Chronic Headaches: Causes, Symptoms, and Relief Options - Family Medicine

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Frequent headaches?


Dear Dr.
Fang,
I have been experiencing headaches since childhood, and as I get older, they seem to be getting more frequent and severe.
Recently, my headaches have intensified! When I have a headache, I usually feel pain around my eyes and temples, along with neck stiffness, overall weakness, and nausea (the last time I even vomited yellow liquid, which seems exaggerated!).
I also have difficulty eating...
I'm not sure if this is related to my physiological condition or my psychological traits.
I tend to be introverted, nervous, and easily feel the presence of stress (I mention this for your reference).

Additionally, my headaches seem to come on suddenly, without any warning signs to prevent them! Sometimes, I even wake up with a headache...
I am reaching my limit because when the headache strikes, I cannot function throughout the day, and it is extremely difficult to endure.

Could you please tell me what might be wrong with me? If there is no treatment available, are there any methods to alleviate the pain during a headache? Lastly, if medical attention is necessary, could you recommend a doctor in the Miaoli area (as I live in Miaoli)? Thank you!
Sincerely,
A frequent headache sufferer

fl1800, 20~29 year old female. Ask Date: 2003/03/05

Dr. Fang Sijie reply Family Medicine


Dear fl1800/29/0:
A) Headaches can be classified into:
1) Tension-type headache: Caused by tension in the facial, neck, and head muscles due to stress, resulting in headache.

2) Vascular headache: Caused by the dilation of blood vessels in the head, which exerts pressure on the vessel walls, leading to headache.

3) Headache caused by brain tumors.

4) Headache due to intracranial hemorrhage.
B) Precautions:
1) Frequent headaches may indicate underlying stress in your current lifestyle.
It may be helpful to discuss with a doctor or counselor to identify triggers for your headaches and try to reduce or eliminate them.

2) Smoking and alcohol are strong contributing factors to vascular headaches.

3) Simple headaches can often be relieved with pain medication, and the following methods may also help:
@ Relaxation.

@ Stretching and massaging the muscles of the shoulders, neck, jaw, and head.

@ Taking a warm bath, lying down, and applying a warm dry towel or a cold damp towel to the painful area.

@ Drinking more fruit juices or non-alcoholic beverages.

@ Getting a good night's sleep is often the best remedy.
C) If the headache is isolated without other symptoms and resolves after one night, there is usually no cause for concern.
However, if the pain persists for more than twenty-four hours or occurs two to three times within a week, you should see a doctor.
If you experience severe headache accompanied by intense vomiting, seek medical attention immediately.
D) I apologize, but I am not familiar with doctors in Miaoli as I do not reside there.
However, you can visit a hospital that has a neurology department for consultation.

Reply Date: 2003/03/05

More Info


Chronic headaches can be a significant burden, affecting daily life and overall well-being. Based on your description, it seems you are experiencing a combination of tension-type headaches and possibly migraines, given the symptoms of nausea and vomiting. Understanding the causes, symptoms, and relief options for chronic headaches is essential for managing your condition effectively.


Causes of Chronic Headaches
Chronic headaches can arise from various factors, including:
1. Tension-Type Headaches: These are the most common form of headaches, often triggered by stress, anxiety, or muscle tension in the neck and shoulders. Your description of feeling pressure around the temples and neck stiffness aligns with this type.

2. Migraines: Migraines are characterized by severe, pulsating pain, often on one side of the head, and can be accompanied by nausea, vomiting, and sensitivity to light and sound. The fact that you experience vomiting and severe pain suggests that migraines could be a possibility.

3. Cervicogenic Headaches: These headaches originate from issues in the cervical spine (neck) and can cause pain that radiates to the head. Your neck stiffness may indicate this type of headache.

4. Psychological Factors: Your self-described personality traits, such as being introverted and sensitive to stress, can contribute to the frequency and severity of headaches. Stress and anxiety can lead to muscle tension and trigger headaches.

5. Other Medical Conditions: Conditions such as sinusitis, hypertension, or even hormonal changes can also lead to chronic headaches. It’s essential to rule out any underlying medical issues.


Symptoms of Chronic Headaches
The symptoms you've described, including:
- Pain around the eyes and temples
- Neck stiffness
- Generalized weakness
- Nausea and vomiting (especially the yellow liquid, which could indicate bile)
- Difficulty eating
These symptoms can vary in intensity and duration, and they can significantly impact your quality of life.


Relief Options
1. Lifestyle Modifications:
- Stress Management: Techniques such as mindfulness, meditation, or yoga can help reduce stress levels and potentially decrease headache frequency.

- Regular Exercise: Engaging in regular physical activity can help alleviate tension and improve overall well-being.

- Sleep Hygiene: Establishing a regular sleep schedule and creating a restful sleeping environment can help improve sleep quality, which is crucial for headache management.

2. Dietary Considerations:
- Keeping a food diary to identify potential dietary triggers (such as caffeine, alcohol, or certain foods) may help you avoid headache-inducing substances.

- Staying hydrated is essential, as dehydration can trigger headaches.

3. Medical Treatment:
- Over-the-counter pain relievers such as ibuprofen or acetaminophen can be effective for mild headaches. However, for more severe headaches, prescription medications may be necessary.

- Preventive medications, such as beta-blockers, antidepressants, or anticonvulsants, can be prescribed by a healthcare provider if headaches are frequent and debilitating.

4. Physical Therapy:
- A physical therapist can help with neck stiffness and muscle tension through targeted exercises and manual therapy.

5. Consultation with a Specialist:
- Given the severity and frequency of your headaches, it may be beneficial to consult a neurologist or headache specialist. They can provide a comprehensive evaluation and tailor a treatment plan specific to your needs.


When to Seek Medical Attention
If your headaches worsen, change in pattern, or are accompanied by neurological symptoms (such as vision changes, weakness, or confusion), it is crucial to seek immediate medical attention.

Local Resources
Since you mentioned residing in Miaoli, I recommend looking for a local neurologist or headache clinic. You can check with local hospitals or clinics for specialists in headache management.

In conclusion, chronic headaches can be complex, but with the right approach, including lifestyle changes, medical treatment, and possibly therapy, you can find relief and improve your quality of life. Don't hesitate to reach out to healthcare professionals who can guide you through this process.

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