I have a question for you.  
I have bad sinuses, get sinus headaches and headaches from snoring.  Anyway, I woke up last Friday to a nice sinus type headache.  As I was getting ready for work, I got some pretty good additional pain in the back of my head/neck area.  Felt like somebody had snuck up and smacked me across the back of my head with a 2x4.  Pain is centered around the base of my skull and working up into the right side of my head.  Had a couple more like that during the night, and ever since I have had this headache continually, in my neck and back of my head, along with a burning sensation that comes and goes.  I live in WI but am staying for the time being in IL, my insurance will not cover me down there.  I have been trying to get an appointment with my regular doctor, at this point it looks like Monday I might get in.  I would go to a walk in clinic, but it's a hella drive and takes a lot of time....I can't even get off work to go anyway.  There is literally no one to do my job, which is to run all the trains on the railroad.  Monday is my first day off in two weeks.  I have been under a huge amount of stress for the last couple of months as well.  Any ideas?  I have heard everything from impacted sinus to anyuerism.  I am dealing with it via 1000mg of acetaminophen, 60mg of pseudoephidrine, and 700mg of aspirin every 6 hours.  It takes the edge off but leaves my head and neck still burning.

Oh yeah....my BP is consistently around 158/90 and has been for over a year now.

Well it is hard to tell what is going on here without a good physical exam, but here is what I think is going on.

You describe symptoms of having either a extended tension headache (less likely) or a cluster headache (very likely given your history).  What is feeding this is likely a vicious cycle of likely sleep apnea (as you descibe snoring) that leads to the tension headaches.  Your elevated BP is likely from this, and I would say that this has been going on for some time if this is the case.

The approach to this is multifaceted.  If you are overweight, you need to lose the weight sooner than later.  I would consult a pulmonologist, and you would probably end up with CPAP and supplemental oxygen when you sleep at night.  This is the best way to treat you symptoms, but again you also need a good physical exam to ensure this is the case.

From what you are saying, I find it very likely you have sleep apnea and resulting tension headaches and increased BP from the same.  Get someone to look at you and tell me what they said.

Armed MD

 I was thinking along the same lines, but even if I get a good 8 or 9 hours of sleep, this sucker just won't go away!  I will update and thanks for the post.  BTW, I am 32, 6'2", 195 lbs.  I don't think that is considered overweight.  I am also a smoker.  I assume quitting would help a whole bunch.

Back when I had a job and my stress level was skyrocketing because of that bastard fdcgh, I was getting tension headaches that felt like electricity shooting up my neck into the back of my head. It hurt so bad that I would wince and couldn't do anything until the pain would stop.

Quitting smoking would be a good thing.  Drink LOTS of water too.  For me it is migraines rather than cluster headaches, but sucks all the same.  You've had some serious stress stuff to deal with there and that is adding to it as well.  Try Excedrin, for me it is the only thing over the counter that works.  As for the sleep apnea, that might be a problem even with getting a lot of sleep because it is not quality sleep.  My brother is on the mask now and it has made a big difference in his life though it took some getting used to.

Good luck, I feel for ya man.

I gotta hijack this.  I've been having chest pains for the past 4 days.  Not sure what.  It is isolated barely below the center of my heart.  Feels like pressure.  I have low blood pressure, resting heart rate of 47.  I ran 2 miles today.  No pain while running.  Just happens every once in a while.  I am paranoid.

Imbrog, at least the pain stopped!!!! [;)]

Ratters - Excedrin is acetaminophen/aspirin and a small dose of caffiene.  My current regimen is basically a high dose of the same thing (taken with a pepsi LOL) PLUS the pseudoephidrine for my sinuses.

ArmedMD...I know to be careful with the ace, I used to drink one weekends fairly heavily, but I haven't for around a year, I have no signs of liver dysfunction and have been tolerating it well so far.  At what dose do I have to get leery of liver damage?

TheKill
If your mucus is thick and bright yellow I would go to an emergency room as soon as possible, infected sinuses are nothing to let go, if not dealt with they can turn into a host of other serious illinesses.  

I Hope you feel better soon.

Yeah, tylenol sinus is acetaminophen and psuedoephidrine in one tablet.  Try my cocktail next time you get one, it works good.  Generally speaking, when I would get one of these headaches, that and some rest in a dark room will handle it in a couple hours.  But I never had the big cramplike pain attacks before, and I never had one stick for a week like this, which is why I am worried.

Thanks for the well wishes guys.  

It is possibly acid reflux or angina.

Acid reflux I understand.  Alcohol and spicy foods.  The pain has recently died down.

Angina?  Dumb it down please.  I have low blood pressure, so I don't think it is a disease.

Most likely I would say tension headache compounded by rebound from your OTC meds.  Either way, I would make sure you get to the doctor, especially if you have any other symptoms, such a dizziness or other neurologic-related problems.  Also, if vomiting occurs and doesn't rid the headache, then go asap.  The caffeine and pseudoephedrine can cause some major problems with rebound, I'd see about cutting way back.

Angina (chest pain) is caused by the heart not receiving enough oxygen and is found in people with heart disease. You probably have seen people with heart problems on tv/movies taking nitroglycerin pills to treat angina. What the nitro does is dialate the capillaries/arteries in the heart to increase blood and oxygen flow.

Rebound?  As in, physiological effects from the OTC meds leaving the system?  I wasn't aware that could be a problem.

I took the OTC meds around 4 am yesterday, got off work, went to sleep, got up around 7pm and the headache is there full force.  Took the OTC's and knocked it down to a manageable level.  How do I know if it's the meds?

That sounds like rebound to me.  Considering the level (dose) and amount of time you've been taking these meds, it is highly likely this is happening.  Drugs act in various way, however, they almost all lead to tachyphylaxis (a decrease in response to a drugs actions at set doses, therefore requiring a higher dosage for efficacy).  Basically, you become physically dependent on a set dosage, and you need more to get the same results.  A lot of people think this only happens with illicit drugs, but it can happen with a lot of meds depending on receptor-ligand interactions.  

I'm not an MD, and if I was I wouldn't DX on the net, however, I would just consider this is a rebound and possibly comorbid with tension H/A or common migraine, or just the sinus H/A and rebound.

I see.  Thanks for the info.  Don't think it's that.  I have good blood pressure.  I'll just ignore it and hope it goes away.  Things are always better when people do that, right?  [BD]

I can't believe you guys play around with your lives guessing what might be wrong. As an example brain tumors will often present with severe headaches after lying down for a while due to pressure buildup.  My wife was having severe headaches. Took her to Kaiser, my HMO. Doctors thought it was probably a sinus infection but they did a CT-scan just to make sure.  If Kaiser, cheap bastards that they are, go through the effort to rule out bleeds or menegitis I would say it would be a good bet to see a doctor.
I would doubt sleep apnea because TheKill doesnt complain of daytime sleepiness or mentions problems falling asleep at night. I have never heard of headaches from sleep apnea happening other than when first waking up though I suppose it could happen.  
Cluster headaches are usually seen on one side of the head with complaints of pain around the eye socket. Pain can also be at base of skull and work around neck. Smoking and especially drinking can be "triggers" for cluster headaches. Lying down usually makes the pain worse.
As you stated "I have heard anything" as to what the cause might be and it well could be. I sure wouldnt wait till Monday to get seen. Good Luck.  Hopefully it is just a sinus infection.

Jim Fixx was in good health when he died of a heart attack while running.  Good blood pressure just means you don't have hypertension has nothing to with condition of your heart.

It sure wouldn't hurt you to find a good CHIROPRACTOR.

A good cervical adjustment can give excellent relief for headaches.

Best advice I can give is to not look for advice on ARFCOM!

I won't attemt to diagnose YOU because I can't obtain a detailed history or perform a physical examination, but for an individual who presents as you do the likely cause of such complaints is occipital neuralgia.

Stress frequently manifests itself as muscle tension often involving the trapezius muscles. The trapezius muscles insert in to the base of the skull. Their area of insertion crosses a set of nerves called the greater occipital nerves which travel upward along the back of the head. When the trapezius muscles are chronically contracted they exert pressure on the GON, causing occipital headache which often radiates up the back of the skull. Sometimes ear pain will accompany headache because an auricular branch comes off the GON. Burning pain is not uncommon with nerve entrapment pain. It usually signifies a preponderance of A delta and C fibre involvement (keeping in mind that nerves are composed of many different types of fibres with different specific functions.)

The neck pain you describe, especially if aggravated by pressure applied to painful tender knots of muscle typically located at the mid point of the muscle, known as trigger points, is indicative of Myofascial Pain Syndrome. This is the liley origin of both the neck and head pain you describe. Occipital neuralgia frequently follows myofascial pain or simple muscle tension pain of the neck musculature.

Treatment: Warm soak application to effected neck muscles, Deep massage of neck muscles.

If masssage is unsuccessful trigger point injections and/or greater occipital nerve blockade will give immediate relief, with the condition's return prevented by massage as described above.

What you describe is very common.

A person presenting with such complaints would not have pain that is consistent with a diagnosis of vascular headache or its cluster variant.

The info about rebound was interesting, never heard that.

I can't imagine the torment some of you go through with headaches. Never had a migraine, doc told me I had a "visual" migrane about 3 months ago. It was weird, no pain. Now I have glass's.

Kill, you have my sympathy. It sounds to me, like a life-style change is what you need more than anything..

I take it you work with choo- choo's???

Go to a doc as said before and get a physical. I had blood pressure in the range that you have for a couple of years and then one week I just didn't have any energy. I had a constant headache and would sleep every momont I could. I went to the hospital and they took my blood pressure and it had jumped up to 187/128. My pulse was hovering in the 110-120 bpm range. I was immediately taken to the cardiac unit and monitored for a few hours.
I was prescribed blood pressure meds and have been taking them every day since.

When Troy posts about guns, it's time to shut up and listen. It should be pretty obvious that when KODoc posts about pain the same rule should apply! [:D]

TT

If you are sleeping on your stomach, this might be a problem.

The chiro option is a real one.  When I sleep on me side or stomach, I have TERRIBLE headaches.

I now sleep on my back with a chiro type pillow.

I sleep much better, and now, when I stay on my back, no problems.  When I sleep many hours on my side, bam, headaches.

Either way, go see a doctor, get a physical.

Good luck

TXL

David, I should clarify.  My insurance will cover to a point.  However, it covers 10% less if I go out of network.  And if I do that, I would have to go to an ER or walk in, which also charges significantly higher than a regular MD visit.  They also regularly deny benefits and you have to contest the ruling to get them to cover it.  If there are other circumstances, like seeking treatment away from home, I get leery that it gives them ammo to play with.  I spoke with someone close to me who is an accountant and Assistant-to-CFO at a major corporation....according to her this is standard practice in order to keep the money earning interest as long as possible before disbursing it.  

I cut down on the ace and aspirin, and quit taking the psuedoephidrine, quit drinking the caffiene, and actually had a night off.  Bingo, I feel somewhat better.  KODoc, yes, the pain radiated up toward my eye at times, and also up into my ear, almost like my eardrum hurt.  I forgot to mention that I had a bad neck sprain about 4 years ago due to rolling a snowmobile, since then my neck is a bother.

I am still going to see my doc tomorrow or Tuesday to check it out.  Thanks for the feedback peeps.  It is appreciated.

I have had this type of headache quite often.  My headaches were caused by two things.  Sometimes they were related to my sinus problems and would not go away until I took an antibiotic.  More frequently, they were caused by arthritis in my neck.  Since you have had a neck injury, this could be your problem as well.  Naproxen (Aleve) works well for this.  It sounds like you may have a combination of the two.  

I hope you feel better soon.  Anyone who doesn't have headaches can not understand the misery they cause.  I suffer from sinus, allergy, tension and migraine headaches; so I usually have a headache of some sort several times a week.  Let us know what the doctor says.

Went to see my Doc Monday.  He checked me out, did some simple nuero tests, and had some x-rays done of my neck/head.  

DX: stress/tension headache, compounded by old neck injury and possible sleep apnea.

The x-rays looked ok according to him.  I am going in for a sleep study in a couple weeks.  He says I have way, way, way too much crap going on in my life for any one sane person.  He prescribed more rest, less stress (how I am supposed to manage that, I don't know), and sent me home with some Vioxx, he says it is to treat pain and inflammation.  I took one tab in the office.  It works unbelievably well.  I skipped taking it yesterday and started getting the pain again.  Took one and boom, it's gone.  Blows away any OTC stuff.

Again, thanks for the feedback and well wishes guys and girls...

Geoff

Masking pain with analgesics is fine as long as efforts are being directed to the cause of the pain. I can mask the pain of acute appendicitis if I consume enough meds but the pathology isn't being resolved by them.

"Reducing stress" is often much easier said than done.

Since your pain returns in the absence of analgesic medication, if it does not improve over a reasonable amount of time, you might consider asking for a referral to a headache or pain management center at you local university hospital where they will administer definitive treatment.

Glad the drug is working, that is awesome.  Yeah, the stress is the hard part.  Reducing stress is kinda like losing weight, to really do it requires a whole lifestyle change.  Of course right now I gotta do both.  If only I just weren't so lazy. [;)]

Good luck, hope the pain stays away.