Can a tension headache persist despite medication?

Question

Hello doctor,

I have been having constant moderate to severe headaches for the past four years, and I mean every single day, all day long, from the time I wake up to the time I fall asleep. Nothing OTC medicine has helped, nothing prescribed has helped. I have been told it is just a tension headache. I was prescribed a medicine, but I can't remember the name. It did not work.

I had a CT scan done, and I was told it came back clear. No one has been able to tell me why I have these headaches. It is getting me to where it is hard to function. I just can't take it anymore. I am waiting to see a specialist, but not sure yet when that will be.

The headache is not just on one spot; it is on my whole head, top of my head, the sides, my forehead, the back of my head, my neck, my eyes feel constantly strained, and my ears are always ringing. A doctor told me that my ears could be ringing if I take medicine on a daily basis. So far, doctors have not figured out what it could be.

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I would like to know some details about your headache.

What is your age?
Since when you started to have you been having headaches?
Is it four years only, or even before that? Where do you feel that headache, in which areas of the head?
What kind of headache do you feel: heavy, throbbing, stretching, bursting, shooting pain, electric current-like pain, or some other kind? Is it severe, moderate, or mild?
Is your headache episodic or persistent?
In episodic headache, how long does one episode last (from onset to complete relief without medication)?
How frequent are these headache episodes before and now? Like, how many times in a week? As you mentioned, is it two times a week since the beginning?
Do you feel any vomiting, watering from the eyes, redness in the eyes, or nasal congestion during a headache?
How is your day-to-day mood?
How is your sleep and vision?
Have you noticed any trigger factors for this headache?
Do you have any ear discharge or hearing impairment?
What medicines have you taken before and in what dosages?
Are you taking any medicine now also?

Revert back in case of further queries.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

It seems that you are having a tension-type headache. I also suggest you undergo an ophthalmology examination to look for intraocular pressure and fundus.

If ophthalmology examination reveals normal findings, you can try Amitriptyline 25 mg HS, and in case of severe headache, you can take Naxdom (Naproxen and Domperidone) 500 mg SOS.

Daily exercise in the form of brisk walking or jogging for 20-30 minutes. Maintain headache diary.

Revert with clinical status after three to four weeks of regular medicines as suggested. This medicine may take two weeks to have its effect. Observe the effect of headache on sleep, mood, and everything.

I hope this helps.

Kindly revert in case of further queries.

Thank you.

Answer 3

Hello,

Welcome back to icliniq.com.

Tension-type headache is usually mild to moderate in intensity, though severe. And it can be episodic or persistent, can also convert into chronic daily headaches too.

The tests CT (computed tomography), MRI (magnetic resonance imaging), and eye check-up all come out to be normal in TTH. It is not a life-threatening disease, but it can affect daily living a lot.

There is no confirmatory test for TTH; it's a clinical diagnosis. Have you started Tab Amitryptiline as suggested in the last query? If you started, what effect did you notice after taking it?

Kindly revert in case of further queries.

Thank you.

Answer 4

Hello,

Welcome back to icliniq.com.

Please do not get stressed by the thought of no relief until any medicine. There are many medicine options available nowadays, and each patient is different. A medicine can be very effective in one patient of same problem, but it can be totally ineffective in another patient with the same problem. There are a lot of variations in each individual in terms of the effect of medicine.

Also in the management of TTH, along with medications, other things like lifestyle modification, regular exercise, yoga therapy, and sometimes psychotherapy are also effective as a combined approach. Keep faith in yourself and God. I wish and pray that you get relieved of your headache soon.

I hope this helps.

Kindly revert in case of further queries.

Thank you.