[44F] With a week-long headache and dizziness

Patient Description

A 44-year-old female has been experiencing an aching headache on both sides of her head for about a week, with an intensity of 6 out of 10. The headache came on suddenly and is associated with recent changes in eating and sleeping habits, as well as stress, depression, and anxiety. Despite efforts to manage these factors, there has been no improvement. The patient also reports occasional dizziness but denies any visual disturbances, weakness or numbness in the limbs, difficulty speaking or understanding speech, or recent head injury. Over-the-counter medications like aspirin, ibuprofen, and Tylenol have not been effective. The patient consumes caffeine and alcohol occasionally without noticing any correlation with the headaches. She is currently menstruating and has no family history of headaches or migraines. Her medical history includes cervical spondylosis, disc degeneration disease, and arthritis in the shoulders, diagnosed five years ago. She is taking 10 mg of amlodipine, 800 mg of ibuprofen, and 0.50 mg of clonazepam once a day, with no known drug allergies.

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Arora's Assessment

What might be happening

Based on the information you have provided, here are some possible explanations for your headache:

  • Tension-Type Headache: This is a common type of headache characterized by a dull, aching pain that affects the entire head. It can be associated with stress, anxiety, and changes in sleep or eating habits.

    • Treatment: Over-the-counter pain relievers like ibuprofen or acetaminophen can help. Stress management techniques, such as relaxation exercises, may also be beneficial.
  • Cervicogenic Headache: Given your history of cervical spondylosis and disc degeneration, it's possible that your headache is originating from issues in your neck. This type of headache can cause pain that radiates from the neck to the head.

    • Treatment: Physical therapy, neck exercises, and medications to manage pain and inflammation can be helpful. Consulting with a healthcare provider for a tailored treatment plan is recommended.
  • Medication Overuse Headache: Frequent use of pain relievers like ibuprofen can sometimes lead to rebound headaches.

    • Treatment: Reducing the use of over-the-counter pain medications and consulting a healthcare provider for alternative treatments can help.

What you can do

While it's important to consult a healthcare professional for a formal diagnosis and treatment plan, here are some steps you can take to manage your symptoms:

  1. Hydration: Ensure you are drinking enough water, as dehydration can contribute to headaches.
  2. Rest: Try to get adequate sleep and rest, as fatigue can exacerbate headaches.
  3. Over-the-counter pain relievers: Medications like ibuprofen or acetaminophen can help alleviate the pain. Be sure to follow the recommended dosage instructions.
  4. Stress Management: Practice relaxation techniques such as deep breathing, meditation, or gentle stretching to manage stress.
  5. Neck Exercises: Gentle neck stretches and exercises may help if your headache is related to cervical issues.
  6. Monitor Your Symptoms: Keep a headache diary to track the frequency, duration, and intensity of your headaches, as well as any potential triggers or patterns. You can use MDandMe to journal your symptoms, track progress, get insights, and share longitudinal medical notes with your provider.

What you should look out for

Reasons to see a doctor more urgently include:

  • If your headache persists or worsens despite trying the above measures
  • If you develop new symptoms such as visual disturbances, weakness or numbness in your arms or legs, difficulty speaking, or severe dizziness
  • If you experience a sudden, severe headache unlike any you've had before

Remember, while I can provide information and suggestions, it's important to consult a healthcare professional for a formal diagnosis and treatment plan. If you have any further questions or need more information, feel free to ask.

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3 mo ago


People Also Ask


What are the common causes of tension-type headaches?

Tension-type headaches are often caused by stress, anxiety, poor posture, and changes in sleep or eating habits. They are characterized by a dull, aching pain on both sides of the head.


How can cervical spondylosis contribute to headaches?

Cervical spondylosis can lead to cervicogenic headaches, where pain originates from the neck and radiates to the head. This is due to degenerative changes in the cervical spine that can irritate nerves and muscles.


What is a medication overuse headache and how can it be prevented?

A medication overuse headache occurs when pain relief medications are used too frequently, leading to a cycle of chronic headaches. It can be prevented by limiting the use of over-the-counter pain relievers and consulting a healthcare provider for alternative treatments.


What lifestyle changes can help manage stress-related headaches?

Lifestyle changes such as regular exercise, adequate sleep, hydration, and practicing relaxation techniques like meditation or yoga can help manage stress-related headaches. Keeping a headache diary to identify triggers can also be beneficial.


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