[44F] Experiencing dizziness, headache, and back pain

Patient Description

A 44-year-old female presents with a 6-month history of lightheadedness, particularly upon standing and bending over, which is most severe in the mornings and rated 5/10 in severity. She also reports a throbbing headache at the front of her head, rated 6/10, lasting for 3 months, and middle back pain described as an electric shock, rated 4/10, which began after falling down the stairs. Additionally, she experiences a burning sensation in her upper abdomen, rated 7/10 in severity, which has been present for 6 months. The patient has noted an increased heart rate, chest tightness, and chills but no loss of consciousness. Her bowel movements this morning were pale and clumpy. She has an allergy to Flagyl but is not currently on any medications and has no known pre-existing conditions or chronic illnesses.

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Arora's Assessment

What might be happening

Based on the information you provided, the following conditions might be considered:

  • Orthostatic Hypotension: This is a form of low blood pressure that happens when you stand up from sitting or lying down. It can make you feel dizzy or lightheaded, and maybe even faint. The fact that your dizziness occurs immediately upon standing supports this possibility.

  • Tension Headaches: These are the most common type of headache, often described as a throbbing pain at the front of the head. They can be triggered by stress, anxiety, poor posture, or skipping meals.

  • Gastritis or Peptic Ulcer Disease: These conditions can cause a burning pain in your upper abdomen. They are often caused by an infection or long-term use of pain relievers.

  • Back Pain due to Injury: As you mentioned falling down the stairs, it's possible that your back pain is a result of an injury from the fall.

Please note that these are only possibilities based on the information you provided. It's important to consult with a healthcare provider for an accurate diagnosis.

What you can do

  1. For your dizziness, try to stand up slowly from a sitting or lying position. This might help reduce the lightheadedness.

  2. Over-the-counter pain relievers can help manage your headache, but they should be used sparingly. Regular physical activity, adequate sleep, and managing stress can also help prevent tension headaches.

  3. For your upper abdominal pain, avoid foods that irritate your stomach, such as spicy, fatty, or fried foods. Also, try to eat smaller, more frequent meals instead of three large meals a day.

  4. Rest and apply a hot or cold pack to your back to help with the pain. Avoid heavy lifting and activities that might worsen your back pain.

What you should look out for

You should seek immediate medical attention if:

  • Your dizziness or lightheadedness gets worse or leads to fainting
  • Your headache is severe and doesn't improve with rest or over-the-counter pain relievers
  • Your abdominal pain is severe, lasts for more than a week, or is accompanied by unexplained weight loss
  • Your back pain is severe, doesn't improve with rest, or is accompanied by other worrying symptoms like fever or unexplained weight loss

Remember, it's important to consult with a healthcare provider for an accurate diagnosis and treatment.

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11 mo ago

People Also Ask


What causes orthostatic hypotension and how can it be managed?

Orthostatic hypotension is caused by a sudden drop in blood pressure when standing up, which can be due to dehydration, prolonged bed rest, or certain medications. It can be managed by standing up slowly, staying hydrated, and wearing compression stockings if recommended by a doctor.


What are the common triggers for tension headaches and how can they be alleviated?

Tension headaches are often triggered by stress, anxiety, poor posture, or skipping meals. They can be alleviated by managing stress, maintaining good posture, getting regular exercise, and ensuring adequate sleep. Over-the-counter pain relievers can also help, but should be used sparingly.


What are the symptoms and causes of gastritis or peptic ulcer disease?

Gastritis or peptic ulcer disease can cause symptoms like burning pain in the upper abdomen, bloating, and nausea. They are often caused by an infection with H. pylori bacteria or long-term use of NSAIDs. Avoiding irritant foods and eating smaller, more frequent meals can help manage symptoms.


How can back pain from an injury be treated at home?

Back pain from an injury can be treated at home by resting, applying hot or cold packs, and avoiding heavy lifting. Gentle stretching and over-the-counter pain relievers may also help, but it's important to avoid activities that worsen the pain.


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