For the past several weeks I have been having slight to severe headaches and nothing I have been taking has been working. Sometimes it will start in either side of my temples and go up to the top and front of my head. I will also get pressure behind my eyes. Every once and a while I will get an electric type feeling on my right, top and front part of my head. I am not having any nasal discharge otherwise I would have thought it to be sinusitis. The headaches affect my vision and my thought process. Plus I feel off balance. Out of 100% of my days, 70% of it I feel like I should not be up and about. I went to see my doctor and he gave me migraine medicine and I took it and it honestly did nothing but make me feel more off. I take Excedrin migraine at least one to two times a day and still nothing. And Motrin and Aleve, you name it I have tried it. I don’t think it is normal to be getting headaches everyday but then again I could be wrong. I just need some direction not a diagnosis.
Doctor Joshua’s Answer:
The most common causes of headache are neck muscle tension and migraine. These also overlap. Over-the-counter medication is usually insufficient. For instance, the dosing of ibuprofen (Motrin) for migraine headache is usually 800 mg minimum, and sometimes a single dose of up to 1600 mg is needed. A doctor’s examination and prescription is needed before such doses can be used.
If you have not suffered from headaches before, it is essential that a complete clinical examination including a neurological examination is done. Your primary care physician can do this, and refer you to a neurologist if there are findings. If there is any reason to suspect a neurological illness, a head MRI or at least a CT with and without contrast is done. Sometimes, spinal tap for CSF is done, but this is usually not needed if headache is the only symptom. Sometimes, headache can be a symptom of a non-neurological illness, such as high blood pressure, kidney or liver dysfunction, etc… therefore, a basic lab routine should be done if there is any reason to suspect such problems.
If the above investigations turn out normal, we can safely start experimenting with different treatments in order to find out which helps you the most. For tension headaches, physiotherapy, job ergonomy evaluation, lifestyle changes, anti-inflammatory drugs (usually a course for a week or two), plus muscle relaxants may be needed.
For migraines, various medical treatments exist. Newer migraine medicines such as triptans are very effective for migraines. However, they are fairly expensive, and in most cases the headaches can be controlled with more conventional medicines such as a combination of ibuprofen, codeine and metoclopramide.
Other possible causes for persisting headache include stress, lack of sleep, sedentary lifestyle and disturbance of sleep rhythm.
Last, but not least, medication headache a common cause of headaches. Just taking painkillers (including Motrin) daily for a couple of weeks may result in headaches that are worst in the mornings, because the body gets accustomed to having the drug in the system, and a headache is commonly the first withdrawal symptom when the drug levels fall during the night.
Please discuss these matters with your doctor. Good luck!
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More answers in Family Doctor, Headache, Medication, Migraine, Neurology
