Persistent Headaches: When to Seek Medical Help

Q: Persistent Headaches: When to Seek Medical Help

Hello： Based on your description, does the headache worsen when you exert yourself (for example, during bowel movements or when holding your breath, known as the Valsalva maneuver)? Have you experienced waking up in the early morning due to headache pain in the past few days? If

Continuous headache lasting more than 48 hours?

Hello Doctor: I am currently on a business trip in mainland China and had to resort to online resources for consultation.
About a week ago, I experienced mild fever and headache due to a cold, but after taking over-the-counter medication, the cold symptoms disappeared.
I felt fine for about 2-3 days.
Two days before the symptoms started, I suddenly experienced a mild headache around 6 PM, but after taking a pain reliever, I woke up the next morning without discomfort.
However, on the third night, I felt a more severe headache, and the pain reliever was ineffective, with the headache persisting until now.

Symptom description:
1.
The pain is primarily located at the back of my head, characterized by a rhythmic throbbing and pressure, which radiates to both temples.
This symptom has lasted for 48 hours, and I do not rule out the possibility of continued pain.
2.
The pain occurs regardless of whether I am standing, sitting, or lying down; generally, walking or moving makes it more uncomfortable.
3.
Staying still can alleviate the pain (at least it does not worsen).
4.
Pain relievers (such as acetaminophen, ibuprofen, and potassium diclofenac) have not shown significant effects.
5.
There are no symptoms of fever, vomiting, or photophobia.
6.
The pain fluctuates between severe and mild; during severe episodes, I am unable to do anything.
7.
When the pain is milder, I can manage tasks while seated.
8.
I have never experienced such a prolonged headache before.
As I will not return to Taiwan for another week, could you please provide some advice? I would greatly appreciate your assistance.
Thank you.

Oba, 30~39 year old female. Ask Date: 2016/09/01

Dr. Hong Weibin reply Neurology

Hello: Based on your description, does the headache worsen when you exert yourself (for example, during bowel movements or when holding your breath, known as the Valsalva maneuver)? Have you experienced waking up in the early morning due to headache pain in the past few days? If you have these two symptoms, you should be cautious as the cause of the headache may not be simple.
In the meantime, you can take regular over-the-counter pain relievers, such as taking them 3-4 times a day, and do not wait until the headache becomes severe to take medication.
Since there are many potential causes of headaches, if you have experienced similar headaches before, it is advisable to see a doctor as soon as possible when you return to your home country.
Wishing you a speedy recovery.

Reply Date: 2016/09/01

More Info

Persistent headaches can be a significant concern, especially when they disrupt daily activities and do not respond to over-the-counter medications. Based on your description, it seems you are experiencing a type of headache that has evolved over the past week, initially starting with mild discomfort and then escalating to more severe pain that has lasted for 48 hours. Here are some insights and recommendations based on your symptoms and the general understanding of headache disorders.

Understanding Your Symptoms
1. Nature of the Pain: You described the pain as a rhythmic throbbing or pressure, primarily located at the back of your head and radiating to the temples. This pattern can be indicative of several types of headaches, including tension-type headaches or even cervicogenic headaches, which originate from issues in the neck.

2. Response to Medication: You mentioned that common analgesics like acetaminophen (Tylenol) and ibuprofen (EVE) have not provided relief. This is an important factor, as headaches that do not respond to typical pain relief measures may require further evaluation.

3. Associated Symptoms: The absence of fever, vomiting, or photophobia (sensitivity to light) is somewhat reassuring, as these symptoms can often indicate more serious conditions such as meningitis or intracranial pressure changes. However, the persistence and intensity of your headache warrant further investigation.

4. Duration and Frequency: The fact that this headache has lasted for two days without significant relief is concerning. While occasional headaches can be common, persistent headaches that last more than 48 hours should be evaluated by a healthcare professional.

When to Seek Medical Help
Given the details you've provided, it is advisable to seek medical attention sooner rather than later. Here are some specific reasons to consider:
- Duration: Headaches lasting more than 48 hours, especially if they are severe and unresponsive to medication, should be assessed by a healthcare provider.

- Change in Pattern: If this headache is different from your usual headaches (in terms of intensity, location, or duration), it may indicate a new underlying issue that needs to be addressed.

- Impact on Daily Life: Since you mentioned that the headache is affecting your ability to perform daily tasks, this is a significant indicator that medical intervention is necessary.

Recommendations
1. Consult a Neurologist: If possible, seek an appointment with a neurologist. They can perform a thorough evaluation, which may include a physical examination, a detailed history of your headaches, and possibly imaging studies like an MRI or CT scan to rule out any serious conditions.

2. Keep a Headache Diary: Documenting your headaches can provide valuable information to your healthcare provider. Note the frequency, duration, intensity, location, and any associated symptoms or triggers.

3. Avoid Self-Medicating: While it may be tempting to continue taking over-the-counter medications, excessive use can lead to rebound headaches. It’s important to follow medical advice regarding pain management.

4. Lifestyle Modifications: Consider factors that may contribute to your headaches, such as stress, sleep patterns, hydration, and posture. Implementing relaxation techniques, ensuring adequate hydration, and maintaining a regular sleep schedule may help alleviate some headache triggers.

5. Emergency Symptoms: If you experience any new symptoms such as sudden vision changes, weakness, confusion, or severe nausea, seek emergency medical care immediately.

Conclusion
Persistent headaches can be a complex issue, and while they may often be benign, it is crucial to take them seriously, especially when they deviate from your normal experience. Seeking medical advice is the best course of action to ensure that any underlying conditions are identified and treated appropriately. Remember, your health is paramount, and addressing these symptoms early can lead to better outcomes.

Similar Q&A

Chronic Headaches: When to Seek Medical Help for Your Pain

I have often experienced migraines since elementary school, and it continues to this day. Although it's not as frequent now, I used to take pain relievers regularly. It wasn't until college that I stopped. I'm not sure if my training in wrestling during vocational ...

Dr. Ye Boshou reply Neurology
I cannot determine the details of your headache from your description, such as whether it is a throbbing pain, a sharp pain, or a pulsating sensation like a blood vessel. Are there any accompanying neurological symptoms? I would recommend seeking treatment from an experienced neu...

Understanding Persistent Headaches: When to Seek Medical Advice

Hello Doctor, I have been experiencing persistent headaches recently. One day, I felt dizzy, broke out in a cold sweat, felt nauseous, and was excessively sleepy. After vomiting, I felt somewhat better the next day, but the headache has continued until now. Currently, I am experi...

Dr. Hu Ziren reply Oncology
Hello, user: I suggest you see a neurologist for your headaches or a psychiatrist to address sleep and psychological stress issues. Thank you!

When to Seek Medical Help for Persistent Headaches?

Hello, I would like to ask: I have been experiencing intermittent headaches for a long time. Should I go to the hospital for a consultation when I have a headache, or is it also acceptable to get checked when I am not in pain?

Dr. Ye Boshou reply Neurology
Hello: Long-term headaches require examination, but you need to provide the following information: 1. When do the headaches occur? How long do they last? 2. Characteristics: Is it a sharp pain? A dull ache? 3. Are there any accompanying symptoms? Such as weakness or vomiting, the...

Understanding Persistent Headaches: Causes and When to Seek Help

Hello, doctor. Recently, I've been experiencing a higher frequency of headaches, which have become persistent over the past few days. The pain is usually located at the back of my head and is a dull ache. Taking pain relievers hasn't been effective. I would like to ask ...

Dr. Jiang Junyi reply Neurology
Hello: You mentioned "developing persistent headaches, typically located at the back of the head, characterized as a dull pain, and pain relievers have little effect." This may suggest chronic daily headache, which is a type of primary headache defined as occurring for ...