Persistent Headaches: Causes and Solutions for Relief - Family Medicine

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Headache


I have been experiencing headaches, dizziness, nausea, and red eyes, which sometimes become blurry, for almost a month.
I have visited a clinic where I received injections and medication that alleviated my symptoms, but they return once I stop taking the medication.
What could be wrong with me? Please help, Dr.
Chen!

APPLE, 30~39 year old female. Ask Date: 2009/01/11

Dr. Chen Mengkan reply Family Medicine


Hello: There are many potential causes of headaches.
I would recommend that you visit the neurology department or family medicine department at a hospital for a differential diagnosis.
Pain relievers generally only alleviate symptoms, and whether further examinations are necessary will depend on the physician's assessment based on your symptoms and physical examination.
I suggest you consider the following questions: the frequency of your headaches, the duration of each episode, accompanying symptoms, the nature of the headache (such as dull, throbbing, or sharp pain), aggravating factors, and relief methods (e.g., massage, medication, sleep).
These factors will help us identify the underlying causes of your headache.
Wishing you a speedy recovery.
Chen Meng-Kan

Reply Date: 2009/01/11

More Info


Persistent headaches accompanied by dizziness, nausea, and visual disturbances such as redness and blurriness can be quite distressing and may indicate a variety of underlying issues. Given that your symptoms have persisted for nearly a month and have only temporarily improved with medication, it is essential to consider several potential causes and appropriate management strategies.


Possible Causes
1. Tension-Type Headaches: These are the most common type of headaches and can be triggered by stress, poor posture, or prolonged screen time. Symptoms typically include a dull, aching pain and a sensation of tightness or pressure across the forehead or on the sides and back of the head.

2. Migraine: Migraines can cause severe headaches, often accompanied by nausea, vomiting, and sensitivity to light and sound. Visual disturbances, known as aura, can occur before or during the headache phase.

3. Cluster Headaches: These are less common but can be extremely painful. They occur in cyclical patterns or clusters and are often accompanied by symptoms such as redness in one eye and nasal congestion.

4. Sinusitis: Inflammation of the sinuses can lead to headaches, facial pain, and pressure, particularly if you have experienced recent upper respiratory infections.

5. Medication Overuse Headaches: If you have been taking pain relief medications frequently, you may be experiencing rebound headaches, which occur when the medication wears off.

6. Neurological Issues: Given the duration and complexity of your symptoms, it is crucial to rule out any serious neurological conditions. This could include conditions like intracranial hypertension or other structural issues within the brain.


Recommended Actions
1. Consult a Neurologist: Since your symptoms have persisted for a month, it is advisable to see a neurologist for a comprehensive evaluation. They may recommend imaging studies such as an MRI or CT scan to rule out any serious conditions.

2. Keep a Headache Diary: Documenting when your headaches occur, their intensity, duration, and any associated symptoms can help your healthcare provider identify patterns and triggers.

3. Lifestyle Modifications:
- Stress Management: Techniques such as mindfulness, meditation, and yoga can help reduce stress and tension that may contribute to headaches.

- Ergonomics: Ensure that your workspace is ergonomically friendly to reduce strain on your neck and back.

- Hydration and Nutrition: Dehydration and poor nutrition can exacerbate headaches. Ensure you are drinking enough water and eating balanced meals.

4. Medication Review: Discuss with your doctor the possibility of adjusting your current medications. If you are experiencing rebound headaches, your doctor may suggest a tapering plan for your pain relief medications.

5. Physical Therapy: If tension-type headaches are suspected, physical therapy focusing on neck and shoulder relaxation may be beneficial.

6. Regular Follow-Up: Given the complexity of your symptoms, regular follow-up appointments with your healthcare provider will be essential to monitor your condition and adjust treatment as necessary.


Conclusion
Persistent headaches with accompanying symptoms such as dizziness and visual disturbances warrant thorough investigation. While common causes like tension headaches and migraines are likely, it is crucial to rule out more serious conditions. By consulting a neurologist, documenting your symptoms, and making lifestyle adjustments, you can work towards finding relief and improving your quality of life. Remember, effective management often requires a multifaceted approach tailored to your specific situation.

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