[59F] Experiencing sharp pain in the lower right side of skull

Patient Description

A 59-year-old female presents with a 2-month history of sharp pain in the lower right side of the skull, which is painful to the touch and has a severity rating of 8 out of 10. The pain is constant and spreads to the shoulder and ear. Additionally, the patient reports neck stiffness but no fever. There are no other accompanying symptoms such as changes in vision, weakness, numbness, sudden vision loss, or jaw pain while chewing. The patient has a history of chronic pain and fatigue, high blood pressure, and high cholesterol, diagnosed several years ago. No known allergies or adverse reactions to medications have been reported. The patient indicates that there is a list of medications being taken, suggesting multiple prescriptions, but the specific medications have not been disclosed.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible diagnoses include:

  • Tension Headache: This is the most common type of headache and can be caused by stress, anxiety, lack of sleep, or depression. The pain is usually described as a constant ache that affects both sides of the head, though it can spread to the neck and shoulders.

    • Treatment typically involves over-the-counter pain relievers, stress management, and regular physical activity.
  • Occipital Neuralgia: This condition involves pain in the upper neck, back of the head and behind the ears, usually on one side of the head. It's often caused by irritation or injury to the occipital nerves, which can happen because of trauma, neck tension, or inflammation.

    • Treatment typically involves pain relievers, nerve blocks, and physical therapy.
  • Cervicogenic Headache: This is a secondary headache, which means that it's caused by another illness or physical issue. In the case of cervicogenic headache, the cause is a disorder of the cervical spine and its component bone, disc and/or soft tissue elements.

    • Treatment typically involves physical therapy, nerve blocks, and sometimes surgery.

Please note that this is not an exhaustive list of all possible conditions, and these conditions may not be the cause of your symptoms. It's also possible that you could be experiencing more than one of these conditions at the same time.

What you can do

  1. Try over-the-counter pain relievers, such as ibuprofen or acetaminophen, to help manage your pain. Always follow the instructions on the packaging and do not exceed the recommended dose.
  2. Apply a warm compress to the painful area for 15 minutes at a time to help relax the muscles and alleviate pain.
  3. Try to maintain good posture and avoid straining your neck and shoulders.
  4. Regular physical activity and exercises that strengthen the neck and shoulders can also help prevent future episodes of pain.

What you should look out for

Please seek immediate medical attention if:

  • Your headache is sudden and severe
  • You have a headache accompanied by confusion, fainting, high fever, or other neurological symptoms
  • The headache is getting progressively worse over a 24-hour period
  • You have a headache following a head injury

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, testing, and care recommendations.

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1 yr ago

People Also Ask


What is occipital neuralgia and how is it treated?

Occipital neuralgia is a condition characterized by sharp, jabbing pain in the back of the head, neck, and behind the ears, often on one side. It is caused by irritation or injury to the occipital nerves. Treatment may include pain relievers, nerve blocks, and physical therapy.


Can high blood pressure contribute to headaches?

Yes, high blood pressure can contribute to headaches, particularly if the blood pressure is very high. It is important to manage blood pressure through medication and lifestyle changes to reduce the risk of headaches and other complications.


What are the symptoms of a cervicogenic headache?

Cervicogenic headache symptoms include pain that starts in the neck and radiates to the head, often on one side. The pain may be accompanied by reduced range of motion in the neck and tenderness in the neck and shoulder muscles.


How can tension headaches be managed at home?

Tension headaches can be managed at home by using over-the-counter pain relievers like ibuprofen or acetaminophen, applying warm compresses to the neck and shoulders, practicing good posture, and engaging in regular physical activity to reduce stress and muscle tension.


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