Expert: Gerald Anzalone, D.C. - 6/13/2011

Question
QUESTION: Hi there. I have a terrible problem which makes me wish I was dead. Please dont laugh at me but my eye and neck muscles actully pull tight and I got terrible pain down the right side of my neck and behind the right eye. As I lay down it feeels as if all the muscles are pullsing my eye back. I have no idea what started this but I have lost hope. I do not know who can help me or what this is. It feels like someone is threading fishing line through my eye neck and ear. I am finished and no apin killers help. thank you

ANSWER: Peter,

Thanks for your question. I sympathize with the pain that you're in.

I can't provide you with a diagnosis over the Internet, and a good physical examination and patient history are imperative toward trying to arrive at a correct diagnosis, which then helps point the patient toward the appropriate treatment.

However, based on the limited information you provided, two things immediately come to mind: occipital-frontal headaches caused by trigger points in the musculature of the back of the skull, and trigeminal neuralgia.

The suboccipitalis muscle can develop myofascial trigger points (tender nodules found in taught bands of skeletal muscle which typically radiate pain away from the tender area) due to stress or tension. The pain referral pattern of the suboccipitalis trigger point may be perceived as a sharp pain shooting from the back of the skull to right behind the eye, or around the side of the head to the eye or around the eye.

This trigger point, like any other trigger point, may be treated by a skilled practitioner of manual therapy: a chiropractor, massage therapist, acupuncturist, or physical therapist. The practitioner you see should be well versed in trigger point treatment. Usually, a form of manual pressure and massage is used. In severe cases, a medical practitioner may inject the trigger point with an anesthetic and/or an anti-inflammatory agent.

Trigeminal neuralgia is usually best treated by a neurologist, and may involve a number of possible treatments. Please see this link for more information on trigeminal neuralgia:

http://facial-neuralgia.org/conditions/tn.html

Of course, the cause of your problem may be something entirely different; you should have a thorough examination by a specialist (a musculoskeletal-based chiropractor, or a medical neurologist).

I hope that this helps to answer your question.

Good luck!

---------- FOLLOW-UP ----------

QUESTION: Is there any drug I can take to stop this aweful pain until I get it sorted out. I have tried everything. Thank you for your time my friend. This is a disaster. I think it is nerve and brain damage because I get such a sharp burning pain in the right eye after taking Ritalin for 20 years (which is the cause and I need my Ritalin) so I will need to go to a mental hospital to get clean. This must be the problem. Thank you

Answer
As a D.C., I cannot advise you on taking prescription medication. However, the symptoms you describe are not consistent with Ritalin use. Taking a stimulant such as Ritalin with excessive amounts of caffeine can cause headache, but your symptoms sound to be something different. For advice on your medication and possibly taking a different medication to help control your symptoms, I suggest you see your primary medical provider, who would be most familiar with your medication repertoire, or a medical neurologist (making sure to bring all of your prescription and over the counter medications and any supplements you may be taking with you). The possibility of a migraine headache, tension headache, or cluster headache should also be ruled out as a possible cause of your symptoms.

Again, the cause of your problem must first be established before an appropriate treatment plan may be offered. It may also be necessary to have a multi-disciplinary approach to your care, in which conservative therapy offered by a chiropractor, massage therapist, physical therapist, or acupuncturist is used in conjunction with medical care.

Good luck.