Neck involvement/headaches

[Livingston]

Do you have any advice on managing my neck pain and related headaches? I have had RA for about 25 years and it went undiagnosed/untreated for a long time. As a result I have a rheumatoid pannus at C2 and erosion of the odontoid process.

I am having increasing problems with headaches that come on when my head is tipped back even slightly (eg to look up, wash my hair in the shower or sit back in a high backed chair). Co-dydramol doesn't really help and I don't particularly want to start taking the tramadol I'm prescribed on a very regular basis. I'm on oral MTX 17.5mg (can't tolerate a higher dose or injections), LEF 20mg a day, HCQ 200mg/400mg alternate days but I frequently end up having weeks off the MTX and LEF because my white count crashes.

[Dr Sandeep Bawa]

Hi,

i trust you have had a recent MRI of your neck?

If the RA is well controlled, then we are looking at analgesia (assuming the cervical spine is stable)

Gabapentin, Lidocaine patches could be considered.

You should discuss your situation with your local Rheumatologist.

Hope this helps

Dr Bawa

[Arthritis Care]

Hi Livingston,

I can appreciate that this kind of pain may be difficult to manage. Apart from the kind of support you can find from the rheumatology department, you might want to hear how other people manage on the day to day. Here's a link to online community at Arthritis Care http://arthritiscareforum.org.uk/viewforum.php?f=8
There can be real value in hearing from other people, with the empathy that can go along with shared experience.

Another avenue might be with a pain management clinic referral - where they can offer much more than just medication.

If you'd like a chat about your situation, you are very welcome to ring us on our Helpline free phone.

Kind regards

Guy
Arthritis Care Helpline
Tel 0808 800 4050 10am - 4pm weekdays