[22F] Experiencing constant migraines and tension headaches

Patient Description

A 22-year-old female reports suffering from constant migraines and tension headaches for the past three months. The migraines are described as being primarily behind the eyes, particularly the right eye, and are accompanied by blurred vision and shooting pains on the right side of the head. The patient notes a sensation similar to sinus pressure, despite the absence of congestion. Symptoms tend to worsen at night, when lying down or leaning over, with pain severity reaching up to 8 out of 10. Light exacerbates the pain, bringing it to a 7 out of 10. While sleep seems to provide some relief, water and ibuprofen have not been effective. This is the first year the patient has experienced headaches, which typically start in the afternoon and progressively worsen. No specific triggers have been identified, and there is no mention of any other medical conditions or medications.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible diagnoses include:

  • Migraines: These are a type of headache characterized by severe pain that can be preceded or accompanied by sensory warning signs such as flashes of light, blind spots, tingling in the arms and legs, nausea, vomiting, and increased sensitivity to light and sound. The excruciating pain that migraines bring can last for hours or even days.

    • Treatment typically involves pain relieving and preventive medications.
  • Cluster headaches: These are severe headaches that occur in patterns or clusters, and are one of the most painful types of headache. They often occur on one side of the head and around the eyes.

    • Treatment involves fast-acting pain relievers, preventive medications, and in some cases nerve blocks.
  • Sinus headaches: Despite your lack of congestion, it's possible that sinus inflammation is causing your symptoms. These headaches usually come with a fever, stuffy nose, cough, congestion, or facial pressure around the forehead or cheeks.

    • Treatment typically involves addressing the underlying cause, such as bacterial or fungal infection.
  • Tension headaches: These are the most common type of headache, and they cause a constant ache or pressure around the head, temples, or back of the head and neck. They're often described as a tight band around the head.

    • Treatment typically involves pain relievers, stress management, and physical therapy.

What you can do

It's important to consult a healthcare provider about your symptoms so they can provide a formal assessment and order relevant tests if necessary. In the meantime, you can try the following to manage your symptoms:

  1. Maintain a regular sleep schedule: Go to bed and wake up at the same time every day, even on weekends.
  2. Stay hydrated: Drink plenty of water throughout the day.
  3. Limit alcohol: Alcohol can trigger migraines in some people, so it's best to avoid it if you're prone to migraines.
  4. Avoid known triggers: If certain foods or odors seem to have triggered your migraines in the past, avoid them.
  5. Regular physical activity: Regular aerobic exercise reduces tension and can help prevent migraines. If your doctor agrees, choose any aerobic exercise you enjoy, including walking, swimming and cycling. Warm up slowly, however, because sudden, intense exercise can cause headaches.

What you should look out for

You should seek immediate medical attention if you experience:

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

Remember, I'm an AI and this advice is not a substitute for professional medical advice. Please consult with a healthcare provider.

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10 mo ago

People Also Ask


What are the common symptoms of migraines and how can they be managed?

Migraines are characterized by severe, throbbing pain often on one side of the head, and can be accompanied by nausea, vomiting, and sensitivity to light and sound. Management includes pain-relieving medications, preventive treatments, and lifestyle changes such as maintaining a regular sleep schedule and avoiding known triggers.


How do cluster headaches differ from other types of headaches?

Cluster headaches are extremely painful and occur in cyclical patterns or clusters. They typically cause intense pain around one eye or one side of the head and can be accompanied by redness, swelling, and nasal congestion. They differ from other headaches in their severity and pattern of occurrence.


Can sinus issues cause headaches even without congestion?

Yes, sinus issues can cause headaches due to inflammation or pressure in the sinus cavities, even if there is no nasal congestion. This can result in a sensation of pressure or pain around the forehead, eyes, and cheeks.


What lifestyle changes can help prevent tension headaches?

Lifestyle changes that can help prevent tension headaches include maintaining a regular sleep schedule, staying hydrated, managing stress through relaxation techniques, and engaging in regular physical activity. Avoiding alcohol and known headache triggers can also be beneficial.


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