Left-Sided Migraine and Anxiety: A Young Adult's Journey

Tension-type headache?

Hello, Doctor Jiang.
Let me explain my condition.
I am 19 years old, and about three days ago, I started experiencing body aches and weakness.
By the afternoon, I developed a headache, and in the evening, I had a fever (37.8°C).
The next morning, the fever subsided, and the body aches almost completely resolved, but my headache persisted, leaning more towards a left-sided migraine.
Additionally, I feel pain on the left side when I bend down or sneeze.
(I’m not sure if it’s psychological, but I feel a strange pressure on the left side of my head.) In the evening, I visited a traditional Chinese medicine doctor who said I had heatstroke and noted that my neck and shoulders were very tight.
After receiving some massage therapy, I felt somewhat better.
However, the next morning (August 28), the migraine returned, and it worsens in certain positions (like bending over).
I also feel that my left eye's vision is slightly worse compared to my right, but I can still see (this has been ongoing for a long time, and I have been using screens frequently).
I tend to be a very anxious and nervous person, often worrying for no reason, and now I am starting to worry again, fearing that something might be wrong in my head.
Three years ago, I had an MRI due to double vision, and the doctor said everything was fine.
What should I do, Doctor? Thank you!

Didi, 10~19 year old female. Ask Date: 2020/08/26

Dr. Jiang Junyi reply Neurology

Hello, based on your description, the most common cause of left-sided neck pain is cervical myofascial pain.
Prolonged periods of looking down can lead to overuse of the trapezius muscle in the back of the neck, resulting in neck and shoulder discomfort.
Initially, resting may alleviate the pain, but over time it can worsen and affect daily activities.
Some patients may experience severe neck pain upon waking, accompanied by stiffness, tightness, and intolerable pain levels.

I recommend the following:
1.
Change Positions: Change your posture every 15 minutes to allow the neck tissues to rest.
Maintaining any posture (including a normal one) for an extended period can lead to tissue fatigue and inflammation, so moving around briefly can reduce the risk of muscle inflammation.
2.
Rest: Rest is essential to allow the muscles to utilize their self-repair capabilities.
Avoid vigorous exercise during this time.
3.
Neck Heat Therapy: Apply heat for 15 to 20 minutes, ensuring the temperature is safe to avoid burns.
4.
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): If you do not have a history of peptic ulcers, allergies to NSAIDs, or impaired kidney function, consider using NSAIDs to reduce inflammation and alleviate pain as needed.
5.
Neck Muscle Stretching Exercises: After the acute pain phase, develop a habit of performing slow, gentle neck stretches every 15-20 minutes at angles that do not cause discomfort, moving the neck up, down, left, and right.
If you experience temporary visual disturbances (such as double vision or vision abnormalities), it may indicate an issue with cerebral blood flow.
It is advisable to review an MRI from three years ago for any intracranial vascular abnormalities and consider undergoing a cervical vascular ultrasound to assess blood flow.
I suggest consulting a neurologist to discuss further examination and treatment options.
Wishing you good health and peace.
Dr.
Jiang, Department of Neurology, Taoyuan Hospital, cares for you.

Reply Date: 2020/08/26

More Info

Hello! Thank you for sharing your situation. It sounds like you are experiencing a combination of physical symptoms, including left-sided migraine, along with anxiety and concerns about your health. Let’s break down your symptoms and explore some potential steps you can take.

From what you've described, your symptoms began with general body aches and fever, which then transitioned into persistent left-sided headaches. The fact that your headache worsens with certain movements, like bending over or sneezing, could indicate a tension-type headache or a migraine. Migraines can often be unilateral (affecting one side of the head) and may be accompanied by other symptoms such as sensitivity to light, sound, or even visual disturbances, which you mentioned as a slight difference in vision between your eyes.

Your experience of anxiety is also significant. Anxiety can manifest physically, leading to muscle tension, which may contribute to headaches. The tightness in your neck and shoulders, as noted by the traditional Chinese medicine practitioner, could be a result of stress and anxiety, which can exacerbate headache symptoms. It’s important to recognize that anxiety can create a cycle where physical discomfort leads to increased worry, which in turn can heighten physical symptoms.

Here are some steps you can consider taking:
1. Consult a Healthcare Professional: Since you have a history of migraines and have experienced changes in your vision, it’s crucial to consult a healthcare provider. They may recommend imaging studies, such as an MRI, to rule out any serious conditions, especially since you have a history of visual disturbances. Given your anxiety about potential neurological issues, addressing these concerns with a doctor can provide peace of mind.

2. Manage Anxiety: Since anxiety can exacerbate physical symptoms, consider seeking support for your mental health. Cognitive-behavioral therapy (CBT) is effective for managing anxiety and can help you develop coping strategies. Mindfulness and relaxation techniques, such as deep breathing exercises, yoga, or meditation, can also help reduce anxiety levels.

3. Lifestyle Adjustments: Pay attention to your lifestyle habits. Ensure you are getting enough sleep, staying hydrated, and eating a balanced diet. Regular physical activity can also help alleviate tension and anxiety. Additionally, consider reducing screen time, especially if you are experiencing visual disturbances, as prolonged use of screens can lead to eye strain and headaches.

4. Pain Management: For immediate relief from headaches, over-the-counter pain relievers such as ibuprofen or acetaminophen may be helpful. However, it’s essential to use these medications as directed and consult with a healthcare provider if you find yourself needing them frequently.

5. Physical Therapy: If muscle tension in your neck and shoulders is contributing to your headaches, physical therapy may be beneficial. A physical therapist can provide exercises and techniques to relieve tension and improve posture.

6. Monitor Symptoms: Keep a headache diary to track your symptoms, triggers, and any associated factors. This can help you and your healthcare provider identify patterns and develop a more effective treatment plan.

7. Stay Informed but Cautious: While it’s natural to seek information online, be cautious about self-diagnosing based on internet searches. Focus on gathering information from reputable sources and discussing your concerns with a healthcare professional.

In conclusion, while your symptoms may be concerning, there are various avenues to explore for relief and management. Addressing both the physical and psychological aspects of your health will be crucial in finding a balance and improving your overall well-being. Remember, you are not alone in this journey, and seeking help is a strong and positive step forward. Wishing you the best in your recovery!

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