine or hydrocodone or morphine, kind of a morphine family drug really helps you with pain. But it is not to be used long term. Because if you use it long term for something like migraine it actually decreases your threshold to pain, and you have more pain, and it doesn't take much to start the pain. So I think in Roger's case doing a thorough neurologic work-up and then finding something to treat his headaches other than Tylenol and pain pills might be the ticket.

Andrew Schorr:

Now, sometimes it's a question of which doctor to go to. Does this sound like a neurologist area or is it a chronic pain specialist or where does he go?

Dr. Lucas:

I think that either headache or chronic pain. And, you know, again the chronic pain folks are usually used to figuring out what comes from a migraine or a chronic headache point of view and what doesn't, and they might be able to point Roger in the right direction as well.

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