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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Does tightness with sharp and stabbing pain near the head indicative of a migraine?

Answered by
Dr. Olsi Taka


Practicing since :2004

Answered : 3360 Questions

Posted on Mon, 4 Jun 2018 in Brain and Spine
Question: Hi there. I struggle with some anxiety and depression etc... often by late morning my head feels tight and full and I will feel weird sharp and stabbing pains throughout my head/temples/neck that swirl around and sometimes by the late afternoon it gets very intense and feels almost like a migraine.

Do you think when I start feeling these weird pains, it’s the start of a migraine or do you think I just have bad tension headaches?

I always feel like when I start feeling this pain there’s nothing I can do to avoid it getting worse later and feel defeated for the whole day.
Answered by Dr. Olsi Taka 23 minutes later
Brief Answer:
Tension type headache likely.

Detailed Answer:
I read your question carefully and I understand your concern.

Judging from the description you provide of head feeling tight and of those moving sharp pains I would say that a tension type headache is the most likely diagnosis. The increased muscle tension is typically manifested through that tightness feeling and is commonly associated with abnormal scalp sensations like those stabbing ones. The fact it increases as the day goes by supports it as well.
Of course it may happen for there to coexist tension type headache and migraine in the same patient but you do not describe anything to make me think of migraine.
You should get an over the counter anti-inflammatory pain killer as soon as the symptoms appear to alleviate them.

I remain at your disposal for other questions.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Olsi Taka 1 hour later
Hi yeah. The pain is like a pin prick kinda pain and a fuzzy feeling over my forehead. The neck and shoulders are always sore and tight.

And when it gets bad it’s ususlly on one temple but can radiate to the ear/eyes/forehead. And it’s ueudlly sharp or stinging or burning. And I can fall asleep with it but it is hard to concentrate or do much because the pain can be intense. It feels energetic. Like trapped energy.

Answered by Dr. Olsi Taka 2 hours later
Brief Answer:
Read below.

Detailed Answer:
Thank you for the additional information!

All that only reinforces my initial opinion about tension type headache, the tightness in the neck and shoulders, the pin prick or stinging sensations in the scalp, it is all in favor of tension type headache which is commonly associated with stress and anxiety. So my recommendation remains the same, over the counter anti-inflammatory pain killers like Ibuprofen in addition to anxiety treatment.

Let me know if I can further assist you.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Olsi Taka 4 hours later
A few more things.

It often feels like it’s a bit of sensory overload. Too much activity during the day. Noise. Talking. Music. Etc... all adds up and eventually overwhelms me. if I do less, it’s less strong... if I do more... it’s worse. But it’s still a low threshold.

It used to be that I’d get just some sharp pain in my ear/neck area but since my nerves broke down it’s much worse.

I wonder if my tolerance will ever raise?

Does that make sense?
Answered by Dr. Olsi Taka 14 hours later
Brief Answer:
Read below

Detailed Answer:
Sorry for answering a little late but in addition of it coming just as I went to sleep the site was undergoing maintenance and I had trouble logging in today.

It makes sense. What you describe there fits with the diagnosis of anxiety and tension type headache perfectly as I said. It certainly can be worked upon by addressing anxiety. That is done through psychotherapy and medication.
Psychotherapy is very helpful in identifying anxiety provoking thinking patterns and learning how to cope with them and relaxation exercises. Activities like yoga should help as well.
If not enough (or do not have access to psychotherapy) medication (antidepressants are first choice) may be added to help you cope with the symptoms.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Olsi Taka 3 days later
Is this closed?

Often along with the other symptoms I get a lot of crackling and popping and crunching in my ears and throughout my face.

Does tension build pressure on the sinuses and ear canals?
Answered by Dr. Olsi Taka 12 minutes later
Brief Answer:
Not due to tension

Detailed Answer:
Those symptoms you describe are not due to tension type headache in itself, it may be associated with some nasal congestion but doesn't affect the ears.
You should have an ear exam on that regard although the I wouldn't exclude them being psychological in nature, due to anxiety. That is due to their waxing and waning nature you seem to describe (an ear or sinus infection would be more constant in its manifestations) and also due to the description of crackling in the face which is unlikely.

Wishing you a happy New Year!
Above answer was peer-reviewed by : Dr. Raju A.T
Follow up: Dr. Olsi Taka 23 hours later
Happy New Year to you as well!

Today the pain is a bit different. There’s constant pressure across my forehead but if I shake my head or nod it becomes sharp pain and when I press down in my shoulders the pain goes from my shoulders all the way up to my temples. And my ears are ringing a bit.

Does this still sound like tension to you?
Answered by Dr. Olsi Taka 5 hours later
Brief Answer:
My opinion remains the same.

Detailed Answer:
Hello again!

It sounds to me like tension type headache and anxiety. It certainly doesn't sound like any brain condition, nor like an ear or sinus issue. None of them are affected by shaking the head or pressing in the shoulders. The combination you describe doesn't anatomically fit with any lesion, which supports the anxiety hypothesis. If only for a few days a viral infection might also cause this combination of symptoms but since you say symptoms have been present for some time I would still go with anxiety and tension type headache.
You should try to relax, try to engage in other activities, some mild to moderate intensity exercises instead of focusing on headaches and attempting maneuvers. That only serves to increase anxiety and tension without any benefit for the pain.

Wishing you good health.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

The User accepted the expert's answer

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