[21M] Experiencing persistent headaches with occasional eye pain

Patient Description

A 21-year-old male has been experiencing persistent, non-severe headaches for 2 months, predominantly on the right side but occasionally on the left. The headaches are described as throbbing and aching, and they worsen when lying down. The patient finds temporary relief with ibuprofen. Eye pain, rated 2 out of 10 in severity, accompanies the headaches. The patient has tried Excedrin in addition to ibuprofen, Tylenol (325mg), and Motrin (200mg), which are taken throughout the week as needed. There is no history of similar headaches in the family, no recent eye injuries, no changes in vision, no nausea or sensitivity to light, and no known allergies or adverse reactions to medications. There is no significant past medical history, and the patient has consumed alcohol approximately three times in recent months.

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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 can be caused by stress, lack of sleep, or certain activities. They often feel like a dull, aching sensation all over your head, and can also cause tenderness in your scalp, neck, and shoulder muscles. Over-the-counter pain relievers such as ibuprofen (Motrin) and acetaminophen (Tylenol) are commonly used to treat tension headaches.

  • Migraines: These are severe headaches that can cause throbbing pain usually on one side of the head. They can last for hours to days, and can be accompanied by sensitivity to light and sound, nausea, and vomiting. However, you've mentioned that you don't experience sensitivity to light or nausea, which are common symptoms of migraines.

  • Cluster Headaches: These are extremely painful headaches that occur in clusters or cycles. They are usually felt on one side of the head and can cause pain around the eye. However, cluster headaches are relatively rare and the pain is usually more severe than what you've described.

  • Sinus Headaches: Since you've mentioned experiencing nasal congestion, it's possible that your headaches could be related to a sinus issue. These headaches usually cause a constant, throbbing pain in the front of your head and face. They are usually accompanied by other sinus symptoms like a runny nose or facial swelling.

Please note that while these are possible causes, only a healthcare professional can provide a definitive diagnosis.

What you can do

Here are some general suggestions that might help:

  1. Maintain a regular sleep schedule: Try to go to bed and wake up at the same time every day, even on weekends. Lack of sleep or too much sleep can trigger headaches in some people.

  2. Stay hydrated: Dehydration can cause headaches. Make sure you're drinking enough fluids throughout the day.

  3. Limit alcohol and caffeine: Both alcohol and caffeine can trigger headaches in some people. Try to limit your intake and see if your symptoms improve.

  4. Manage stress: High levels of stress can trigger headaches. Techniques such as meditation, deep breathing, and yoga might help reduce your stress levels.

  5. Over-the-counter pain relievers: Continue taking ibuprofen (Motrin) or acetaminophen (Tylenol) as needed for pain relief. However, be careful not to overuse these medications, as that can lead to medication-overuse headaches.

What you should look out for

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

  • A sudden, severe headache like a thunderclap
  • Headache with a fever, stiff neck, mental confusion, seizures, double vision, weakness, numbness, or speaking difficulties
  • Headache after a head injury, especially if the headache gets worse
  • A chronic headache that is worse after coughing, exertion, straining, or a sudden movement
  • New headache pain if you're over 50

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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10 mo ago

People Also Ask


What are the common causes of persistent headaches in young adults?

Common causes of persistent headaches in young adults include tension headaches, migraines, sinus issues, and sometimes stress or dehydration. It's important to consider lifestyle factors such as sleep patterns, stress levels, and hydration.


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

Tension headaches typically present as a dull, aching sensation all over the head, often with tenderness in the neck and shoulders. Migraines usually cause throbbing pain on one side of the head and may be accompanied by nausea, and sensitivity to light and sound, although these symptoms can vary.


What lifestyle changes can help reduce the frequency of headaches?

Lifestyle changes that can help reduce headache frequency include maintaining a regular sleep schedule, staying hydrated, managing stress through techniques like meditation or yoga, and limiting alcohol and caffeine intake.


When should I seek medical attention for a headache?

You should seek medical attention for a headache if it is sudden and severe, accompanied by symptoms like fever, stiff neck, confusion, or if it occurs after a head injury. Also, if you experience a chronic headache that worsens with physical activity or if you are over 50 and experiencing new headache pain.


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