[22F] Experiencing headaches, back pain, and gastrointestinal symptoms

Patient Description

A 22-year-old female has been experiencing a consistent pressure headache around the side of the temple rated 5/10 for severity, worsening with stress and anxiety, and managed with Tylenol and ibuprofen. She has also been having sharp upper back spasms rated 8/10 for severity, particularly worse at night. Additionally, she reports blurry vision at times, weakness in her legs, and has been experiencing upper stomach pain/spasms, nausea, bloating, and constipation for a week, with any food intake worsening the bloating. She has been taking Fluoxetine 20mg since January and uses over-the-counter Gas-X for bloating. There is no recent history of injury, fever, chills, or significant weight changes, and no family history of migraines, headaches, or gastrointestinal disorders.

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Arora's Assessment

What might be happening

Based on the information you've provided, you may be experiencing:

  • Tension Headache: These headaches are often described as a constant pressure or aching around the head, particularly at the temples or back of the head. They can be triggered by stress and anxiety, which you've mentioned. Over-the-counter pain relievers such as Tylenol or ibuprofen are often effective in relieving tension headaches.

    • Treatment typically involves pain relievers and stress management techniques.
  • Gastrointestinal Distress: Your symptoms of upper stomach pain, bloating, and constipation could be due to a variety of conditions, such as Irritable Bowel Syndrome (IBS), Gastritis, or Peptic Ulcer Disease. These conditions can cause discomfort, bloating, and changes in bowel habits.

    • Treatment often involves dietary changes, stress management, and sometimes medication.
  • Musculoskeletal Back Pain: This is a common cause of back pain and can result from strain, overuse, or underlying structural issues. The fact that your pain is worse at night and described as sharp could suggest a musculoskeletal origin.

    • Treatment typically involves rest, physical therapy, and pain management.

Please note that these are potential explanations based on the symptoms you've described, but they are not definitive. It's important to consult with a healthcare provider for an accurate diagnosis.

What you can do

  1. Continue taking your prescribed and over-the-counter medications as directed by your healthcare provider.
  2. Try to identify and manage sources of stress and anxiety, as these can contribute to tension headaches and gastrointestinal distress.
  3. Consider incorporating gentle exercises like stretching or yoga into your routine to help alleviate back pain.
  4. Keep a food diary to track what you eat and how it correlates with your gastrointestinal symptoms. This could help identify potential food triggers.
  5. Stay hydrated and try to consume a balanced diet rich in fiber to help with constipation.

What you should look out for

Seek immediate medical attention if you experience:

  • Severe headache that comes on suddenly
  • Headache accompanied by fever, stiff neck, confusion, seizure, double vision, weakness, numbness, or difficulty speaking
  • Severe abdominal pain
  • Bloody or black stools
  • Unintentional weight loss
  • Back pain that is severe, doesn't improve with rest, or is associated with bladder or bowel control issues

Remember, while I strive to provide accurate information, I'm not a doctor. Always consult with a healthcare provider for a formal diagnosis and treatment.

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10 mo ago

People Also Ask


What are tension headaches and how can they be managed?

Tension headaches are often described as a constant pressure or aching around the head, particularly at the temples or back of the head. They can be triggered by stress and anxiety. Management typically involves over-the-counter pain relievers like Tylenol or ibuprofen and stress management techniques.


What could be causing my gastrointestinal symptoms like bloating and constipation?

Your gastrointestinal symptoms could be due to conditions like Irritable Bowel Syndrome (IBS), Gastritis, or Peptic Ulcer Disease. These conditions can cause discomfort, bloating, and changes in bowel habits. Treatment often involves dietary changes, stress management, and sometimes medication.


How can I alleviate sharp upper back spasms that worsen at night?

Sharp upper back spasms can be due to musculoskeletal issues, such as strain or overuse. To alleviate them, consider rest, physical therapy, and pain management strategies. Gentle exercises like stretching or yoga may also help.


What should I do if my symptoms suddenly worsen or new symptoms appear?

If your symptoms suddenly worsen or you experience new symptoms such as severe headache, severe abdominal pain, or back pain associated with bladder or bowel control issues, seek immediate medical attention. These could be signs of a more serious condition.


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