I get migraines and light sensitivity. How to manage it?

Question

Hello doctor,

I have been experiencing significant pain in my neck and head, along with shoulder pain. The pain in my neck spreads across and down my left shoulder.

I also feel burning and shock-like pains from the base of my skull to the front of my head, sometimes making it too painful to touch or brush my hair.

I experience migraines with sensitivity to light, and the burning sensations extend down the tops of my arms. Additionally, I have a consistently high resting heart rate, around 90 beats per minute, which also occurs during sleep.

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

Your symptoms suggest a combination of cervicogenic headache (headache originating from the neck) and cervical nerve irritation (possibly involving the upper cervical nerves, such as C2 to C4).

These can cause burning, shooting, or electric-shock-like pain radiating from the base of the skull to the scalp and shoulders. This type of pain is often worsened by neck movement or tension in the upper back muscles.

The constant headaches with light sensitivity could also indicate overlapping migraine features.

At the same time, the persistently high resting heart rate (tachycardia) may be a response to ongoing pain, anxiety, or muscle tension, or less commonly, an issue such as thyroid dysfunction, dehydration, or autonomic imbalance.

Treatment involves both relieving the pain and addressing the underlying cause.

In the short term, anti-inflammatory medications (such as Ibuprofen or Naproxen) and muscle relaxants can help reduce inflammation and muscle spasms.
If nerve irritation is prominent, your doctor might prescribe neuropathic pain medications such as Pregabalin, Gabapentin, or low-dose Amitriptyline.
Applying warm compresses to the neck and upper shoulders, practicing gentle neck stretching and posture correction, and avoiding prolonged periods of head bending (such as phone or computer use) are crucial.
Physiotherapy focusing on neck stabilization, trigger-point release, and upper back strengthening can greatly improve recovery.
If symptoms persist, an MRI (magnetic resonance imaging) of the cervical spine should be done to rule out a disc bulge or nerve compression.

For your elevated heart rate, check thyroid levels (T3 (triiodothyronine), T4 (thyroxine), and TSH (thyroid-stimulating hormone)), hemoglobin, and electrolytes, and ensure good hydration and adequate rest.

If the tachycardia remains unexplained or associated with palpitations, chest pain, or breathlessness, a cardiac evaluation (ECG (electrocardiogram), or echocardiogram) is essential.

Your condition seems musculoskeletal with nerve involvement, possibly compounded by migraine and stress. A combined approach that encompasses pain control, posture correction, physiotherapy, adequate sleep, and medical review can help alleviate symptoms and prevent their worsening.

I hope this helps.

Thank you and take care.

Regards.