[23F] With chronic daily headaches and associated symptoms

Patient Description

A 23-year-old female has been experiencing headaches almost every day for approximately four years. The pain is described as very sharp and consistent, located behind the temples on both sides. Touching above the temples exacerbates the pain. The headaches can last a few hours, and occasionally, they persist for most of the day. Sleep and marijuana sometimes provide relief, but Tylenol is not effective. The patient also experiences nausea and eye strain during headaches, with occasional sensitivity to light and sound and visual disturbances (seeing floating objects in peripheral vision). There are no associated symptoms of weakness, numbness, dizziness, or balance issues. The headaches developed gradually over time, with no identifiable triggers or patterns. The patient has not been evaluated by a healthcare professional for these headaches and has no history of head injuries or concussions. Past attempts to manage the headaches included Ibuprofen and BC powder. The patient has no known allergies or adverse reactions to medications and is not currently taking any medications. Additional medical history includes a past episode of passing out due to early pregnancy and occasional light-headedness when getting too hot or standing up too quickly.

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Arora's Assessment

What might be happening

Based on the information you have provided, here are some possible explanations for your headaches:

  • Tension Headaches: These are the most common type of headaches and are often described as a constant, dull ache on both sides of the head. They can be triggered by stress, poor posture, or muscle tension.

    • Treatment: Over-the-counter pain relievers like ibuprofen or acetaminophen can help. Stress management techniques, such as relaxation exercises, may also be beneficial.
  • Migraines: Migraines are characterized by severe, throbbing pain, often on one side of the head. They can be accompanied by nausea, sensitivity to light and sound, and visual disturbances like seeing spots or flashing lights.

    • Treatment: Prescription medications are often required to manage migraines. Lifestyle changes, such as avoiding known triggers and maintaining a regular sleep schedule, can also help.
  • Cluster Headaches: These are less common but very severe headaches that occur in cyclical patterns or clusters. They are often described as sharp, burning pain around one eye or temple.

    • Treatment: Prescription medications and oxygen therapy are commonly used to treat cluster headaches.
  • Chronic Daily Headaches: Given that your headaches occur almost daily, this could be a form of chronic daily headache. These can be due to a variety of underlying conditions, including tension-type headaches and migraines.

    • Treatment: A healthcare provider can help determine the underlying cause and recommend appropriate treatment, which may include medications and lifestyle changes.

What you can do

While it's important to consult a healthcare professional for a formal diagnosis and treatment plan, here are some steps you can take to manage your symptoms:

  1. Keep a Headache Diary: Track your headaches, including their frequency, duration, and any potential triggers. This can help you and your healthcare provider identify patterns and develop a treatment plan. You can use MDandMe to journal your symptoms, track progress, get insights, and share longitudinal medical notes with your provider.

  2. Stay Hydrated: Dehydration can trigger headaches, so make sure you're drinking enough water throughout the day.

  3. Maintain a Regular Sleep Schedule: Poor sleep can contribute to headaches. Aim for 7-9 hours of sleep per night and try to go to bed and wake up at the same time every day.

  4. Manage Stress: Stress is a common headache trigger. Practice relaxation techniques such as deep breathing, meditation, or yoga.

  5. Limit Caffeine and Alcohol: Both caffeine and alcohol can trigger headaches in some people. Try to limit your intake and see if it makes a difference.

  6. Over-the-Counter Pain Relievers: Medications like ibuprofen or acetaminophen can provide relief for some types of headaches. However, be cautious about overuse, as this can lead to rebound headaches.

What you should look out for

Seek medical attention if you experience any of the following:

  • Sudden, Severe Headache: A headache that comes on suddenly and is extremely painful could be a sign of a more serious condition, such as a stroke or aneurysm.
  • Neurological Symptoms: If you experience weakness, numbness, difficulty speaking, or vision changes, seek immediate medical attention.
  • Persistent or Worsening Headaches: If your headaches are becoming more frequent or severe, it's important to consult a healthcare provider.
  • Headache with Fever or Stiff Neck: These symptoms could indicate an infection, such as meningitis, and require prompt medical evaluation.

Remember, while this information can help you understand your symptoms, it's important to consult a healthcare professional for a formal diagnosis and treatment plan.

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4 mo ago


People Also Ask


What are the common symptoms of tension headaches?

Tension headaches are often described as a constant, dull ache on both sides of the head. They can be triggered by stress, poor posture, or muscle tension, and may be accompanied by tenderness in the scalp, neck, and shoulder muscles.


How can migraines be distinguished from other types of headaches?

Migraines are typically characterized by severe, throbbing pain, often on one side of the head. They can be accompanied by nausea, sensitivity to light and sound, and visual disturbances such as seeing spots or flashing lights.


What lifestyle changes can help manage chronic daily headaches?

Lifestyle changes that can help manage chronic daily headaches include maintaining a regular sleep schedule, staying hydrated, managing stress through relaxation techniques, and limiting caffeine and alcohol intake.


When should someone seek medical attention for headaches?

Medical attention should be sought for headaches that are sudden and severe, accompanied by neurological symptoms like weakness or numbness, persistent or worsening over time, or associated with fever or a stiff neck.


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