[20F] Experiencing chronic frontal headaches

Patient Description

A 20-year-old female has been experiencing chronic headaches for several months, occurring predominantly in the afternoon, approximately five days a week. The headaches are described as dull with a slight throbbing sensation when the head is 'upside down.' The current headache intensity is rated as a 2 out of 10. The patient finds relief from these headaches through rest, chiropractic visits, icing the back, and meditation. There is no reported sensitivity to light or sound, neck stiffness, scalp tenderness, nausea, or visual disturbances, but there is difficulty focusing during episodes. The patient has not sustained any head injuries or concussions and does not regularly take medications for headaches. The patient is currently menstruating and takes Vienva (0.1mg/0.02mg) for birth control, although adherence to the medication is inconsistent. There are no known allergies, no other medications being taken, and no past medical history of chronic illnesses or conditions.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are a few possibilities:

  • Tension Headaches: These are the most common type of headache and they can be related to stress, depression, or anxiety. Over-the-counter pain relievers, rest, and stress management can often help.

    • Treatment typically involves over-the-counter pain relievers, rest, and stress management.
  • Migraines: Although your symptoms don't perfectly align with typical migraines, they can cause throbbing pain and can last from hours to days. Symptoms can be triggered by certain activities, foods, or hormonal changes.

    • Treatment often involves medications to relieve symptoms and prevent future attacks, as well as lifestyle changes to avoid triggers.
  • Medication Overuse Headaches: If you frequently use headache medication, you could get a headache each day if you stop taking it. However, you've mentioned that you're not taking any medications regularly for your headaches.

  • Hormonal changes: Given your age and gender, it's possible that hormonal changes related to your menstrual cycle could be contributing to your headaches. However, you've mentioned that your headaches are not related to your period.

What you can do

  • Keep a headache diary: This can help you identify triggers for your headaches so you can avoid them. Include details about when your headaches occur, how long they last, and anything that provides relief.

  • Maintain a healthy lifestyle: Regular physical activity, a healthy diet, staying hydrated, and getting enough sleep can help reduce the frequency and severity of your headaches.

  • Manage stress: Techniques such as relaxation exercises, meditation, and yoga may help.

  • Consult a healthcare provider: If your headaches continue to bother you, it's important to consult a healthcare provider. They can provide a formal diagnosis and discuss treatment options with you.

What you should look out for

  • If your headache is severe and sudden, seek immediate medical attention.
  • If your headache is accompanied by a fever, stiff neck, mental confusion, seizures, double vision, weakness, numbness, or difficulty speaking, seek immediate medical attention.
  • If your headache gets worse over days or weeks or it's unlike any you've had before, consult a healthcare provider.

Please remember that while I strive to provide accurate and helpful health information, this advice is intended to be general in nature. You should seek care from a healthcare provider to obtain a formal diagnosis and treatment.

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11 mo ago

People Also Ask


What are tension headaches and how can they be managed?

Tension headaches are the most common type of headache, often related to stress, anxiety, or depression. They are typically characterized by a dull, aching sensation all over the head. Management includes over-the-counter pain relievers, rest, and stress management techniques such as relaxation exercises and meditation.


Can hormonal changes related to birth control affect headache patterns?

Yes, hormonal changes, including those related to birth control, can affect headache patterns. Some women experience headaches due to fluctuations in hormone levels, especially around their menstrual cycle. It's important to monitor any changes in headache patterns when starting or changing birth control methods.


What lifestyle changes can help reduce the frequency of headaches?

Lifestyle changes that can help reduce the frequency of headaches include maintaining regular physical activity, eating a balanced diet, staying hydrated, getting enough sleep, and managing stress through techniques like yoga and meditation.


When should someone seek medical attention for headaches?

Medical attention should be sought if a headache is severe and sudden, or if it is accompanied by symptoms such as fever, stiff neck, mental confusion, seizures, double vision, weakness, numbness, or difficulty speaking. Additionally, if a headache worsens over days or weeks or is unlike any experienced before, consulting a healthcare provider is recommended.


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