Head and Neck Discomfort: Possible Neurological Causes

Feeling unwell?

Hello, doctor.
For the past couple of days, I've been feeling tightness and heaviness on both sides of my head (near the temples), and sometimes it even hurts.
I also feel this sensation above my neck, including when I'm sleeping or walking, and I occasionally feel a bit dizzy, leaning to one side, but in reality, I'm not.
Could you please explain what this might be?

Qiu Xiaojie, 20~29 year old female. Ask Date: 2021/11/22

Dr. Jiang Junyi reply Neurology

Dear Ms.
Chiu,
You mentioned that the "tightness and heaviness on both sides of your head (near the temples)" may suggest tension-type headache, which is caused by muscle tightness in the head.
Common symptoms include a squeezing pain in the forehead and temples, resembling the feeling of wearing the golden headband of the Monkey King.
Since this is caused by muscle fatigue, it typically starts in the afternoon and peaks in the evening or at night.
Taking a warm bath, getting a massage, or sleeping can provide relief.
Lack of sleep, stress, or anxiety can exacerbate the severity of the headache.

In summary, tension-type headaches may be triggered by stress, anxiety, or poor posture leading to excessive muscle tension.
It is recommended to engage in muscle relaxation exercises, such as yoga, or to pay attention to your posture.
Pharmacological treatment usually involves muscle relaxants, anxiolytics, and mild analgesics.
If symptoms persist, other causes such as infections or metabolic disorders may need to be considered.

I suggest consulting a neurologist for further discussion and treatment.
Thank you for your inquiry, and feel free to reach out with any related questions!
Wishing you good health and happiness,
Dr.
Jiang Junyi, Department of Neurology, Taoyuan Hospital

Reply Date: 2021/11/22

More Info

Head and neck discomfort, particularly around the temples and upper neck, can be indicative of several neurological and musculoskeletal issues. Based on your description of feeling tightness, heaviness, and occasional pain in the temples, as well as sensations of dizziness, it is essential to consider a few potential causes.

1. Tension-Type Headaches: One of the most common causes of discomfort in the head and neck area is tension-type headaches. These headaches are often characterized by a feeling of tightness or pressure around the forehead, temples, or back of the head and neck. They can be triggered by stress, poor posture, or prolonged periods of concentration, such as working at a computer. The tightness you feel could be muscle tension resulting from stress or poor ergonomics.

2. Cervicogenic Headaches: These headaches originate from issues in the cervical spine (neck) and can cause referred pain to the head. If you have any neck stiffness or discomfort, it could be contributing to your symptoms. Cervicogenic headaches often accompany neck pain and can be exacerbated by certain neck movements.

3. Migraine: Although you did not mention classic migraine symptoms like nausea or sensitivity to light, migraines can sometimes present with tension-like symptoms. Migraines can also cause dizziness or a sensation of imbalance, which might explain the feelings of dizziness you experience.

4. Neurological Issues: Given the complexity of the nervous system, it is crucial to rule out any neurological conditions. Symptoms like persistent dizziness, especially if it feels like you are leaning to one side, could indicate vestibular issues or other neurological concerns that warrant further investigation.

5. Muscle Strain or Spasm: Tightness in the neck and head can also result from muscle strain or spasms. This can occur due to poor posture, sleeping in an awkward position, or even stress. Muscle tension can lead to discomfort and may also contribute to headaches.

6. Other Considerations: Conditions such as sinusitis, temporomandibular joint (TMJ) disorders, or even dental issues can cause referred pain to the head and neck area. If you have any dental problems or jaw pain, it might be worth discussing with your dentist.

Recommendations:
- Consult a Healthcare Professional: Given the range of potential causes, it is advisable to consult a neurologist or a healthcare provider specializing in headaches. They can perform a thorough examination and may recommend imaging studies, such as an MRI or CT scan, to rule out any serious conditions.

- Lifestyle Modifications: Consider evaluating your posture, especially if you spend long hours at a desk. Ergonomic adjustments can significantly reduce muscle strain. Regular breaks and stretching exercises can also help alleviate tension.

- Stress Management: Engaging in relaxation techniques such as yoga, meditation, or deep-breathing exercises can help manage stress and reduce muscle tension.

- Physical Therapy: If muscle tension is a significant contributor to your symptoms, physical therapy may be beneficial. A physical therapist can provide targeted exercises and treatments to relieve tension and improve posture.

- Keep a Symptom Diary: Documenting when your symptoms occur, their intensity, and any associated activities can provide valuable information for your healthcare provider.

In conclusion, while your symptoms may be related to tension or musculoskeletal issues, it is essential to rule out any underlying neurological conditions. A comprehensive evaluation by a healthcare professional will help determine the most appropriate course of action for your discomfort.

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