[57F] Experiencing severe headache, neck pain, and other symptoms

Patient Description

A 57-year-old female presents with a severe, throbbing headache that is felt all over the head, sharp and achy neck pain, nausea, fatigue, and heart palpitations that include racing, skipping, and fluttering sensations. These symptoms have been present for two days and are rated 10/10 for severity. The patient also reports feeling weak and has difficulty concentrating but has not experienced any stiffness in the neck. Despite feeling hot, no specific mention of fever was made. The patient has a significant medical history of lupus, fibromyalgia, rheumatoid arthritis, asthma, depression, kidney disease, and antiphosphalid antibodies, with these conditions being managed for over 25 years. Current medications include losartan, amlodipine, eliquis, trazadone, cymbalta, and restasis. The patient has confirmed allergies to multiple medications but did not specify which ones. No recent injuries, stressful situations, or changes in exercise routine were reported to account for the current symptoms.

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Arora's Assessment

What might be happening

Based on the information you've provided, the following conditions could be causing your symptoms:

  • Migraine: This is a type of headache that can cause severe throbbing pain, 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. However, your headache is all over your head and not just on one side, which is less typical for a migraine.

    • Treatment typically involves pain relieving medications and preventive medications.
  • 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 often associated with muscle tightness in the neck and scalp, and can be associated with stress or awkward head positioning.

    • Treatment typically involves pain relieving medications and lifestyle modifications such as stress management and regular physical activity.
  • Cluster headache: This is a rare type of headache that is marked by severe, piercing pain on one side of the head, often around the eye. They occur in cyclical patterns or clusters, which gives the condition its name. However, your headache is all over your head and not just on one side, which is less typical for a cluster headache.

    • Treatment typically involves pain relieving medications, preventive medications, and lifestyle modifications.
  • Lupus headache: As you have a history of lupus, it's possible that your headache is related to this condition. Lupus can cause a variety of symptoms, including severe headaches similar to migraines.

    • Treatment typically involves medications to manage lupus, such as nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, and antimalarial drugs.
  • Fibromyalgia: This is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues. As you have a history of fibromyalgia, it's possible that your symptoms are related to this condition.

    • Treatment typically involves a combination of medications, exercise, stress management techniques, and healthy lifestyle habits.
  • Rheumatoid arthritis: This is a chronic inflammatory disorder that can cause pain, swelling, and stiffness in the joints. As you have a history of rheumatoid arthritis, it's possible that your symptoms are related to this condition.

    • Treatment typically involves medications, physical therapy, and sometimes surgery.
  • Panic disorder: This is a type of anxiety disorder that causes panic attacks, which are sudden feelings of terror when there is no real danger. Panic attacks can cause symptoms such as heart palpitations, sweating, trembling, shortness of breath, and feelings of impending doom.

    • Treatment typically involves psychotherapy, medications, and lifestyle modifications.
  • Heart conditions: Heart palpitations can be a sign of a heart condition, such as heart rhythm problems (arrhythmias), heart disease, or heart attack. It's important to get these symptoms checked out by a doctor, especially if they're accompanied by symptoms such as shortness of breath, dizziness, chest pain, or fainting.

    • Treatment depends on the specific heart condition and may involve medications, lifestyle changes, medical procedures, or surgery.

Please note that this list is not exhaustive, and other conditions could also be causing your symptoms. It's important to see a healthcare provider for a formal diagnosis and treatment.

What you can do

Given the severity of your symptoms, it's important to seek medical attention as soon as possible. In the meantime, here are some things you can do:

  1. Rest and stay hydrated.
  2. Try to avoid any known headache triggers, such as certain foods, drinks, or activities.
  3. Practice stress management techniques, such as deep breathing, meditation, and yoga.
  4. Keep a symptom diary to track your symptoms and any potential triggers. This can be helpful information to share with your healthcare provider.

What you should look out for

Seek immediate medical attention if you experience any of the following:

  • Severe headache or neck pain that comes on suddenly
  • Headache accompanied by fever, stiff neck, mental confusion, seizures, double vision, weakness, numbness, or speaking difficulties
  • Headache after a head injury, especially if the headache gets worse
  • A chronic headache that is worse after coughing, exertion, straining, or a sudden movement
  • New headache pain if you're over 50

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, diagnosis, and treatment.

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11 mo ago

People Also Ask


What are the common symptoms of a migraine and how do they differ from other types of headaches?

Migraines typically cause severe, throbbing pain on one side of the head and are often accompanied by nausea, vomiting, and sensitivity to light and sound. This differs from tension headaches, which usually involve a constant band-like pain around the head, and cluster headaches, which cause severe pain around one eye. Treatment for migraines often includes pain relief and preventive medications.


How can lupus contribute to headaches and what are the treatment options?

Lupus can cause headaches similar to migraines due to inflammation affecting the nervous system. Treatment options may include NSAIDs, corticosteroids, and antimalarial drugs to manage lupus symptoms and reduce headache frequency.


What are heart palpitations and when should they be a cause for concern?

Heart palpitations are sensations of a racing, fluttering, or pounding heart. They can be caused by stress, anxiety, caffeine, or heart conditions. If palpitations are accompanied by dizziness, chest pain, or shortness of breath, it's important to seek medical attention as they could indicate a more serious heart issue.


How can fibromyalgia affect daily life and what are some management strategies?

Fibromyalgia is characterized by widespread musculoskeletal pain, fatigue, and cognitive difficulties, often referred to as 'fibro fog.' Management strategies include medications, regular exercise, stress management techniques, and maintaining a healthy lifestyle to help alleviate symptoms and improve quality of life.


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