Persistent Head Pain: Causes and Treatment Options

Q: Persistent Head Pain: Causes and Treatment Options

Hello, Miss： You mentioned "gastroesophageal reflux... <br>I almost always sleep with my head elevated on my side (using a pillow and a body pillow to alleviate discomfort), and I wonder if my sleeping position is causing headaches." Elevating the head can indeed lead to overuse

I've been experiencing a persistent feeling of pressure and dull pain in my head lately?

Hello Doctor, my situation is as follows: Recently, I have been experiencing pain on the left side of my head, specifically the top and the back left side, which started in early December.
Initially, it was occasional sharp pain, but last week it turned into a persistent, throbbing dull pain (all on the left side of my head).
I have a history of gastrointestinal issues; since February of last year, I have been suffering from recurrent gastroesophageal reflux disease (GERD) for a duration of 10 months.
In July of last year, I underwent an endoscopy, which showed no issues, and I was diagnosed with bile reflux and dyspepsia.
Since I have not found relief from the gastroenterology department and I tend to get easily anxious and stressed, I started seeing a specialist for autonomic nervous system disorders in October.
Additionally, I experience gastroesophageal reflux at night, so I sleep with my head elevated and on my side (using a pillow and a body pillow to alleviate discomfort).
I am not sure if my sleeping position is contributing to my headaches.
In November, I visited a gynecologist and had blood tests for vitamin D, which showed a deficiency of only 12.
The doctor recommended a high-dose vitamin D supplement (10,000 IU daily) for three months.
I am unsure if this has any impact on my current condition.
I mainly want to consult you about my headache issue.
Thank you for your assistance.
If I need to visit a hospital, which department would be most appropriate?

Niming, 20~29 year old female. Ask Date: 2024/01/02

Dr. Jiang Junyi reply Neurology

Hello, Miss: You mentioned "gastroesophageal reflux...
I almost always sleep with my head elevated on my side (using a pillow and a body pillow to alleviate discomfort), and I wonder if my sleeping position is causing headaches." Elevating the head can indeed lead to overuse of the trapezius muscles in the neck, similar to the issues faced by those who frequently look down.
For gastroesophageal reflux, it is recommended to elevate the entire head of the bed.

Additionally, in daily life, it is advisable to avoid foods that contain spices, fats, chocolate, coffee, cocoa, tea, mint, glutinous rice, bananas, citrus fruits, tomatoes, pineapples, sodas, and cola, as well as to refrain from smoking and drinking alcohol.
Avoid consuming excessively hot or cold foods.
It is suggested to adopt a low-fat, high-protein diet, eating smaller portions (about 70% full) and having multiple meals (4 to 6 meals) throughout the day, as overeating can lead to excessive gastric acid secretion and increased intra-gastric pressure.
Chew food thoroughly and slowly, and only drink a moderate amount of liquid during meals to assist food passage.
Do not lie down within 2 hours after eating, and avoid eating 3 hours before bedtime.

It is recommended to sleep on your left side to utilize gravity to keep stomach acid in the stomach.
Maintain a positive mood and manage stress appropriately.
Avoid wearing tight clothing and bending over while working.
Regarding cervicogenic headaches, it is advisable to perform neck muscle stretching exercises regularly, developing a habit of gently stretching the neck up, down, left, and right every 15 to 20 minutes at angles that do not cause discomfort.
I recommend consulting a neurologist or a rehabilitation physician for further evaluation and treatment.

Thank you for your inquiry.
If you have any related questions, feel free to discuss them further.
Wishing you good health, peace, and happiness.
Dr.
Jiang Junyi, Taoyuan Medical Center, cares about you.

Reply Date: 2024/01/02

More Info

Persistent head pain can be a complex issue, often resulting from a combination of factors, including physical, psychological, and lifestyle influences. Based on your description, it seems that you are experiencing a specific type of headache that has evolved from occasional sharp pains to a more constant throbbing sensation localized on the left side of your head. This change in the nature of your headache is significant and warrants a thorough evaluation.

Possible Causes of Your Head Pain
1. Tension-Type Headaches: Given your history of anxiety and stress, it is possible that your headaches are tension-type headaches. These are often characterized by a dull, aching sensation all over the head, and they can be exacerbated by stress, poor posture, and inadequate sleep. Your mention of sleeping with your head elevated to alleviate gastroesophageal reflux symptoms might also contribute to muscle tension in the neck and shoulders, leading to headaches.

2. Migraines: The unilateral nature of your headache (pain on the left side) could suggest a migraine, especially if you experience other symptoms such as nausea, sensitivity to light, or visual disturbances. Migraines can be triggered by various factors, including stress, dietary changes, and hormonal fluctuations.

3. Cervicogenic Headaches: Since you have a history of gastrointestinal issues and have been sleeping in a position that may strain your neck, cervicogenic headaches could be a possibility. These headaches originate from the cervical spine and can cause pain that radiates to the head.

4. Vitamin D Deficiency: Your recent diagnosis of vitamin D deficiency could also play a role in your overall health, including your pain perception. Vitamin D is essential for various bodily functions, including muscle and nerve function. A deficiency can lead to muscle weakness and discomfort, which might contribute to your headache.

5. Gastroesophageal Reflux Disease (GERD): While GERD primarily affects the digestive system, chronic discomfort and anxiety related to this condition can lead to tension and headaches. The discomfort from reflux may also disrupt your sleep, further exacerbating headache symptoms.

Recommended Actions
1. Consult a Neurologist: Given the persistence and change in the nature of your headaches, it would be prudent to consult a neurologist. They can perform a thorough evaluation, which may include imaging studies such as an MRI or CT scan to rule out any structural issues.

2. Lifestyle Modifications: Consider making adjustments to your sleep environment. While elevating your head can help with reflux, ensure that your pillow supports your neck properly to avoid strain. Additionally, practicing relaxation techniques such as yoga or meditation can help manage stress and reduce headache frequency.

3. Nutritional Support: Continue with the vitamin D supplementation as advised by your doctor. It may also be beneficial to evaluate your overall diet to ensure you are getting adequate nutrients that support neurological health, such as omega-3 fatty acids, magnesium, and B vitamins.

4. Physical Therapy: If your headaches are related to neck tension, physical therapy may help. A physical therapist can guide you through exercises to strengthen neck muscles and improve posture.

5. Monitor Triggers: Keep a headache diary to identify potential triggers. Note the frequency, duration, and intensity of your headaches, along with any associated symptoms and lifestyle factors (diet, sleep, stress levels). This information can be invaluable for your healthcare provider in determining the best course of action.

Conclusion
In summary, your persistent head pain could stem from a combination of tension, potential migraines, and lifestyle factors related to your gastrointestinal issues. It is essential to seek a comprehensive evaluation from a neurologist to explore these possibilities further. In the meantime, consider lifestyle modifications and nutritional support to help manage your symptoms. Remember, addressing both the physical and psychological aspects of your health is crucial for effective treatment.

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