[34M] With constant head and neck pain, double vision, and weakness

Patient Description

A 34-year-old male reports experiencing constant pressure at the top of the head and neck, with restricted movement of the head, for the past 7 weeks. The pain is described as both sharp and dull, with an intensity rated at 9 out of 10 for the head and 10 out of 10 for the neck. The patient notes that the pressure is exacerbated by sleeping and has not found any relief. Additionally, the patient has experienced double vision and weakness. There is no history of injuries or accidents that might have caused these symptoms.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are some possible explanations:

1. Cervicogenic Headache

  • Rationale: Cervicogenic headaches are often caused by issues in the neck and can present as a constant pressure at the base of the skull, along with restricted head movement. The pain can be sharp or dull and may worsen with certain activities, such as sleeping.
  • Typical Treatments: Treatment often includes physical therapy, medications like NSAIDs for pain relief, and sometimes nerve blocks or other interventional procedures.

2. Tension-Type Headache

  • Rationale: Tension-type headaches can cause a constant pressure sensation and are often associated with muscle stiffness in the neck and shoulders. They can be triggered by stress, poor posture, or prolonged periods of sitting.
  • Typical Treatments: Over-the-counter pain relievers, stress management techniques, and physical therapy can be helpful.

3. Neurological Issues

  • Rationale: Given the severity of your symptoms (intensity of 9/10, double vision, and weakness), a neurological issue such as a pinched nerve, cervical spine disorder, or even more serious conditions like a brain tumor or aneurysm should be considered.
  • Typical Treatments: Immediate medical evaluation is crucial. This may involve imaging studies like MRI or CT scans, and consultation with a neurologist.

What you can do

For Head and Neck Pain:

  1. Seek Immediate Medical Attention: Given the severity of your symptoms and the presence of double vision and weakness, it's important to see a healthcare provider as soon as possible. These could be signs of a serious condition that needs prompt evaluation.
  2. Pain Management: While waiting for your appointment, you can try over-the-counter pain relievers like ibuprofen or acetaminophen, but do not exceed the recommended dosage.
  3. Physical Therapy: Gentle neck exercises and stretches may help alleviate some of the stiffness. However, avoid any movements that exacerbate your pain.
  4. Posture: Maintain good posture, especially if you spend long periods sitting. Use ergonomic chairs and take frequent breaks to move around.

For Double Vision and Weakness:

  1. Immediate Evaluation: These symptoms are concerning and warrant immediate medical evaluation. They could indicate a neurological issue that needs urgent attention.
  2. Avoid Driving: Double vision can impair your ability to drive safely. Arrange for someone to take you to your medical appointments.

What you should look out for

Given the severity of your symptoms, you should seek medical care as soon as possible. Reasons to seek care even more urgently include:

  • Sudden, severe headache that feels like the worst headache of your life
  • Fainting or loss of consciousness
  • Sudden weakness or numbness, especially on one side of the body
  • Difficulty speaking or understanding speech
  • Severe neck stiffness or pain that doesn't improve with over-the-counter medications

Remember, while I can provide information based on your symptoms, it's crucial to consult a healthcare professional for a formal diagnosis and appropriate treatment. You can also use MDandMe to journal your symptoms, track your progress, get insights, and share your medical notes with your provider.

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4 mo ago


People Also Ask


What are cervicogenic headaches and how are they treated?

Cervicogenic headaches are headaches that originate from issues in the neck. They can cause constant pressure at the base of the skull and restricted head movement. Treatment often includes physical therapy, pain relief medications like NSAIDs, and sometimes nerve blocks or other interventional procedures.


What could cause double vision and weakness along with head and neck pain?

Double vision and weakness, along with severe head and neck pain, could indicate a neurological issue such as a pinched nerve, cervical spine disorder, or more serious conditions like a brain tumor or aneurysm. Immediate medical evaluation is crucial to determine the cause and appropriate treatment.


How can tension-type headaches be managed effectively?

Tension-type headaches can be managed with over-the-counter pain relievers, stress management techniques, and physical therapy. Improving posture and taking breaks from prolonged sitting can also help alleviate symptoms.


When should I seek immediate medical attention for head and neck pain?

You should seek immediate medical attention for head and neck pain if you experience symptoms like a sudden, severe headache, fainting, sudden weakness or numbness, difficulty speaking, or severe neck stiffness that doesn't improve with over-the-counter medications.

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