Hello all,

I've had chronic tension headaches 3-5 times a week for over 6 years now... I've been to my PCP, Several Psychiatrists, a TMJ Specialist & a Neurologist about these and have not been able to find anything that really helps. I suffer from anxiety so i've been on various ADs over the years... The only one that's helped reduce the frequency of my headaches was Effexor but it had some nasty side effects so I recently stopped that & switched to Wellbutrin (Been on it for 2 weeks - waiting for it to kick in)

Been reading a lot of threads on here trying to get some ideas on what to do for my headaches. Hoping I can get some feedback from other with similar issues that have found some relief. Here's my deal:


* Dull, moderate pain pressure around my forehead, on the sides and back of my head & neck
* Pain behind the eyes
* Pain in my upper jaw & teeth when it's really bad
* 3-5 times a week
* They last 4-8 hrs, sometimes all day
* TMJ symptoms - I have a bunch of these symptoms, been evaluated by a specialist who suspects I may have a TMJ disorder. They outlined a treatment plan for me, but it's not covered by my insurance and is gonna run me around $5k all said & done. So... I'm trying medications first.

As Needed Meds I've Tried:

* OTC Meds (Tylenor, Advil, Aleve, Excedrin, etc..) - tried them all, nothing works
* Fiorocet - Doesn't work
* Imitrex - Started that today - Took 3... nothing

Preventitive Meds I've Tried:

* Lexapro - Great for my anxiety, only temporary relief for my headaches. I suspect a placebo effect.
* Effexor - Prescribed by my neurologist who said my headaches are classic chronic daily headaches. This med worked pretty well for my anxiety & reducing the frequency and intensity of my headaches... but only at a dose of 225mg a day.Surprised Which had some horrible sexual side effects that I just cant deal with. Plus the withdrawal from this med was awful!
* Wellbutrin - Just started this one as as an alt AD w/ less sexual side effects after coming off the Effexor. Only 2 weeks in and my headaches are back full force.

So... Long story but that's where I'm at. I'm soooo sick of having a headache almost every day of my life. Hoping someone on here has had a similar situation and could share some insight.

Thanks in advance guys!

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replied February 16th, 2012
Chronic tension headaches & what I've done to manage them
Hi Justin,

I have had chronic tension headaches for 4-5 years. Without meds, I am pretty much disabled as I can't go to work, do housework, etc. because they are so bad. I have had MRI's of my head, neck, upper and lower back. I was tested for nerve damage. I was misdiagnosed as having migraines. After a lot of trial and error, I have enough tools to be a productive member of society again. I try to keep my baseline as low as possible, reducing the overall impact of a severe tension headache.

A severe tension headache is usually triggered by physical or emotional stress. This can be standing on my feet all day, not getting enough sleep, worrying about a presentation, forgetting to eat, etc. I have at least one headache a week, each lasting a few days. It's not unusual for me to have pain every day for weeks.

I use generics for everything, but put the brand names in for your reference.

Drug history
I was on amitriptyline (Elavil) for over a year, but had problems with side effects. I switched to nortriptyline (Pamelor), which is a metabolite of amitriptyline, and have fewer side effects. Both are depressants and were made for anxiety. Amitriptyline is the most common and most effective drug for chronic tension headaches on the market. In addition to a daily dose of nortriptyline (75 mg currently), I take tizanidine (Zanaflex) on an as-needed basis. It puts me to sleep, but is the only significant dampener/way to reduce my baseline.

Non-drug remedies
- I also take OTC acetaminophen formulated with caffeine (Excedrin Tension Headache), which provides a small amount of relief. My doctor is worried about my liver from use of it for so long, but it can bring me from an 8 to a 6 on a 10 point pain scale, so it's always a hard decision.
- I sometimes use a TENS machine at home to relax my back, shoulders, and neck. I can't feel how tense I am most of the time as my brain has cut off feedback from my muscles. It was ~$50, plus the costs of replacing the pads periodically.
- Deep tissue massage gives me a lot of help, but is pretty expensive.
- I had some success with physical therapy involving biofeedback, but it's not covered on my insurance long enough to help in the long term.
- Chronic headaches and weight gain from the amitriptyline have left me in pretty bad shape. I tried doing Pilates with a certified physical therapist, and it really helped, but was too expensive.
- The Chiropractor was useless; I tried it for a few years. I've since learned that most of what they do is not based on peer-reviewed science, so am not surprised that it didn't help me in the long term. The only good thing that came out of it was x-rays that showed how tight my muscles were.

I don't know if it's relevant, but I'm female and 25.

I hope this helps a little.
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