Persistent Head Discomfort: Possible Causes and Solutions

Q: Persistent Head Discomfort: Possible Causes and Solutions

Hello： Your symptoms are indeed rare and quite unusual. <br>I recommend visiting the neurology department at a medical center for a detailed examination. <br>If, for some reason, an MRI cannot be performed, high-resolution computed tomography (CT) scans can also be considered!

Head discomfort?

Hello Doctor, I have a feeling of swelling and soreness in the upper part of both eyeballs (similar to eye fatigue).
When I apply pressure, the discomfort in the upper part of the eyeball intensifies, while the lower part feels completely normal.
The eye sockets are fine.
Additionally, I experience a dull, tight pain in my head (not too severe), from my eyebrows to the back of my head.
I often feel the urge to close my eyes and rest or sleep, and I frequently furrow my brows to alleviate the discomfort.
I have seen both an ophthalmologist and a neurologist (with EEG testing), and they both said everything is normal, suggesting it might be tension-type headaches.
However, pain relievers have not helped at all.
Although the symptoms have lessened over the past two months, they have not completely disappeared.
This condition is present upon waking, so it cannot be due to excessive eye use.
About an hour after getting up, the symptoms peak, making me feel very fatigued and drowsy.
After about 1-2 hours, the symptoms lessen again.
After a full day of work, around 5 PM, the symptoms peak once more, and then they again lessen after 1-2 hours, but they never completely go away.
I also carry this discomfort into sleep, and I wake up in pain during the night.
The discomfort is evenly distributed on both sides and does not occur on just one side.
I have researched online and found that many headaches occur upon waking and then lessen or disappear, but my experience is different; I feel slightly better upon waking, but then the symptoms worsen, and during the worsening phase, I feel an overwhelming urge to sleep and just want to close my eyes and rest.
Since no issues have been identified and I cannot undergo an MRI due to having braces, I would like to ask the doctor what possibilities this could indicate.
Thank you.

Niming, 40~49 year old female. Ask Date: 2015/10/31

Dr. Zhang Junwei reply Neurosurgery

Hello: Your symptoms are indeed rare and quite unusual.
I recommend visiting the neurology department at a medical center for a detailed examination.
If, for some reason, an MRI cannot be performed, high-resolution computed tomography (CT) scans can also be considered!

Reply Date: 2015/10/31

More Info

Hello! Thank you for sharing your symptoms in detail. Based on your description, it seems that you are experiencing a combination of eye discomfort and tension-type headaches. Let's break down your symptoms and explore potential causes and solutions.

Symptoms Overview
1. Eye Discomfort: You mentioned a feeling of pressure and soreness in the upper part of both eyeballs, which worsens with pressure. The lower part of your eyes feels normal, and your eye sockets are fine.

2. Head Pain: You experience a dull, tight pain that extends from your forehead to the back of your head. This pain is not severe but is persistent enough to cause discomfort.

3. Fatigue and Sleepiness: You often feel the need to close your eyes and rest, especially after waking up and towards the end of the workday.

4. Timing of Symptoms: Your symptoms peak shortly after waking up and again in the late afternoon, suggesting a possible link to your daily activities or sleep quality.

Possible Causes
1. Tension-Type Headaches: Given your symptoms and the fact that you have been evaluated by both an ophthalmologist and a neurologist, it is plausible that you are experiencing tension-type headaches. These headaches are often associated with muscle tension in the neck and scalp, which can lead to discomfort in the forehead and behind the eyes.

2. Eye Strain: Although you mentioned that your symptoms peak after waking up, prolonged periods of screen time or focusing on tasks can lead to eye strain, which may contribute to the discomfort you feel in your eyes. Even if you are not using your eyes excessively at night, the quality of your sleep and the position you sleep in can affect how your eyes feel upon waking.

3. Sleep Quality: Poor sleep quality can exacerbate headaches and eye discomfort. If you are not getting restful sleep, it can lead to increased fatigue and sensitivity to pain.

4. Sinus Issues: Although you did not mention nasal congestion, sinus pressure can sometimes cause discomfort around the eyes and forehead. If you have had any recent upper respiratory infections or allergies, this could be a contributing factor.

5. Dental Issues: Since you are wearing braces, it is also worth considering that dental issues or jaw clenching could be contributing to your headaches. Tension in the jaw can radiate to the head and cause discomfort.

Recommendations
1. Relaxation Techniques: Since tension-type headaches are often stress-related, incorporating relaxation techniques such as deep breathing, meditation, or gentle yoga can help reduce muscle tension and alleviate headaches.

2. Ergonomic Adjustments: If you spend a lot of time at a computer, ensure that your workspace is ergonomically set up. Your screen should be at eye level, and you should take regular breaks to reduce eye strain.

3. Sleep Hygiene: Focus on improving your sleep quality. Establish a regular sleep schedule, create a calming bedtime routine, and ensure your sleep environment is comfortable and conducive to rest.

4. Consult a Dentist: Since you have braces, it may be beneficial to consult with your orthodontist or a dentist about any potential issues related to jaw clenching or teeth grinding, which could be contributing to your headaches.

5. Follow-Up with a Neurologist: If your symptoms persist despite these measures, consider following up with a neurologist for further evaluation. They may recommend imaging studies like an MRI when you are able to do so, to rule out any underlying conditions.

6. Physical Therapy: A physical therapist can help you with exercises to relieve neck tension and improve posture, which may alleviate some of your symptoms.

In conclusion, while your symptoms may be indicative of tension-type headaches and eye strain, it is essential to continue monitoring your condition and seek further medical advice if necessary. Keeping a symptom diary can also help you and your healthcare providers identify patterns and triggers. Thank you for reaching out, and I hope you find relief soon!

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