hi lisa,
don't worry about me too much, yes, migraines, any headache i suppose, can be truly horrible, but i've been lucky to be able to recognize my triggers and find ways of relieving them. i've also been lucky that caffeine works so well for my migraines, as well as, if not better than any other "drug" i've tried, though must say, never found the need for the heavy duty migraine drugs. the only migraines that i just have to "wait out" are hormonal, thank goodness hormones fluctuate and within a few days, even these migraines pass.
the occipital muscle is a muscle in the back of the head and when its in spasm, i get the headaches. however, muscles all seem to spasm together, so if my upper back is spasming, then the neck will, and if the neck does, then the occipital muscle does. its one great big party! so i try to find the original culprit best i can. not surprised at the rheumatologist's comments, but physiatrists specialize in helping people overcome these sorts of issues. and PT can be quite useful as well. maybe seek out a physiatrist (notice not psychiatrist, but physiatrist....most people have never heard of them, i wouldn't have except for the fact that my first PT sent me to one and i fell in love with her, bestest doctor i ever had!....but like any field of medicine, the knowledge of the doctor can vary, right now i'm going to one who's advice is "if you have to lose your career due to your health, so be it.", needless to say, i'm going back to my old one who felt this new one could help me more and the only reason i tried her, but the old one did help more than i think she realized and at least she cared and was motivated to get me out of pain and functioning whenever i'd flare.)
anyway, its the physiatrist's who do the trigger point injections with the lidocaine, but that's only if you have active trigger points to inject. pain docs are also often trained in this technique.
as for the ultrasound machine. here is mine and i

it:
http://www.mendmeshop.com/ultrasound.phpi did a lot of research on it to make sure i was getting something as close to what they use in PT as possible. the energy output is the same. the only difference is pulsed vs continuous, but that seems to be ok. you can search on here for me talking about home ultrasound machines for more info. louise on here who is a PT helped me decide on the right one.
hope you get some relief soon as well,