Tension in the Temples: Causes and Solutions

Tightness in the temples?

Hello Dr.
Jiang,
I have not experienced similar symptoms before (tightness in the temples, nausea, and a sense of imbalance).
Here is a record of the process:
On October 15, 2021, during a company health check (gastrointestinal endoscopy):
a.
Duodenal ulcer
b.
Prescribed "Bai Yi Kui" medication (side effects: headache, constipation, diarrhea, dizziness)
c.
On the third day, while lying on the sofa and using my phone, I suddenly experienced tightness in my head and dizziness (headache and dizziness) (I usually lie on the sofa and use my phone after work and dinner).
On November XX, after stopping "Bai Yi Kui," I still felt headaches, slight imbalance, and nausea.
a.
Currently, I feel tightness in my temples, forehead, glabella, and occipital region.
On November 29, I felt some relief in the tightness in my temples, forehead, and glabella, but sometimes still experienced nausea.
In December XX, compared to the symptoms in October and November, there has been improvement, but I still feel tightness in my temples or forehead.
The symptoms are not "very painful" and do not affect my daily work.
However, I do feel that sometimes my temples and the top of my head are tight.
Could this indicate a brain issue? Will the tightness in my temples persist for a long time (from mid-October until now)? (Currently, I am doing some stress-relief exercises.)
Thank you.

William, 40~49 year old female. Ask Date: 2022/01/03

Dr. Jiang Junyi reply Neurology

Dear Mr.
William,
You mentioned experiencing "headaches / slight imbalance / feelings of nausea...
currently feeling tightness in the temples / forehead / between the eyebrows / back of the head" and that "lying on the sofa while using your phone" may indicate cervical myofascial pain, possibly due to issues with the upper cervical spine.
Prolonged periods of looking down can lead to overuse of the trapezius muscles in the back of the neck, resulting in neck and shoulder pain.
Initially, resting may alleviate the pain, but it can progressively worsen, affecting your daily activities.
I recommend the following:
1.
Change positions: Alter your posture every 15 minutes to allow the neck tissues to rest.
Maintaining any position (including a normal one) for an extended period can lead to fatigue and inflammation in the tissues, so moving around briefly can reduce the risk of muscle inflammation.
2.
Rest: Allowing the muscles to utilize their self-repair capabilities is essential, and vigorous exercise should be avoided 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, you may consider using NSAIDs to reduce inflammation and alleviate pain.
(Since you have a duodenal ulcer, it is advisable to use COX-2 inhibitors.)
5.
Neck muscle stretching exercises: After the acute pain phase, develop a habit of performing gentle neck stretches every 15 to 20 minutes at angles that do not cause discomfort, including movements up, down, left, and right.
I suggest consulting a neurologist or a rehabilitation specialist for further evaluation and treatment.
Thank you for your inquiry, and feel free to discuss any related questions! Wishing you good health and peace.
Dr.
Jiang Junyi, Taoyuan Medical Center

Reply Date: 2022/01/03

More Info

Understanding tension in the temples, particularly when accompanied by symptoms such as nausea and a sense of imbalance, can be quite concerning. Based on your detailed history, it seems that you have experienced a range of symptoms that may be interconnected. Let's break down the potential causes and solutions for your condition.

Potential Causes
1. Medication Side Effects: You mentioned taking "百抑潰" (likely a proton pump inhibitor or similar medication) for your duodenal ulcer. Common side effects of such medications can include headaches, dizziness, and gastrointestinal disturbances. If you experienced headaches and dizziness after starting this medication, it’s possible that these symptoms could have persisted even after discontinuation, as your body adjusts.

2. Tension-Type Headaches: The tightness you feel in your temples could be indicative of tension-type headaches. These headaches are often characterized by a feeling of pressure or tightness around the forehead or temples and can be triggered by stress, poor posture, or prolonged screen time, such as lying on the couch and using your phone.

3. Gastrointestinal Issues: Given your history of gastrointestinal problems, including a duodenal ulcer, it’s possible that your digestive health could be contributing to your symptoms. Nausea can often accompany gastrointestinal disturbances, and the discomfort may radiate to the head, causing tension and headaches.

4. Anxiety and Stress: The feelings of nausea and imbalance, along with the tightness in your temples, could also be related to anxiety or stress. Stress can manifest physically in various ways, including muscle tension, which could explain the tightness you feel in your temples.

5. Vestibular Issues: If you are experiencing a sense of imbalance, it may be worth considering vestibular issues, which relate to the inner ear and balance. This could be a separate issue or related to your overall health status.

Solutions and Recommendations
1. Consult a Healthcare Professional: Given your symptoms and medical history, it’s essential to consult with a healthcare professional, preferably a neurologist or a gastroenterologist. They can conduct a thorough evaluation, including imaging studies if necessary, to rule out any serious conditions.

2. Monitor Your Symptoms: Keep a detailed diary of your symptoms, noting when they occur, their intensity, and any potential triggers. This information can be invaluable for your healthcare provider in diagnosing the issue.

3. Stress Management Techniques: Since you mentioned doing some stress-relief exercises, continue to incorporate relaxation techniques such as deep breathing, yoga, or meditation into your routine. These can help alleviate tension and improve your overall sense of well-being.

4. Posture and Ergonomics: Pay attention to your posture, especially when using your phone or computer. Ensure that your workspace is ergonomically designed to reduce strain on your neck and shoulders, which can contribute to tension headaches.

5. Hydration and Nutrition: Ensure you are well-hydrated and consuming a balanced diet. Dehydration and poor nutrition can exacerbate headaches and gastrointestinal issues.

6. Physical Activity: Regular physical activity can help reduce stress and tension. Aim for at least 30 minutes of moderate exercise most days of the week, which can also improve your mood and overall health.

7. Follow-Up on Gastrointestinal Health: Since you have a history of gastrointestinal issues, ensure that you are following up with your gastroenterologist to monitor your ulcer and any related symptoms. They may recommend dietary changes or further treatment options.

Conclusion
While the symptoms you are experiencing can be distressing, they are often manageable with the right approach. By consulting with healthcare professionals, monitoring your symptoms, and implementing stress management techniques, you can work towards alleviating the tension in your temples and improving your overall health. Remember, it’s essential to listen to your body and seek help when needed.

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