The Headache That Wouldn't Go Away Even After 10 Painkillers: The Real Cause Was 'Here'

Have you ever felt frustrated and in despair after getting a "normal" result on a brain MRI when your head was splitting with pain? For 70% of the chronic headache patients who visit my neurosurgery clinic, the problem wasn't in their brain, but in a completely unexpected 'place.' Today, I will reveal the true cause of that terrible headache, which will finally help you stop relying on the painkillers you've been carrying around every day.

A phrase I hear very often in my clinic is: "Doctor, then what exactly is the problem? My brain MRI is normal..." I fully understand that question and your frustration. The brain is fine, yet the headache persists.

Why Does It Still Hurt When the Brain is Normal?

Please note this important fact: the cause of a headache is not always the brain.

There are so many parts of our body that can cause headaches: the brain itself, the membranes surrounding the brain, the blood vessels around it, the nerves and muscles in the neck, the jaw joints, and more. Among these, a brain MRI only shows the brain itself.

Source: World Health Organization (WHO), Classification of Headache Causes Worldwide

In my experience, out of 100 chronic headache patients who visit my clinic, 70 of them have issues elsewhere, not in the brain. What is the most common cause among them? The cervical spine—in other words, the neck.

The Cervical Spine Causes Headaches?

Many people are surprised. They ask, "What does the neck have to do with headaches?" But the connection is actually huge.

Our neck is full of nerves and blood vessels. If the cervical spine is in bad shape or the neck muscles become stiff, these nerves and blood vessels are affected. Then, the signals sent by the nerves are felt as a headache.

Source: Korean Neurological Association, Study on the Association Between Cervical Radiculopathy and Headaches

In fact, headaches in patients who come in with cervical issues have distinct characteristics. It usually starts at the back of the head and spreads to the sides or the forehead. There are signs, such as waking up in the middle of the night or the headache worsening when turning the neck.

Why Painkillers Don't Work

Here comes an important question: "Then why don't painkillers work?"

Painkillers are medications that suppress pain signals in the brain. However, it's difficult to 100% block the nerve signals coming from the cervical spine just by regulating brain chemicals. That's why no matter how many painkillers you take, it doesn't solve the fundamental problem.

Source: Neurosurgery Clinical Data, Study on Painkiller Responsiveness Due to Cervical Issues

One patient was taking 10 painkillers a day. Three in the morning, three at lunch, and four in the evening. That was the only way they were barely hanging on. Because the painkillers couldn't resolve the root cause, there was a vicious cycle of constantly increasing the dosage.

There Are Other Causes Besides the Cervical Spine

Of course, the cervical spine is not the only cause. There are quite a few other reasons.

There is a condition called Myofascial Pain Syndrome, where the neck muscles themselves become stiff and sensitive. This also doesn't show up on a brain MRI. There are also tension headaches caused by stress and bad posture. Headaches can also occur when there's a problem with the jaw joint.

Source: Neurological Society, Classification of Various Causes of Chronic Headaches

The common thread here is that none of these conditions show up on a brain MRI. Therefore, the cause cannot be found solely through a brain MRI scan.

These Things Actually Happen

One patient had been suffering from headaches for 3 years. Their teeth and jaw hurt, and their head was throbbing. They went to a neurologist, a dentist, and even a psychiatrist. The diagnoses they received from different hospitals varied. The most common diagnosis was, "Since your brain is normal, it seems to be due to stress."

When I examined them closely in my clinic, the condition of their cervical spine was poor. The nerves coming from the neck were being irritated. By focusing on nerve injection therapy and physical therapy, they were able to stop taking painkillers after 3 months. Painkillers they had been taking for 3 years.

Another patient had even taken a brain MRI and was told it was normal. But when we looked closely at their neck, the muscles were extremely stiff. By focusing on posture correction and stress management, the intensity of their headache dropped by half in just 2 weeks.

For another patient, the jaw joint was the issue. When they chewed food, the jaw was stimulated, putting pressure on the nerves, which manifested as a headache. With the help of a jaw specialist, they corrected the issue, and the headache disappeared completely.

Where Is Your Headache Coming From?

If you have been suffering from headaches, check for these signs.

Does the headache start at the back of the head? Does it hurt more when you move your neck? Does it worsen in a specific posture (for example, in front of a computer)? Do you wake up in the middle of the night? If you have these symptoms, it's highly likely to be a cervical issue.

Source: Neurosurgery Clinical Experience, Characteristics of Headaches Caused by Cervical Issues

Have painkillers rarely worked for you? Does it hurt again just 2 hours after taking one? If so, it's more likely a physical issue rather than a brain issue. This is because headaches caused by brain tumors or brain diseases generally respond to painkillers to some extent.

Q&A

Q. Then why take a brain MRI? A. To rule out brain diseases. A normal result means the brain is safe, and then we look for other causes.

Q. If it's a cervical issue, shouldn't the neck hurt too? A. Not necessarily. Even if the neck is fine, the nerve signals can manifest solely as a headache.

Q. Should I really stop taking painkillers? A. You can take them if needed while finding the cause and getting treatment. However, you shouldn't just keep taking painkillers indefinitely.

Q. How are cervical issues treated? A. Conservative treatments like nerve injections, physical therapy, and posture correction are the main approaches. Most cases do not require surgery.

Q. What should I do to get an accurate diagnosis? A. Neurological exams are crucial. I mean reflex, strength, and sensory tests. Also, the structure and muscles of the neck must be examined closely.

In Summary

Your chronic headache might not be due to your brain. A normal brain MRI is actually good news. It means your brain is safe. If so, you just need to look for the cause elsewhere. Now is the time for an accurate diagnosis instead of relying on painkillers.

Your Headache: Is It Really Because of Your Brain?

Headache starting from the back of the head? Does it worsen when moving your neck? Does it only hurt in specific postures? It might be a cervical issue.

Painkillers aren't working? Does it keep coming back no matter how much you take? Is the dosage constantly increasing? Suspect somewhere other than the brain.

Your neck is fine, but you have a headache? Even without neck pain, nerve signals can manifest as a headache.

Already been to multiple hospitals? Get re-evaluated focusing on neurological exams. A different diagnosis might emerge.

Finding the true cause of your headache is the very first thing you need to do. Do you want to stop taking painkillers? Get an accurate diagnosis. There will be an answer.

Sources

Source: World Health Organization (WHO), Classification of Headache Causes Worldwide Source: Korean Neurological Association, Study on the Association Between Cervical Radiculopathy and Headaches Source: Neurosurgery Clinical Data, Study on Painkiller Responsiveness Due to Cervical Issues Source: Neurological Society, Classification of Various Causes of Chronic Headaches Source: Neurosurgery Clinical Experience, Characteristics of Headaches Caused by Cervical Issues