[19F] Experiencing frequent headaches with neck stiffness and light sensitivity

Patient Description

A 19-year-old female has been experiencing frequent, throbbing, and aching headaches for 2 weeks. The pain originates from the back of the neck and progresses to the temples. The intensity of the headache is severe, rated at 8 out of 10, and is exacerbated by standing for prolonged periods and eye strain. The headaches occur mostly in the mornings and late evenings. Temporary relief is obtained from Tylenol, but the headache recurs within 30 minutes to an hour. Accompanying symptoms include fatigue, loss of appetite, and sluggishness. The patient also reports sensitivity to light and significant neck stiffness, but no fever or 'thunderclap' headaches. Additionally, for the past 5 days, the patient has experienced an inability to burp after meals, which leads to chest discomfort described as tightness. There is no known family history of frequent headaches or migraines, and the patient denies recent use of recreational drugs, caffeine, or alcohol. The patient has an allergy to Amoxicillin, which causes a rash, but is not currently on any medications.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible causes for your symptoms include:

  • Tension Headaches: These are often associated with a dull, aching sensation all over your head. It's often described as a feeling of a tight band around your forehead or at the back of your head. It's often accompanied by tenderness in your scalp, neck and shoulder muscles, which might explain the neck stiffness you're experiencing.

    • Treatment typically involves pain relievers such as Tylenol, which you've mentioned provides temporary relief. Lifestyle modifications, such as stress management and improved posture, can also help.
  • Migraines: These are intense or severe headaches often accompanied by other symptoms such as sensitivity to light, which you've mentioned. They can also cause throbbing pain, usually on one side of your head.

    • Treatment typically involves medications to help reduce the frequency and severity of migraines. Lifestyle changes, such as regular sleep, hydration, and avoidance of migraine triggers, can also help.
  • Gastroesophageal Reflux Disease (GERD): This is a digestive disorder that occurs when acidic stomach juices, or food and fluids back up from the stomach into the esophagus. It can cause chest discomfort and difficulty burping.

    • Treatment typically involves lifestyle changes and over-the-counter medications. Avoiding certain foods and drinks that can trigger reflux, such as fatty or fried foods, tomato sauce, alcohol, chocolate, mint, garlic, onion, and caffeine, can help.

Please note that these are possibilities based on the information you've provided and not a definitive diagnosis.

What you can do

  1. Try to identify any triggers for your headaches, such as specific foods, activities, or situations, and avoid them if possible.
  2. Practice good posture, especially if you're doing activities that strain your neck or back.
  3. Stay hydrated and maintain a regular sleep schedule.
  4. Try over-the-counter pain relievers for your headaches, but don't exceed the recommended dosage unless instructed by a healthcare professional.
  5. For your difficulty burping and chest discomfort, try eating smaller, more frequent meals instead of three large ones. Avoid foods and drinks that can trigger reflux.
  6. Consult a healthcare professional for a proper diagnosis and treatment plan.

What you should look out for

Please seek immediate medical attention if you experience any of the following:

  • Severe headache that comes on suddenly
  • Headache accompanied by fever, stiff neck, confusion, seizure, double vision, weakness, numbness, or difficulty speaking
  • Headache after a head injury
  • Chronic, progressive headache that's accompanied by other unexplained symptoms
  • Difficulty breathing or severe chest pain

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, testing, and care recommendations.

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11 mo ago

People Also Ask


What are the common symptoms of tension headaches?

Common symptoms of tension headaches include a dull, aching sensation all over the head, a feeling of tightness or pressure across the forehead or on the sides and back of the head, and tenderness in the scalp, neck, and shoulder muscles.


How can I differentiate between a migraine and a tension headache?

Migraines are typically more severe than tension headaches and are often accompanied by throbbing pain on one side of the head, sensitivity to light and sound, nausea, and sometimes visual disturbances. Tension headaches usually involve a constant, dull pain and a feeling of pressure or tightness around the head.


What lifestyle changes can help manage GERD symptoms?

Lifestyle changes to manage GERD symptoms include eating smaller, more frequent meals, avoiding foods and drinks that trigger reflux (such as fatty foods, caffeine, and alcohol), not lying down immediately after eating, maintaining a healthy weight, and avoiding smoking.


When should I seek medical attention for a headache?

You should seek medical attention for a headache if it comes on suddenly and is severe, is accompanied by symptoms like fever, stiff neck, confusion, or difficulty speaking, occurs after a head injury, or is chronic and progressive with other unexplained symptoms.


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