HomeAnswersNeurologyheadacheI have been experiencing frequent headaches. Please help.

What are the effective treatments for recurrent headaches?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Answered by

Dr. Hitesh Kumar

Medically reviewed by

iCliniq medical review team

Published At January 28, 2024
Reviewed AtFebruary 2, 2024

Patient's Query

Hi doctor,

I am 36 years old and weigh 132 pounds. Last month, I had headaches every day. When I take a painkiller, the headache goes away, but it comes back again. My blood pressure is slightly elevated, but I also have headaches when it is normal. I am not taking any medication regularly.

Kindly help.

Answered by Dr. Hitesh Kumar

Hello,

I appreciate that you have chosen icliniq.com for your medical needs.

I am here to give you the best care possible.

I would like to know some further details about your headache:

  1. When did you start experiencing these headaches?
  2. In which part of your head do you feel the headaches? (You can attach a photo taken from a little distance with your hand over the area where you feel the headache. You can attach two to three photos from the front or sides if the headache area is large)
  3. What type of headaches do you experience - heaviness, bursting, squeezing, stretching, throbbing, or another kind?
  4. Are your headaches intermittent or persistent?
  5. If intermittent, how long does one episode of headache last (without taking a painkiller tablet)?
  6. Do you experience any nausea or vomiting during a headache episode?
  7. Is the headache associated with any redness in your eyes, watering from your eyes, or nasal blockage?
  8. Have you noticed any specific trigger factors for these headaches?
  9. Before the past month, how frequently were these headaches occurring? How many times per week?
  10. Are you taking any regular medication for your headaches (apart from painkillers)? If yes, please provide the name, dosage, and frequency.
  11. How is your vision for distant objects and near objects?
  12. Have you undergone a CT or MRI scan or any other investigation for your headaches? If yes, please send the reports along with your blood test reports.

Other information:

  1. How is your sleep routine?
  2. Do you get sleepy soon after lying in bed, or does it take a long time?
  3. Once you feel sleepy, do you experience frequent awakenings during sleep?
  4. Do you feel refreshed upon waking in the morning?
  5. How is your usual mood during your daily activities?
  6. Are you generally happy, leaning toward the sad side (thinking about past events), leaning toward the worried side (thinking about future things), irritable, or something else?

Looking forward to your response in order to help you.

Thank you.

Regarding follow up

Reply with the above-mentioned information for better understanding and further assessment.

Patient's Query

Hello doctor,

Thank you for the reply.

  1. Since when did your headaches start? They started a couple of months ago, but in the last month, they have occurred every day.
  2. In which part of your head do you feel the headaches? (You can attach a photo taken from a little distance, with your hand placed over the part of the head where you feel the headache. You can attach 2-3 photos from the front and sides if the headache area is large.) Mostly, I feel pain in my forehead and near my eyes. Last month, I had my eyes checked, and I changed my glasses because I thought that might be the reason, but my headache continues.
  3. What kind of headaches do you experience - heaviness, bursting, squeezing, stretching, throbbing, or some other kind? Mostly, the sensation is like squeezing.
  4. Are your headaches intermittent or persistent? I could say both. After taking a painkiller, the pain goes away for 2 to 3 hours, but then it comes back again.
  5. If intermittent, how long does one episode of a headache last (without a painkiller tablet)? Without a painkiller, the pain can last for hours, maybe even the whole day.
  6. Do you feel any nausea or experience vomiting during a headache episode? The last time the headache was so strong that I did vomit. My blood pressure was also strange, it was measured at 110/90.
  7. Is the headache associated with any redness in your eyes, watering from your eyes, or nasal blockage? No.
  8. Have you noticed any specific trigger factors for these headaches so far? No, I have been trying to understand if they are connected to something, but I cannot say for sure at this point.
  9. How frequent were these headaches before one month? How many times in a week? Before a month, they occurred maybe every second day or so.
  10. Do you take any regular medication for your headaches (apart from painkillers)? If yes, please provide the name, dosage, and frequency. No, I am only taking Nurofen.
  11. How is your vision for distant objects and for near objects? Generally, my vision is okay. Only in the evening when I am tired, it is a bit blurred.
  12. Have you undergone a CT or MRI scan or any other investigations for your headaches? If yes, please send the reports along with blood test reports too. Not yet.

Other information:

  1. How is your sleep routine? Do you get sleepy soon after lying in bed, or does it take a long time? Once you get sleepy, do you have frequent awakenings during sleep? Do you feel refreshed upon waking in the morning? Taking into account that I am the mother of two 5-year-olds, my sleep is not steady for sure. Usually, I do not fall asleep easily; I need some time to fall asleep. It's also very easy for me to wake up at any sound. I also have a lot of dreams. When I wake up, I feel tired, and my body does too.
  2. How is your usual mood during day-to-day activities? Are you generally happy, leaning toward the sad side (thinking about past events), leaning toward the worried side (thinking about future things), irritable, or something else? Sometimes I am more or less fine, but I have moments when I am worried about the future or sad about past events.
Answered by Dr. Hitesh Kumar

Hello,

Glad to have you back!

I am here to help you get the best medical advice.

I understand your concern.

With your description, several possibilities come to mind:

  1. Tension Headache.
  2. Chronic Migraine Headache.
  3. Secondary causes of a headache need to be ruled out.

I hope this has helped you.

Thank you.

Investigations to be done

The required investigations include: Magnetic resonance imaging (MRI) of the brain with contrast, electrocardiogram (ECG), T3 (triiodothyronine), T4 (thyroxine), and TSH (thyroid stimulating hormone), serum vitamin B12 level, and ophthalmology consultation to assess refraction, intraocular pressure (IOP), and fundus examination.

Differential diagnosis

The differential diagnosis includes tension headache, chronic migraine headache, and the need to rule out secondary causes of headaches.

Treatment plan

I suggest you try the tablet Amitriptyline 10 mg once at night time after ruling out secondary causes for the headache.

Preventive measures

Preventive measures include: Engage in daily jogging for 20 to 30 minutes in the morning. Maintain regularity in sleep, wake, and meal timings. Try to identify trigger factors and avoid them.

Regarding follow up

Review with above-mentioned investigation reports.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Hitesh Kumar
Dr. Hitesh Kumar

Neurology

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