[51F] Experiencing severe, throbbing headache and nausea

Question

I've never had a headache last so long. I don't know what to do to make this stop.

Patient Description

A 51-year-old female has been experiencing a severe, throbbing headache that is most intense at the back of the head since Tuesday. The pain severity varies from 4 to 7 out of 10 and worsens with movement, phone use, or bending over. Accompanying symptoms include nausea and changes in vision and sensitivity to light, but no fever or neck stiffness. The headache has been gradually getting worse, not starting suddenly. The patient has tried migraine medication and oxycodone without full relief. Current medications include pravastatin sodium, bupropion XL, desvenlafaxine ER succinate, estradiol patch, progesterone micro, levothyroxine, liothyronine, carisoprodol, oxycodone, and celecoxib. There is no mention of any pre-existing conditions or chronic illnesses.

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Arora's Assessment

What might be happening

Based on the information you have provided, possible diagnoses include:

  • Migraine: A type of headache characterized by severe throbbing pain or a pulsing sensation, usually on one side of the head. It's often accompanied by nausea, vomiting, and extreme sensitivity to light and sound. Migraine attacks can last for hours to days, and the pain can be so severe that it interferes with your daily activities.

    • Treatment of migraines often involves medications to help reduce the severity of symptoms and prevent future attacks.

  • Tension headache: This is the most common type of headache, and its cause is not well understood. The pain is often described as a constant band-like pain around the head, a tightness, or a pressure. Tension headaches are not typically associated with other symptoms like nausea, vomiting, or light sensitivity.

    • Treatment of tension headaches is usually with over-the-counter pain relievers. However, if these headaches are frequent, your doctor may prescribe stronger pain relievers.

  • Medication overuse headache: This type of headache occurs when medications stop relieving pain and begin to cause headaches. You're at risk of these types of headaches if you use more than a certain amount of headache medication for more than a few days in a week.

    • Treatment involves reducing or stopping the medication that's causing these headaches. You should speak with your doctor before making any changes to your medication regimen.

What you can do

  1. Try to rest and relax. If possible, rest in a dark, quiet room.
  2. Place a cool cloth or ice pack on your forehead or the back of your neck.
  3. Stay hydrated. Drink plenty of water.
  4. Avoid activities that worsen your headache.
  5. Keep a headache diary. Note when your headaches start, what you were doing at the time, how long they last and what, if anything, provides relief. Over time, a pattern may emerge.

What you should look out for

Reasons to see a doctor more urgently:

  • If your headache is sudden and severe
  • If your headache is accompanied by a fever, stiff neck, mental confusion, seizures, double vision, weakness, numbness or speaking difficulties
  • If your headache gets worse over days and changes in pattern
  • If your headache is following a head injury

Please remember that while I strive to provide accurate information, I am an AI and not a doctor. You should consult with a healthcare professional for a formal diagnosis and treatment.

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8 mo ago

People Also Ask

What are the common symptoms of a migraine headache?

Common symptoms of a migraine headache include severe throbbing pain or a pulsing sensation, usually on one side of the head, nausea, vomiting, and extreme sensitivity to light and sound. Migraine attacks can last for hours to days and can be debilitating.

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

A migraine is typically characterized by severe, throbbing pain often on one side of the head, accompanied by nausea and sensitivity to light and sound. A tension headache, on the other hand, usually presents as a constant band-like pain around the head, with tightness or pressure, and is not typically associated with nausea or light sensitivity.

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

A medication overuse headache occurs when pain relief medications are used too frequently, leading to a cycle where the medication stops relieving pain and instead causes headaches. Treatment involves reducing or stopping the medication causing the headaches, under the guidance of a healthcare professional.

When should I seek urgent medical attention for a headache?

You should seek urgent medical attention for a headache if it is sudden and severe, accompanied by a fever, stiff neck, mental confusion, seizures, double vision, weakness, numbness, or speaking difficulties, or if it follows a head injury or changes in pattern and worsens over days.

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1 Comments

Leo#3962

8 mo ago

Sometimes headaches can be a result of too many medications or the interactions between medications. It's possible that your combination of medications might be related to your current headache, so you could check with your doctor asap. You might also need a stronger migraine abortive medication, which again you can ask your doctor about.

In the meantime, two at-home remedies you can try are:

  1. Wrap a cold towel around your head
  2. Soak your feet in warm/hot water

This is meant to get blood to flow away from your head and hopefully alleviate the pain a little. Let me know if it helps at all!

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