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Suggest Treatment For Tension Headache And Severe Anxiety
Question: I'm feeling a little better but not 100% yet I went to the doctor 2 weeks ago for the pressure behind my head and after examining me and a few questions he diagnosed me with tension headaches due to stress and anxiety also said he felt a couple nuts on my neck I made an appointment to see a psychiatrist tomorrow Monday morning because I'm still feeling a little anxiety and nervousness and I think that's why my head is not 100% back to normal yet he ended up giving me some ibuprofen and muscle relaxers and said I should feel better in 2 weeks but I do feel a little better I'm not 100% better so hopefully after I see the psychiatrist they gave me some medication and whatever other help they offer I will be back on track to feeling 100% healthy and normal again
Brief Answer:
Let's talk about headaches
Detailed Answer:
Good evening. Many thanks for posing your situation and its description. I understand you've been diagnosed with tension type headaches, given some medication in the form of muscle relaxants and ibuprofen but do not feel any better. You've got an appointment with a psychiatrist to evaluate you for your feelings of anxiousness and nervousness and for that reason you feel that your head may not be altogether back to "100%" normal. You say that the physician felt a couple of "nuts" on the back of your neck. I'm assuming you meant to say, "KNOTS". You were given a prognosis of 2 weeks to feeling better but this has not come to pass.
You've not really posed a question but my assumption is that you are still dealing with headaches, anxiety, and nervousness. I am a neurologist and headache specialist therefore, my comments are going to be necessarily geared toward opining on tension type headaches which have not subsided in 2 weeks being treated with ibuprofen and muscle relaxants. What I can say about nervousness and anxiety is that they are considered COMORBID conditions that we frequently see in association with headaches. However, only the psychiatrist will be able to tell for sure whether your anxiousness/nervousness is a cause or effect of the headaches. Make sense?
You've not described anything having to do with the instructions you were given to take the ibuprofen and muscle relaxants therefore, I will say this...the most common PROBLEM I encounter in headache patients who have ongoing symtoms without relief from the medications they've been given is either they are:
1. not diagnosed with the proper headache type
2. not taking the most appropriate medication for the headache type they have
3. overusing the medications they've been prescribed for the CORRECT headache type.
Which one of the above 3 are you? I can't say simply based upon the information you've provided. But I will say this....if you are taking more than 15 DOSES of ibuprofen and/or muscle relaxants within a 30 day period then, you risk falling into a condition known as MEDICATION OVERUSE HEADACHE. This is an extremely common problem seen in headache patients and one that is unfortunately contributed to by both physicians and patients. Few people are aware of the parameters for counseling patients on avoiding overuse but the number are the following:
1. If medications such as ibuprofen, acetaminophen, aspirin are used then, a total of 15 doses is the limit per 30 days without risking OVERUSE or what used to be called REBOUND headaches.
2. If medications such as Imitrex, Maxalt, other triptans, Midrin, Treximet, etc. are used then, only 10 doses per 30 days should be used otherwise OVERUSE headache may be precipitated.
What I also do in all my headache patients is to solidy the actual headache type through use of a HEADACHE DIARY or LOG which can be obtained from online and filled out over a 2-4 week period so that the physician can easily see the symptoms, the progression, and the possible triggers associated with the headaches. General physicians and internists are typically not the best people to deal with such logs therefore, if your headaches are not being cleared and your physician is not able to help via a headache diary you should ask for a referral to a headache specialist or a neurologist.
By all means see your psychiatrist and get a diagnosis, however, in my opinion I believe it is to your benefit to get a solid diagnosis on the type of headaches you have by filling out a headache diary and being aware of potential medication overuse problems. If necessary get seen by a headache specialist and don't be afraid of speaking up against the use of a lot of drugs in place of more conservative and proactive forms of intervention such as breathing/relaxation techniques, biofeedback therapy, and a good review of risk factors that are not commonly looked at that can cause sleep disorders such as PTSD, insomnia, nightmares, SLEEP APNEA, GERD, and medication induced headaches.
If your question was adequately responded to could you do me a favor and not forget to CLOSE THE QUERY if you've no more questions?
I sincerely hope you start to feel a bit better and are able to take advantage of the information I've mentioned in order to obtain the best treatment possible and start turning things around.
This query has utilized a total of 42 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.
Let's talk about headaches
Detailed Answer:
Good evening. Many thanks for posing your situation and its description. I understand you've been diagnosed with tension type headaches, given some medication in the form of muscle relaxants and ibuprofen but do not feel any better. You've got an appointment with a psychiatrist to evaluate you for your feelings of anxiousness and nervousness and for that reason you feel that your head may not be altogether back to "100%" normal. You say that the physician felt a couple of "nuts" on the back of your neck. I'm assuming you meant to say, "KNOTS". You were given a prognosis of 2 weeks to feeling better but this has not come to pass.
You've not really posed a question but my assumption is that you are still dealing with headaches, anxiety, and nervousness. I am a neurologist and headache specialist therefore, my comments are going to be necessarily geared toward opining on tension type headaches which have not subsided in 2 weeks being treated with ibuprofen and muscle relaxants. What I can say about nervousness and anxiety is that they are considered COMORBID conditions that we frequently see in association with headaches. However, only the psychiatrist will be able to tell for sure whether your anxiousness/nervousness is a cause or effect of the headaches. Make sense?
You've not described anything having to do with the instructions you were given to take the ibuprofen and muscle relaxants therefore, I will say this...the most common PROBLEM I encounter in headache patients who have ongoing symtoms without relief from the medications they've been given is either they are:
1. not diagnosed with the proper headache type
2. not taking the most appropriate medication for the headache type they have
3. overusing the medications they've been prescribed for the CORRECT headache type.
Which one of the above 3 are you? I can't say simply based upon the information you've provided. But I will say this....if you are taking more than 15 DOSES of ibuprofen and/or muscle relaxants within a 30 day period then, you risk falling into a condition known as MEDICATION OVERUSE HEADACHE. This is an extremely common problem seen in headache patients and one that is unfortunately contributed to by both physicians and patients. Few people are aware of the parameters for counseling patients on avoiding overuse but the number are the following:
1. If medications such as ibuprofen, acetaminophen, aspirin are used then, a total of 15 doses is the limit per 30 days without risking OVERUSE or what used to be called REBOUND headaches.
2. If medications such as Imitrex, Maxalt, other triptans, Midrin, Treximet, etc. are used then, only 10 doses per 30 days should be used otherwise OVERUSE headache may be precipitated.
What I also do in all my headache patients is to solidy the actual headache type through use of a HEADACHE DIARY or LOG which can be obtained from online and filled out over a 2-4 week period so that the physician can easily see the symptoms, the progression, and the possible triggers associated with the headaches. General physicians and internists are typically not the best people to deal with such logs therefore, if your headaches are not being cleared and your physician is not able to help via a headache diary you should ask for a referral to a headache specialist or a neurologist.
By all means see your psychiatrist and get a diagnosis, however, in my opinion I believe it is to your benefit to get a solid diagnosis on the type of headaches you have by filling out a headache diary and being aware of potential medication overuse problems. If necessary get seen by a headache specialist and don't be afraid of speaking up against the use of a lot of drugs in place of more conservative and proactive forms of intervention such as breathing/relaxation techniques, biofeedback therapy, and a good review of risk factors that are not commonly looked at that can cause sleep disorders such as PTSD, insomnia, nightmares, SLEEP APNEA, GERD, and medication induced headaches.
If your question was adequately responded to could you do me a favor and not forget to CLOSE THE QUERY if you've no more questions?
I sincerely hope you start to feel a bit better and are able to take advantage of the information I've mentioned in order to obtain the best treatment possible and start turning things around.
This query has utilized a total of 42 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I got some blood work done about a mont and halg ago and it took about 5 days to get the results back that was the worst anxiety and nervousness I have felt in a long period of time all I kept thinking was the worst ,mornings were the worst for me for some reason my anxiety and nervousness was the worst in the mornings.I was prescribed zolft 3 weeks prior to that and it made me feel worst,lost of sleep lost of apetite and my anxiety and nervousness remained the same id not worst at times so on the 5 th day I found out I could get mt blood results on line I went on line and when I got to the page that had my results I felt anxiety extremely nervous and worried about getting some bad news and I felt tbis tingling sensation in the back of my head that started in my ne k like a wave of pressure that ran from mt nevk ti the back of my head this was at about 4 pm and I drove home and just felt alir of pressure the back of my head like not a headache but very wierd also like I was in a haze or kind if in a cloud fir the remainder of the afternoon until I went to bed this was thursday evening,friday when I got up I wAs very worried about the results and luckily fir me I was able to get a hild of my dictors nurse at 7 am and wS told everything came back normal it was like a ton of bricks was lifted of my shoulders and I felt much better,now into saturday morning I noticed like some slight pressure in the back of my head it was wierd because ive never suffered from headache or migraines ir the pressure that I was feeling or felt,didnr think much of it now into monday me and my family were headed out of town on vacation in Tuesday and for some reason felt nervous and anxiety about the trip well starting tuesday I started feeling that pressure on and of all day and fir the rest of the week two weeks later is when I saw the doctor and was given the ibeprophen and muscle relaxers ti take fir a period of 2 weeks ibeprophen 800 mg 3times a day and 1 muscle relaxer begore bed I dont feel the pressure anymore like I did but as the day progresses the muscle or nerve behind my ear is soar and has been since I started feeling this way in my head and because ive frlt this way for about a month and not 100% better it causes me anxiety and nervousness all day in the mornings I wake up about 2-4am and start thinking about my head and it gives me a mild migraine like behind my left eye or like nasal cavity under my left eye from stressing I start think it's a brain tumour or something serious and I get all worked up do you think it is a tumor doc??? I dont feel dizzy ir nauseous or fainting none of that just like that muscle I was talking about behind my left ear is sore,when I get home I put ice on it and it gies away and I feel normal or in the mid day if its bothering me I put some tiger balm and it feels much better but that exact spot when I also message it it goes away,ive alsi been taking over the counter medication like exedrin and aleve.it wirks at times but the ice or message do the trick again doc do u think it's a tumor or something that requires surgery thats what scares me too death and has given me alot of nervousness and anxiety and I feel like that also triggers the pressure or the tiny little pulse feeling I feel not right behind my left ear but around that area a little above that muscle or nerve behind my left ear please tell me this dossnt sound like something serious doc???
Brief Answer:
I do not think your description suggests a brain tumor
Detailed Answer:
Thank you for the detailed description of your situation. I also can appreciate the amount of stress and anxiety you may be feeling and also understand why your physician may be tempted to call your headaches stress or tension type, however, for the reasons I mentioned above, 2400mg. ibuprofen PLUS muscle relaxants on a daily basis, in my opinion, is a risky regimen which can cause gastric irritation along with opening the patient up to what I told you was a very common situation created sometimes by patients and sometimes by doctors.
First of all, I would not think of tumor as a very likely possibility in your case so my workup would be directed at the headaches in the way I previously described.
Secondly, I would want you to fill out a headache diary which will take a variety of important parameters into consideration and to do this for a minimum of 2-4 weeks using whatever means and prescriptions you've been given to treat and reduce your headaches. I would not necessarily add any new medications in this time period for the headaches. The headache diary then, dictates the most likely class of headache you are suffering from (sounds like tension type, maybe mixed with some migraine features, however, there is also a chance that ibuprofen is being over prescribed and contributory to ongoing headaches.
Thirdly, keep in mind the numbers I gave you. 15 doses of ibuprofen PER MONTH for headaches. At 3 doses daily of the highest dose of ibuprofen that can be given by prescription you will be entering risky territory after 5 days of that regimen.
If your question was adequately responded to could you do me a favor and CLOSE THE QUERY if you've no more questions?
I sincerely hope you start to feel a bit better and are able to take advantage of the information I've mentioned in order to obtain the best treatment possible and start turning things around.
This query has utilized a total of 86 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.
I do not think your description suggests a brain tumor
Detailed Answer:
Thank you for the detailed description of your situation. I also can appreciate the amount of stress and anxiety you may be feeling and also understand why your physician may be tempted to call your headaches stress or tension type, however, for the reasons I mentioned above, 2400mg. ibuprofen PLUS muscle relaxants on a daily basis, in my opinion, is a risky regimen which can cause gastric irritation along with opening the patient up to what I told you was a very common situation created sometimes by patients and sometimes by doctors.
First of all, I would not think of tumor as a very likely possibility in your case so my workup would be directed at the headaches in the way I previously described.
Secondly, I would want you to fill out a headache diary which will take a variety of important parameters into consideration and to do this for a minimum of 2-4 weeks using whatever means and prescriptions you've been given to treat and reduce your headaches. I would not necessarily add any new medications in this time period for the headaches. The headache diary then, dictates the most likely class of headache you are suffering from (sounds like tension type, maybe mixed with some migraine features, however, there is also a chance that ibuprofen is being over prescribed and contributory to ongoing headaches.
Thirdly, keep in mind the numbers I gave you. 15 doses of ibuprofen PER MONTH for headaches. At 3 doses daily of the highest dose of ibuprofen that can be given by prescription you will be entering risky territory after 5 days of that regimen.
If your question was adequately responded to could you do me a favor and CLOSE THE QUERY if you've no more questions?
I sincerely hope you start to feel a bit better and are able to take advantage of the information I've mentioned in order to obtain the best treatment possible and start turning things around.
This query has utilized a total of 86 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Yes thank you doc over all I am feeling better than I was 4 weeks ago I dont feel the pressure in my head all day and waje up feeling fine its as the day goes on that I start feeling a little discomfort or pressure I take a break at mid day for lunch and lay down and relax fir about 30 min to 45 min and feel fine again then I feel a little discomfort when I get off at 3 pm go home.and relax and put some.heating pad and a message and feel fine again.I will start taking a diary as of tomorrow and see what kind of medication I get.from my psychiatrist tomorrow and only take 2 exedrin of 500 mg for.tension headach rhat I have if needed because like I said I have felt alot better from 4 weeks ago but mot 100% yet.I also had some acupuncture done on friday and I think it did do a difference.hopefully after tomorrow's visit I eill be on the right track to feeling 100% my srlf again.thank ypu for your time doc and all the information and advice you iffered me tiday I really appreciate it and feel alot better after talking to you.have a great day
Brief Answer:
Patient Patience is important key to success
Detailed Answer:
Nice to hear that you're feeling that much better compared to 2 weeks ago. Please still stay vigilant not just now but in the future what the risks are for headaches becoming even more resilient and refractory to treatment if they become intensified due to OVERUSE of analgesics.
Headache diaries are widely available on the Internet. Check out this link and see which of the diaries may fit your style of documentation. Some are "better" than others in terms of the information they gather but in the end you should choose something that is easy to understand and easy for you to fill out and easy for your doctor to analyze QUICKLY....and don't be too surprised if most doctors won't be as interested in looking at your work as you are in providing the information or doing it....trust me...it's worth doing for many reasons......find a doctor or specialist who believes in this type of documentation and organization. It makes a HUGE difference to treatment when you go based on what the patient relates and put down in black and white as opposed to what they MAY REMEMBER....most of which never goes beyond a few hours in the past....right?
Here's the link:
https://www.yyyyyyy.com/search?q=yyyyyyyy+diary&tbm=isch&tbo=yyyyyyyyy=univ&sa=X&ved=0ahUKEwjGvf-yyyyyyyyyyyyyyyyyyyyyyyy=1024&bih=635
If your question was adequately responded would you do me a favor and CLOSE THE QUERY at this point?
I sincerely hope you start to feel a bit better and are able to take advantage of the information I've mentioned in order to obtain the best treatment possible and start turning things around. I also hope you'll take a serious look at the diary concept and use it not only for headaches but just about for anything where the doctor will be better treating you if they've got a detail of information you've collected over time.
This query has utilized a total of 103 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.
Patient Patience is important key to success
Detailed Answer:
Nice to hear that you're feeling that much better compared to 2 weeks ago. Please still stay vigilant not just now but in the future what the risks are for headaches becoming even more resilient and refractory to treatment if they become intensified due to OVERUSE of analgesics.
Headache diaries are widely available on the Internet. Check out this link and see which of the diaries may fit your style of documentation. Some are "better" than others in terms of the information they gather but in the end you should choose something that is easy to understand and easy for you to fill out and easy for your doctor to analyze QUICKLY....and don't be too surprised if most doctors won't be as interested in looking at your work as you are in providing the information or doing it....trust me...it's worth doing for many reasons......find a doctor or specialist who believes in this type of documentation and organization. It makes a HUGE difference to treatment when you go based on what the patient relates and put down in black and white as opposed to what they MAY REMEMBER....most of which never goes beyond a few hours in the past....right?
Here's the link:
https://www.yyyyyyy.com/search?q=yyyyyyyy+diary&tbm=isch&tbo=yyyyyyyyy=univ&sa=X&ved=0ahUKEwjGvf-yyyyyyyyyyyyyyyyyyyyyyyy=1024&bih=635
If your question was adequately responded would you do me a favor and CLOSE THE QUERY at this point?
I sincerely hope you start to feel a bit better and are able to take advantage of the information I've mentioned in order to obtain the best treatment possible and start turning things around. I also hope you'll take a serious look at the diary concept and use it not only for headaches but just about for anything where the doctor will be better treating you if they've got a detail of information you've collected over time.
This query has utilized a total of 103 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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