Tuesday, July 26, 2011

Treatments Galore

The decision to get an occipital nerve stimulator (ONS) implanted was not an easy one.  I first worked tirelessly with a neurologist, pain doctor, and various alternative health practitioners for over 4 years before coming to this conclusion. ONS is for intractable headaches - meaning headaches that are not easily treatable.  To get to a point where my doctor recommended the ONS, I had to try many other more "conservative" treatments.  They are as follows:
  • Medial branch nerve blocks C2-C7 (2 rounds)
  • Epidural steroid injection C6
  • Trigger point injections of lidocaine into shoulder and neck muscles
  • Deep tissue and trigger point massage
  • Rolfing
  • Occipital nerve blocks (5 rounds)
  • Occipital nerve radiofrequency ablation
  • Triptan medications
  • "Preventative" medications (propranolol, Topamax)
  • Nerve pain meds (Neurontin, Lyrica)
  • Muscle relaxers
  • Narcotic pain killers
  • Antidepressants (tricyclic, SSRI's, SNRI's)
  • Dental bite guard for TMJ
  • Chiropractic care with myofascial release
  • Traditional acupuncture (3 different practitioners)
  • Chinese herbs
  • Acupuncture into myofascial trigger points with electrodes attached to needles
  • TENS unit
  • Dietary changes (caffeine-free, gluten-free, soy-free, low-sugar, low-carb, low acid, no artificial sweeteners)
  • Special pillows (Tempurpedic, Buckwheat, memory foam sleep wedge, feather)
  • Ice packs
  • Moist heat
  • Stretching and physical therapy
  • Yoga
  • Meditation
  • Aromatherapy
  • Numerous supplements and other treatments with naturopath
  • Counseling
  • Exercise
  • Activity restrictions
It's not that none of the above treatments ever worked.  Those that did help either didn't help enough or didn't provide pain relief consistently.  For example, the occipital nerve block injections were very helpful.  I got down to 1-2 days of pain a week with those, and the relief lasted about 6 weeks.  However after 4 rounds, they stopped working altogether.

My current treatment regimen is a combination of Norco (a hydrocodone/acetaminophen pill), a muscle relaxer, Gabapentin, ice packs on back of my head, moist heat on my neck and shoulders, occasional use of a TENS unit on my neck and shoulder muscles, lavender aromatherapy, and a dark room with a very soft feather pillow (anything firm puts more pressure on the nerves ---> more pain), and strict activity limitation.

I tried to combine several disciplines to approach my headaches holistically.  I'm sure there are a multitude of treatments I didn't try, but I'm comfortable with the knowledge that I did the best I could with the resources I had.  I have great doctors that did their best, and now agree that the ONS is my next best option.

Above picture is courtesy of the very talented Deborah Leigh via Flickr. My head often looked the same with all the needles they were sticking in me.

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