[25F] Experiencing headaches, neck aches, and nausea

Patient Description

A 25-year-old female has been experiencing aching headaches on the right side of her head extending down her neck, with an intensity of 3 out of 10, occurring off and on for about a month, usually in the afternoons. The frequency of these headaches has increased over time. Additionally, she reports a daily dull neck ache with the same intensity level for a few months, which sometimes feels a little better when moving her neck. She also experiences nausea but has not identified specific triggers for her symptoms. She has a history of anxiety and depression diagnosed in 2016 and is currently taking Lexapro and a multivitamin. She has no known allergies or adverse reactions to medications.

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Arora's Assessment

What might be happening

Based on your symptoms, here are a few possibilities:

  • Tension Headaches: These are often associated with a dull, aching sensation all over your head. It's also common to feel tenderness or sensitivity around your neck, forehead, scalp, or shoulder muscles. Tension headaches are often caused by stress, lack of sleep, or holding your head in a certain way for a long time.

    • Treatment usually involves over-the-counter pain relievers, stress management, and lifestyle changes.
  • Migraines: These are severe headaches that can cause throbbing pain on one side of your head. They can also cause nausea and sensitivity to light and sound, although you mentioned you don't really experience these. Migraines can be triggered by many factors, including stress, certain foods, or changes in sleep pattern.

    • Treatment often involves a combination of medications and lifestyle changes to help manage your symptoms and prevent further attacks.
  • Cervicogenic Headache: This is a secondary headache, meaning it's caused by another illness or physical issue. In the case of cervicogenic headache, the cause is a disorder of the cervical spine and its component bony, disc and/or soft tissue elements. The pain is perceived in the head from a source in the neck.

    • Treatment typically involves physical therapy, nerve blocks, and sometimes surgery.

Please note that while these are possible causes, they are not the only ones. It's important to consult with a healthcare provider for an accurate diagnosis.

What you can do

Here are some general suggestions that might help:

  1. Over-the-counter pain relievers: Non-prescription medications such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin IB) often help relieve tension headaches.
  2. Rest and relaxation: Make sure you're getting enough sleep each night and try to manage stress. Relaxation techniques such as yoga, meditation, or deep breathing can help.
  3. Regular exercise: Physical activity can help reduce the frequency and intensity of headaches and migraines.
  4. Stay hydrated: Dehydration can cause headaches. Make sure you're drinking enough water each day.
  5. Maintain good posture: Poor posture can cause neck strain and trigger headaches.

What you should look out for

Please seek immediate medical attention if you experience:

  • A sudden, severe headache that's different from past headaches.
  • Headache with 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, I'm an AI and this advice is based on the symptoms you've told me. It's important to consult with a healthcare provider for an accurate diagnosis and treatment.

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10 mo ago

People Also Ask


What are the common causes of tension headaches?

Tension headaches are often caused by stress, lack of sleep, poor posture, or holding your head in a certain position for a long time. They can also be triggered by eye strain, fatigue, or emotional stress.


How can anxiety and depression affect headache symptoms?

Anxiety and depression can exacerbate headache symptoms by increasing muscle tension and stress levels, which can lead to more frequent or severe headaches. Managing these mental health conditions can help reduce headache frequency and intensity.


What lifestyle changes can help manage cervicogenic headaches?

Lifestyle changes that can help manage cervicogenic headaches include maintaining good posture, engaging in regular physical activity, practicing stress management techniques, and ensuring proper ergonomics at work. Physical therapy and exercises to strengthen neck muscles can also be beneficial.


When should I seek medical attention for a headache?

You should seek medical attention for a headache if it is sudden and severe, different from past headaches, accompanied by symptoms like fever, stiff neck, confusion, or seizures, 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 have new headache pain, it's important to consult a healthcare provider.


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