I have my usual dose of spring fever and want clear out the house, go do and see everything. Then there are my three plus migraines per week, with aura, fibromyalgia, and general pre, mid, and post-drome time lost. Enter new pain - lower back, sciatica, down the left leg to knee and foot. MRI says degenerative changes to discs, right bulge of one disc, not significant enough to requre surgery (good news.) Physical therapy and adding Relafen 500 mgs. twice a day to my considerable bouquet of twice daily meds. Even with this, I am waking up 3-4 times a night due to back and leg pain. I have the feeling my ortho thinks I am expressing more pain than condition warrants. Will be seeing my Neuro in three weeks. Am tired of being in pain, now lacking bodily rest between migraines. Could this all be interrelated? Will the Relafen cause rebound Migraines? I'm feeling discouraged, and reluctant to schedule activities with my family and friends. Any suggestions about questions I should ask my Neurologist? Thanks, Lynne
Relafen is an nonsteroidal anti-infalmmatory drug (NSAID), which can cause Medication Overuse Headache.
While your lower back problems may not cause a Migraine attack, they certainly can trigger one. Spring seems to be a more difficult time for many Migraineurs, and people with chronic pain problems, I know it is for me.
Any chance you could travel to see a Migraine specialsit? Seeing an expert will be worth the extra effort it takes to get there. The New England Center for Headache is in Stamford, Ct and has world class experts there. The rest of our patient recommend list can be found HERE.
Forgive me if I am repeating myself here, have you tried keeping a Migraine diary that would help you identify and manage any Migraine triggers you may have? Our Migraine triggers page has valuable information you can find HERE.
Hi Nancy, Thanks so much for your helpful reply. The information on MOH was particularly interesting and will help me during my upcoming appointment. I currently see a Neurologist who specializes in Migraine management, and do know most of my stress, environmental, weather, and food triggers. My frustration is that I have good medical care yet I don't seem to be gaining ground in my quality of life. We adjust my meds per my responses, or new ones become available, so I now still average three a week, but with lower severity. I'm trying to focus on what I can do, and let go of that which I can't, but this new set of physical symptoms is one more set of challenges to work through. I can see where it will be important to coordinate my meds between my providers. Thanks again, Lynne
As a Physical Therapist who suffers migraines, I can tell you it is critical that you notify both of your physicians about eachother's care, so that they can coordinate YOUR care appropriately.
I provide my neurologist's name and number for everyone I see so that they send their reports directly to my neurologist's office. I might suggest the same for others, including you, so that everyone is on the same page-so to speak. It makes everyone more comfortable, and keeps all information available for the people who are trying to help me feel better.
Regarding your back and lower extremity symptoms, you might suggest your PT send duplicates of his/her notes, including the evaluation(or you can request a copy of your records) be sent to your neurologist, or you be provided a second set of your medical records. This could potentially be important information for a physician now or in the future if the damage gets any worse on your spinal cord. Your records might indicate a change in strength, or perhaps a difference in reflexes, perception of pain, location of pain, numbness & tingling, etc.
I also suffer from back and leg pain (for which I've had to have a fusion), along with our horrid migraines. I only say this because I can truly relate to what you're going through-I get it. Just be sure that your care is well coordinated by ONE person. You might consider making that ONE person your neurologist, as he/she is the one who provides the prescriptions for the majority of your meds. If you do decide this, be sure to have this conversation with both your neurologist and your orthopedist.
I've seen many people denied pain meds over the years because they had too many docs involved in their cases prescribing meds. Most good docs will agree to be in charge of the medications-if they are already prescribing, and are aware of, and in contact with, the other problems being treated in your body.
Hope this helps some. Let me know how it goes! And, hang in there. As for sleep, ask about trying to sleep with a pillow between your knees while on your side, and under your knees while on your back. Also, if you notice bowel or bladder symptoms, call your neurologist immediately and notify them.
Note: While I am licensed, I am not practicing currently due to disability for migraines. Do not replace this information for information you have already been provided by a health-care professional involved in your case. Always seek medical advice before changing your healthcare plan.
CJ
Hi Lynne- Medication Overuse Headaches turned out to be a big part of the problem for me. After reading about them here on the migraine board, I decided to wean myself off of my "morning cocktail" of Tylenol, Aleve, Ibuprofen, Sudafed and a cup of coffee. It was not easy as my worst headache pain was in the morning, and I had a child to get off to school.
I went through two really tough weeks, but at the end of those two weeks, I noticed I was no longer getting a "rebound" headache at 2 PM. So, my 2 PM headache was actually being CAUSED by my little morning "cocktail."
I then decided to give up the coffee altogether and just drink a lot of water in the mornings.
The morning headaches began to ease up. I now take headache meds three or less days a week.
I had my first really bad migraine in a month last Monday, and did not take ANY medication for it. I'm not sure why. I guess I just got out of the habit of taking meds. I just put a "rice pack" on my head. (A tube sock full of rice, with a knot tied at the end, heated up in the microwave.) I knew eventually the migraine would go away. It was gone by the next day.
Now that I have stopped taking so much medication, my migraine-preventative (I take Topamax) is finally working better.
It was not easy to start taking less abortive meds, but it was worth it.
Regards,
Diana
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Dear CJ - Thanks so much for your caring and helpful comments. I have taken action and provided my neurologist's info to my ortho, and also, with the encouragement of my physical therapist, referred myself to an ortho who specializes in spinal care, pain management and rehabilitation. Happily I have an appointment with the new doc on 5/21 ! I am assured that he will take a less passive approach to my back and leg discomfort. His office has instructed me to hand carry my x-rays and MRI to the appointment. I feel much less discouraged, hope to have some helpful advice from this new doctor, and better outcome with coordination of care with my neurologist.
I share your frustration at being unable to pursue your chosen career path at this time. Please know that you have helped me greatly. Thanks again, Lynne
Hi Diana,
Thanks so much for your comments! Yes - I'm down to one cup of coffee, and what seems like gallons of water all day, ha ha. I only use abortive meds for migraine the three or four days a week that I get them. (relpax or maxalt). The relafen is taken twice a day as an anti-inflammatory for my arthritis and my back, just started in march, but I will be discussing this with my new back & pain doc next week as well as my neurologist the following week. About 5 years ago I got caught up in the "rebound" headache nightmare, and try carefully to avoid it now as best as I can.
I took Topamax for a few years, but was switched to Zonegran last summer. I also take a calcium channel blocker as a preventative. Exercise helps when my back isn't quite so fired up. Thanks again, Lynne
Thanks again! Lynne
How did it go with your new doc? Doesn't it feel good to be empowered with knowledge about your own body? I am so proud of you for taking the initiative and stating that you needed more spedialized/coordinated care, and that you even hand carried your radiology results (x-rays;MRI,etc.)! I hope you have a speedy recovery from your neuro/back/lower extremity problems, and that even your medical issues related to migraines will resolve too!
CJ
Thanks so much for your inquiry, CJ! The new doc was very thorough, and wants me to have an EMG and discuss my case with my Neurologist (who is a migraine specialist). He did not have a definitive diagnoisis, or treatment plan at this point, but is having me continue physical therapy, expercise and the anti-inflammatory medication. It appears that I have arthritis and a small right sided bulge in a lumbar disc, but not significant enough to cause the radiopathy and level of pain that I am experiencing. I'm still uncomfortable, not looking forwar to an EMG, but feel I'm on the right path as I have my next appointment with my neurologist next Tuesday.
It does feel empowering to walk in with my own films, explain my MAPP, and other medication regimen, and my growing understanding of my physiology and right to seek answers and possible solutions.
Thanks again for asking, I hope you have a pain free and comfortable weekend! Lynne
Hi Diana. I used to take a morning "cocktail" for early morning migraines and pretty much continue with the Excedrin Migraine all day. I found an easier answer tho - I got a new cervical pillow. I felt better the first morning I used it. My old pillow was too thick for sleeping on my back and caused problems all day. I like it when I can solve something without drugs. Also, if I eat breakfast first, sometimes I don't need to take anything, and if I do, at least it isn't on an empty stomach.
Also, I posted this to Lynne's post but I don't know if you read it - my new chiro has me lie on my back with my head hanging over the side of the bed. It really hurts when you do it, but even a couple minutes help. I was also extremely dizzy at first but got over that. This has actually gotten rid of migraines for me and helped with neck and shoulder pain. The goal is to get up to 20 minutes, which I've only done once.
Good luck! Susan