instruction: hello doctor a couple of weeks ago I woke up with a bad headache and a very stiff neck it was so painful that I could not make it through a regular day without crying and intense pain since this time I have been to the doctor four times and each time they gave me more medicines I have also been to a chiropractor four times because one of the doctors recommended it after he took an ray the headaches have gone away I suffer from headaches and this pain is so different now I have constant pain in the back of my lower neck and only on the left side the stiff neck has improved and I can manage a day but I am still in intense pain the only medicines I am taking at this time are over the counter medicines what do I need to do
output: hello your symptoms may be related to occipital neuralgia which is an irritation of the occipital nerve which lies in the back of your head I would like to know what were the results of your neck ray this neuralgia can be exacerbated by cervical spondyloarthritis I recommend starting indomethacin twice daily if you have no contraindications to it stomach problems or high blood pressure I recommend consulting with a neurologist for a careful physical examination an antiepileptic drug like valproate or lamotrigine may be necessary to relieve your pain I hope this helps cervical spondyloarthritis or intracranial cause neck ray brain it computed tomography scan indomethacin anti epileptics valproate topiramate or lamotrigine