Eye Pressure and Head Pain: Causes and Relief Strategies

Q: Eye Pressure and Head Pain: Causes and Relief Strategies

Dear Ms. P： The symptoms you mentioned resemble typical vascular headaches, commonly known as migraines. The diagnostic criteria for migraines are as follows： 1. Headaches occur more than 5 times. 2. Without taking pain relief medication, the headache las

High intraocular pressure, pain in the temples and eye sockets, stiffness in the shoulders and neck, and nausea?

Hello Doctor: I have been troubled by a persistent issue that occurs occasionally, and each time it is quite uncomfortable.
The situations in which it happens are not consistent, but it tends to occur more often after work and frequently after "exciting events," such as after singing at karaoke or during company parties (where there is a lot of laughing and shouting).
The symptoms start with a dull ache and pressure behind my eyes, which then spreads to my eye sockets, temples, and both sides of my head.
I'm not sure if this is related to high intraocular pressure or intracranial pressure.
At the same time, I also experience stiffness in my shoulders and neck, creating a feeling of discomfort that extends from my shoulders all the way to the area around my eyes.
These combined symptoms can also lead to dizziness and nausea (and in severe cases, I do vomit).
Sometimes lying down helps alleviate the discomfort, but other times, even after resting or waking up, I still feel significant pressure and discomfort in my eyes.
I previously thought it was an eye issue and consulted an ophthalmologist, but I was only given eye drops to relax the eye muscles, which didn't help much...
I would like to know what might be causing this situation.
Is it a specific condition? What can I do for self-relief during acute episodes? Thank you.

P, 20~29 year old female. Ask Date: 2023/01/19

Dr. Jiang Junyi reply Neurology

Dear Ms.
P:
The symptoms you mentioned resemble typical vascular headaches, commonly known as migraines.
The diagnostic criteria for migraines are as follows:
1.
Headaches occur more than 5 times.
2.
Without taking pain relief medication, the headache lasts for more than 4 hours.
3.
Under normal circumstances, the headache will resolve on its own within 3 days (72 hours).
4.
At least two of the following four characteristics are present: unilateral pain, pulsating pain, moderate to severe pain (rated 0-10 on a pain scale, with a minimum of 4), and daily activities exacerbate the headache or are avoided (such as walking or climbing stairs).
5.
At least one of the following symptoms is present: nausea, vomiting, photophobia, or phonophobia.
This type of headache lasts from 4 to 72 hours.
The characteristics of the headache include unilateral pain that feels like throbbing or pressure, often accompanied by a heartbeat or pulse sensation.
Severe pain can lead to nausea and vomiting, as well as sensitivity to light and sound.
Additionally, activities such as moving around, going up and down stairs, or shaking the head can worsen the headache.
Many patients require pain relief medications or preventive medications to assist with management.
In addition to medication treatment, lifestyle adjustments are also very important.
This includes developing good habits, maintaining a regular schedule, ensuring adequate but not excessive sleep, avoiding overexertion, and managing stress.
Some individuals may have specific triggers, such as certain foods, alcohol, drastic temperature changes, or moving in and out of air-conditioned environments during hot summers.
Avoiding these situations can help prevent migraines.
During an acute attack, over-the-counter oral pain relievers are often compound formulations with more complex ingredients.
While they can be used, it is important to follow the instructions and not to increase the dosage on your own.
Medications prescribed by doctors may include acetaminophen (such as Tylenol), aspirin, non-steroidal anti-inflammatory drugs (NSAIDs), ergotamine (such as Cafergot), or triptans (such as Imitrex, Maxalt, or Relpax).
I recommend that you consult a neurologist to discuss examination and treatment options.
Thank you for your inquiry, and feel free to reach out for further discussion.
Wishing you good health and peace,
Dr.
Jiang, Department of Neurology, Taoyuan Hospital

Reply Date: 2023/01/19

More Info

Your symptoms of eye pressure and head pain, especially following periods of excitement or stress, can be quite distressing. Based on your description, it seems that you may be experiencing a combination of tension-type headaches and possibly migraine-related symptoms, which can be exacerbated by factors such as stress, fatigue, and prolonged eye strain.

Understanding the Symptoms
1. Eye Pressure and Pain: The sensation of pressure or pain behind the eyes can be related to several factors. One common cause is eye strain, which can occur after prolonged use of screens or engaging in activities that require intense focus. This strain can lead to discomfort in the eye muscles and surrounding areas.

2. Head Pain: The progression of pain from the eyes to the temples and sides of the head suggests a tension-type headache or a migraine. Tension headaches are often triggered by stress, poor posture, or muscle tension in the neck and shoulders. Migraines, on the other hand, can be triggered by various factors, including stress, certain foods, and environmental changes.

3. Neck and Shoulder Tension: The stiffness in your neck and shoulders could be contributing to your headaches. Muscle tension in these areas can lead to referred pain, which means that pain is felt in a different area than where it originates. This is common in individuals who spend long hours in front of computers or engage in activities that require repetitive movements.

4. Nausea and Dizziness: The feelings of dizziness and nausea, especially when severe, can be associated with migraines. Migraines can cause a range of symptoms, including sensitivity to light and sound, nausea, and vomiting.

Possible Causes
- Tension-Type Headaches: Often caused by stress, anxiety, or muscle tension in the neck and shoulders. They can be triggered by prolonged periods of concentration or excitement.

- Migraines: These can be triggered by various factors, including stress, lack of sleep, or even certain foods. Migraines often present with unilateral head pain, nausea, and sensitivity to light and sound.

- Eye Strain: Prolonged screen time or activities that require intense focus can lead to eye strain, resulting in discomfort and headaches.

Relief Strategies
1. Self-Care Techniques:
- Rest and Relaxation: When symptoms arise, find a quiet, dark room to rest. Lying down can help alleviate some of the pressure and discomfort.

- Cold Compress: Applying a cold compress to your forehead or the back of your neck can help reduce headache pain.

- Hydration: Ensure you are well-hydrated, as dehydration can exacerbate headaches.

- Gentle Stretching: Perform gentle neck and shoulder stretches to relieve muscle tension.

2. Lifestyle Modifications:
- Ergonomic Adjustments: Ensure your workspace is ergonomically friendly to reduce strain on your neck and eyes.

- Screen Breaks: Follow the 20-20-20 rule: every 20 minutes, look at something 20 feet away for at least 20 seconds to reduce eye strain.

- Stress Management: Engage in relaxation techniques such as yoga, meditation, or deep-breathing exercises to manage stress levels.

3. Medical Consultation:
- If your symptoms persist or worsen, it is advisable to consult with a healthcare professional. A neurologist can help determine if you are experiencing migraines or tension-type headaches and may recommend appropriate treatments, including medication or physical therapy.

4. Follow-Up with Eye Care: Since you have previously seen an eye doctor, consider returning for a follow-up if your symptoms continue. They may want to assess for any underlying conditions that could be contributing to your symptoms.

Conclusion
Your symptoms are likely multifactorial, involving eye strain, tension headaches, and possibly migraines. Implementing self-care strategies and making lifestyle adjustments can significantly help manage your symptoms. However, if the discomfort continues, seeking professional medical advice is essential to rule out any serious conditions and to receive tailored treatment options.

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