[42F] Experiencing headache, eye twitching, and lower back pain

Patient Description

A 42-year-old female presents with a constant, sharp, 'crackly' headache located primarily in the forehead, rated 5/10 in intensity, which began yesterday. The headache is exacerbated by looking up or bending down. Additionally, the patient reports a few months' history of left eye twitching occurring 6-8 times daily. Lower back pain described as achy has been present for 5 days, also rated 5/10, and is somewhat relieved by a heating pad. The patient has recently discontinued Depo-Provera due to a prolonged menstrual cycle lasting nearly four months. She is currently taking over-the-counter ibuprofen 800mg. There is no history of chronic illness, known allergies, or adverse reactions to medications, and no recent injuries.

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Arora's Assessment

What might be happening

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

  • Tension Headache: This is a common type of headache characterized by a dull, aching sensation all over the head. It is often described as a feeling of a tight band or dull ache around the head or behind the eyes. These headaches are often related to stress, depression, or anxiety. Over-the-counter pain relievers such as ibuprofen can help, but it's important to manage stress and anxiety as well.

    • Treatment typically involves pain relievers, but also stress management techniques like meditation, relaxation exercises, physical therapy, and in some cases, antidepressants.
  • Eye Strain: Long hours focusing on an activity such as reading, driving, or using a computer or other digital device can lead to eye strain, which can cause your eye to twitch. It's usually not serious and should resolve on its own once you rest your eyes.

    • Treatment involves resting your eyes, adjusting the lighting or your screen, and if necessary, getting an eye exam to check for underlying conditions.
  • Musculoskeletal Back Pain: This is a common condition often caused by strain from lifting heavy objects, poor posture, or sitting in the same position for long periods. It's usually not serious and should improve with rest, heat, and over-the-counter pain relievers.

    • Treatment typically involves rest, heat, over-the-counter pain relievers, and physical therapy. In some cases, prescription medication or surgery may be required.

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

What you can do

  1. Rest and hydrate: Make sure you're getting enough sleep and staying hydrated. Dehydration and lack of sleep can both contribute to headaches and eye twitching.
  2. Manage stress: If you're feeling stressed or anxious, this could be contributing to your symptoms. Techniques such as deep breathing, yoga, and meditation can help manage stress levels.
  3. Over-the-counter pain relief: Continue taking over-the-counter pain relievers as needed for your headache and back pain.
  4. Eye care: If you spend a lot of time on screens, make sure to take regular breaks to rest your eyes. Adjusting the lighting and reducing glare can also help reduce eye strain.

What you should look out for

If your symptoms persist or worsen, it's important to seek medical attention. Specifically, you should contact a healthcare provider if:

  • Your headache intensifies or is accompanied by other symptoms such as fever, stiff neck, confusion, seizures, double vision, weakness, numbness, or difficulty speaking.
  • Your eye twitching continues for more than a week, affects other parts of your face, or is accompanied by redness, swelling, or discharge from the eye.
  • Your back pain persists for more than a week, is severe or doesn't improve with rest, or is accompanied by unexplained weight loss, bladder or bowel control problems, or fever.

Remember, while I strive to provide accurate and helpful information, I'm not a doctor and this advice should not replace a consultation with a healthcare provider.

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11 mo ago

People Also Ask


What are the common causes of tension headaches and how can they be managed?

Tension headaches are often caused by stress, anxiety, poor posture, or eye strain. They can be managed with over-the-counter pain relievers, stress management techniques like meditation and relaxation exercises, and ensuring proper posture and ergonomics.


Why might my eye be twitching frequently, and when should I be concerned?

Eye twitching, or myokymia, is often caused by stress, fatigue, caffeine, or eye strain. It is usually harmless and resolves on its own. However, if it persists for more than a week, affects other parts of the face, or is accompanied by redness or swelling, you should consult a healthcare provider.


What are some effective ways to relieve musculoskeletal back pain at home?

To relieve musculoskeletal back pain at home, you can use heat therapy with a heating pad, take over-the-counter pain relievers like ibuprofen, practice gentle stretching exercises, and ensure proper posture. Resting and avoiding activities that exacerbate the pain can also help.


How can discontinuing Depo-Provera affect my menstrual cycle?

Discontinuing Depo-Provera can lead to changes in your menstrual cycle, such as irregular periods or prolonged bleeding, as your body adjusts to the change in hormone levels. It may take some time for your cycle to normalize, and if you have concerns, it's best to consult with a healthcare provider.


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