[26F] Experiencing headaches with neck and shoulder pain

Patient Description

A 26-year-old female has been experiencing aching headaches for the past two months, primarily occurring at night and around early afternoon. The headaches sometimes radiate to the neck and shoulder, causing dull pain but are relieved by Panadol. Additionally, the patient reports intermittent feverish episodes lasting about 30 minutes every 2 to 3 days. There is no history of recent injury, changes in vision, balance, or coordination, and no known allergies or adverse reactions to medications. The patient consumes alcohol once a month, not more than four beers per occasion, and has a birth control implant. No other medications or pre-existing conditions have been reported.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible explanations for your symptoms include:

  • Tension Headache: This is the most common type of headache and can be caused by stress, anxiety, lack of sleep, or skipping meals. The pain is often described as a dull ache, and it can affect the front, top, or sides of the head. Some people also experience shoulder or neck pain with tension headaches.

    • Treatment typically involves over-the-counter pain relievers like ibuprofen or acetaminophen (Panadol). Lifestyle modifications such as regular exercise, adequate sleep, and stress management can also help.
  • Migraine: This is a type of headache characterized by severe, throbbing pain usually on one side of the head. It can be accompanied by other symptoms like sensitivity to light and sound, nausea, and vomiting. Some people also experience neck stiffness or pain.

    • Treatment involves medications to relieve symptoms and prevent future attacks. Lifestyle changes like avoiding triggers, regular exercise, and adequate sleep can also help.
  • Fever of Unknown Origin: This refers to a persistent fever that cannot be explained after initial medical evaluation. It can be caused by a variety of conditions, including infections, cancers, and autoimmune diseases.

    • Treatment depends on the underlying cause, which can be determined through further testing.

Please note that these are possibilities based on the information you've provided, and they may not be the actual cause of your symptoms. It's important to consult a healthcare provider for a proper diagnosis and treatment.

What you can do

  1. Continue taking over-the-counter pain relievers as needed for your headaches. However, be careful not to exceed the recommended dosage as this can lead to other health problems.
  2. Try to identify any potential triggers for your headaches and avoid them if possible. This could include certain foods, lack of sleep, or stress.
  3. Stay hydrated and eat a balanced diet. This can help improve your overall health and may also help reduce your headaches.
  4. Monitor your temperature regularly. If your fever persists or gets worse, seek medical attention immediately.

What you should look out for

Seek immediate medical attention if you experience any of the following:

  • Severe headache that comes on suddenly
  • Headache accompanied by a stiff neck, fever, confusion, seizures, double vision, weakness, numbness, or difficulty speaking
  • Persistent fever that doesn't improve with over-the-counter medications
  • Any new or worsening symptoms

Remember, it's important to consult a healthcare provider for a proper diagnosis and treatment. This information is intended to be educational and should not be used as a substitute for professional medical advice.

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9 mo ago


People Also Ask


What are the common causes of tension headaches?

Tension headaches are often caused by stress, anxiety, lack of sleep, or skipping meals. They can also be triggered by poor posture or eye strain.


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

Tension headaches typically present as a dull, aching pain around the head, often with neck and shoulder discomfort. Migraines, on the other hand, are usually characterized by severe, throbbing pain on one side of the head, often accompanied by nausea, vomiting, and sensitivity to light and sound.


What should I do if my fever persists despite taking medication?

If your fever persists despite taking medication, it's important to consult a healthcare provider. Persistent fever could indicate an underlying condition that requires further investigation and treatment.


Can birth control implants cause headaches or fever?

While headaches are a reported side effect of hormonal birth control, including implants, fever is not commonly associated. If you suspect your birth control is causing symptoms, discuss this with your healthcare provider.

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