Hiya,
sorting out what is the exact cause or type of headache can be difficult, and you may have proper migraines and you may have some that originate from the AS as well.
I do n't think a normal migraine will last for days and days and go up and down.
If it's AS look for it worsening with a flare, and improving with the flare and AS medication.
Bad in the mornings and at night. Moving can help ( whereas with a mograine you want to keep really still because of the pounding )
The top most part of your neck provides nerves which go up into the rear half of your skull along specific tracks they often get irritated by the AS process, check out lesser and greater occipital nerves. When it's chronic you can trace them by the pain.
More rarely the trigeminal nerves get irritated these are primarily in the face but do extend further into regions near the occipital nerve branches. That in me has been the hardest one to diagnose as it's rare to get both occip and trig but when you check out where they both extend to and how swollen I get it's not exactly rocket science to work out why both may be irritated by the AS process.
To diagnose and treat chronic problems with these nerves
I've found typical migraine medication did not help,
I'm on tegretol which helps to a point, tramadol seems the best pain killer without hitting the opiates and anti-inflammatory.
I've had facet block injections which proved the origin of the neck pain but caused more problems than they fixed.
Just recently had some occipital blocks and they have helped heaps, although post injection swelling has been a problem, but I was pretty swollen before.
The headaches can wreck your life on top of chronic disease and you need to hunt for good medical support for them. Most Dr.s blame it on stress anxiety etc, but honest the pain from it is horrendous.
I few years back we had a good discussion on them and most found that getting an oral steroid course was the best way of dealing with the AS inspired ones.
Good Luck and I hope this helps
Dave
