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    What causes recurring headache behind the head and nausea?

Posted on Wed, 25 May 2016 in Headache and Migraines
Question: Hi. I'm XXXXXXX MacDonald. I have a headache on and off for 4 weeks. At first we thought it was a migraine but it is at the back of head, as though it were a straight line from ear to ear. Migraine meds did not help it. I am nauseous off and on. I am having acupuncture but I don't always feel great following a treatment. The glands under my jaw are tender but not exceptionally swollen. Could I just have hurt my neck>
Answered by Dr. Olsi Taka 58 minutes later
Brief Answer:
Read below.

Detailed Answer:
Hello! I am Olsi Taka and I am a medical doctor specialized in Neurology.

That pain is not typical for migraine, not so much because of the location (migraine has many variants), but because it is rare to develop new migraine at your age and usually in 4-72 hours attacks with normal intervals in between.

The causes of headache in that area (occipital headache) can be several. One possible frequent reason is high blood pressure. I wonder if you have measured it during these past 4 weeks. High blood pressure can very commonly manifest with such headache. If that is the case, naturally medication to lower blood pressure is needed.

One other frequent cause is neck issues. Neck trauma which you mention is certainly a possible cause, but you should have some recollection of having hurt your neck. Anyway even without a clear episode of neck trauma, neck arthritic changes (which become more probable as we get older) may manifest with pain radiating to the back of the head. Usually medication like Ibuprofen do alleviate the pain, muscle relaxants like Flexeril can help as well. Physical therapy should be instituted to enable muscles to better support the spine.

Possible other causes may include brain trauma, some brain malformations, stroke, infections etc.

So the first step is evaluating blood pressure. If that is normal on repeat measurings than given the persistence of pain for 4 weeks some tests would be necessary, starting with cheap ones like a neck x-ray, blood count and inflammation markers (ESR, CRP) for fractures, dislocations, infection or inflammation changes, up to more expensive ones like head and neck MRI if no cause is found and symptoms persist.

I remain at your disposal for further questions.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Olsi Taka 4 minutes later
Thank you for your information. I didn't specifically hurt my neck. I am wondering when thinking about this if I would have strained my neck with carrying heavy bags on my shoulders or lifting a puppy who has gotten too heavy. a head massage when I had my hair washed last week felt divine but the discomfort came back slowly thereafter. Do you think acupuncture is a good treatment?
Answered by Dr. Olsi Taka 12 minutes later
Brief Answer:
Read below.

Detailed Answer:
Neck arthritis can certainly be exacerbated by too much strain. Usually Ibuprofen does help at least partially at alleviating the pain.
As for acupuncture it is a little difficult to express a clear opinion. Because acupuncture is not exercised by medical professionals there lack studies to evaluated its benefit, you do not find much on the literature.
The only measure for which there are studies to have proven benefit in neck spine issues is physical therapy. However acupuncture it is considered at least safe to try unlike some other treatments like chiropractics which is not advised in neck issues due to a risk for neck artery dissection and stroke. So its use is not discouraged when other means do not work.

I hope to have been of help.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Olsi Taka 9 minutes later
Thank you. I think I'll go with ibuprofen. I will also stand in a warm shower and let the water help a bit. Is a warm compress advised? It could definitely be exacerbated by arthritis.
Answered by Dr. Olsi Taka 13 minutes later
Brief Answer:
Yes heat application is fine.

Detailed Answer:
Heat applications are commonly used and are (partially) successful in a percentage of patients with neck issues. So yes, it is advised.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Answered by
Dr. Olsi Taka


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