[TN from PA]

Hi Harrison,

Thank you for the reply and all the effort and time you contribute to maintaining this great site.

Great questions and I will say that I am not certain of the answers. The human body is very complicated. The headaches started approximately 30 years ago and seemed to focus in the forehead between the eyes leading me to assume they were "sinus" based.

After many years of sinus "treatments" including allergy shots, surgery and several antihistamines I sought out other specialists including a neurologist who also had a history of headaches and was a principal investigator for sumatriptan while at Cleveland Clinic. She instinctively (to my observation) palpated my shoulder and neck muscles and noticed significant tightness. She prescribed a titrating regimen of tizanidine which in her opinion had relaxed those muscles. The muscles never seemed to bother me but the headaches moved form the forehead to the upper neck/base of skull area.

Physical therapy was prescribed and was quite helpful but after a year or so the headaches returned and in my search for a doctor to perform a "trigger point injection" I stumbled upon a pain specialist who while glancing over several images (CT Scans, MRI's) asked if I had ever had any head or neck trauma. My reply was, yes, a serious head-on car wreck at age 21 (1974). My lower jaw was fractured in three places while the steering wheel was keeping me from going through the windshield.

The pain specialist referred me to an Orthopedic Surgeon with excellent experience in cervical fusion. That was 2007 and he told me he would fuse the area but suggested I wait a year, if the pain was tolerable, because about ten percent of cases would stabilize and not worsen. Low odds but worth it. I was hopeful for stem cell technology and developed an as needed drug regimen of muscle relaxers, anti-inflammatories and triptans. Also used an at home neck traction device.

The aging process is probably adding to the degeneration and I learned my Grandfather had similar neck problems - genetic component also?

Great health other than the neck. I am a serious student and practitioner of personal nutrition. Exercise is limited by the neck situation. Pull-ups, push-ups and such are a source of delayed pain.

My belief is that the shrinking discs are compressing the nerves and triggering headaches. Exertion of the upper back and neck muscles accentuates/causes this nerve compression where those nerves exit the spine. I have occasional tingling in left first and second fingers and once had an electric like shock run down my left arm while turning quickly to answer a telephone. Very glad that was only once.