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Suggest Treatment For Headaches While Having Anxiety

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Posted on Wed, 1 Feb 2017
Question: I have had headaches for the past month. Some sharp shooting pain behind my eye. Still comes often throughout the day. Sometimes in my temple. My neck hurts and cracks a lot as well. But the pain is like a brain zap and sometimes just a shooting pain behind my eye like an ice pick headache but atleast 10-20 times a day. Sometimes it happens when I take a deep breath. Has me very concerned. I had a ct scan at the ER and they said it was clear.

I also have a severe anxiety disorder which I have now been prescribed Xanax and Zoloft yesterday. They keep saying it is stress but the pains come when I am calm just as often as when I am stressed. I don't know if my panic could be creating these pains but usually they start the panic rather then come after it. I also get some sharp burning pains in the top of my head but the sharp pains behind the eye and temple are the more concerning.

I often feel like they stop me in my tracks. It is now almost a month and it is affecting my sleep due to the anxiety they create. Even if I wake up positive they come out of nowhere and get me worried. I don't know if a CT scan was good enough. I am so worried about this.

The CT scan was done 12/22/16 and the pain is still there every day. Sometimes when I tilt my head down or move too fast. Sometimes it is random. Sometimes it happens when i turn my head.

I have suffered from migraines my entire life and I know what that pain feels like. This is not the same. It is constant every day. Sometimes i am nauseous but i think that could be from the panic. My vision is not really blurred much but I am in a constant state of panic and always feel faint like I am going to pass out.

I don't know if anxiety can actually cause all these different pains. I had the panic attacks and stuff prior but never had the headache and tightness of my head and heavy feeling. Also the pain is sometimes in the back of my head at the base of my scalp and I get a lot of random pins and needle pain all over my head.
doctor
Answered by Dr. Ishu Bishnoi (40 minutes later)
Brief Answer:
Cause of headache and eye pain

Detailed Answer:
Hi XXXX, thanks for asking from HCM.


I can understand your concern. The sharp pain behind eyes with headache can be due to few reasons like

- Myopia or hypermetropia - As the pain is especially located behind eyes, the cause of pain can be eye disorder like poor visual acuity (myopia or hypermetropia). Kindly consult ophthalmologist for
: visual acuity testing

it can be suspected more if pain occurs after trying to focus your eyes, visual blurring.

- Glaucoma - It is another eye disorder which can cause severe pain in eyes and headache. It means increased eye pressure. It can lead to
severe eye pain
watering from eyes
photophobia (fear from light)
visual blurring

Ophthalmologist will rule it out.

- Frontal and maxillary sinusitis - Long standing pain around eyes and back of eyes are very commonly due to air sinus infection. The frontal and maxillary sinus infection can become chronic if there is history of allergy/repeated common cold/deviated nasal septum.

It can be suspected in you if you are having heaviness in head, post nasal discharge, history of allergy. For this, you need to consult ENT specialist. Long standing sinusitis sometimes require nasal endoscopy treatment.

- Stress headache - If all other organic causes have been ruled out, it can be the cause. It is one of the most common type of headache. This involves frontal part, gives band like sensation around forehead, more pain after focusing eyes/mental stress/lack of sleep, no vomiting, no visual blurring.
It is more common in case of anxiety or depression.

For you, my advise is to rule out ENT and Ophtha causes and then we can think about stress headache.

The neck pain and crack sound are suggestive of poorly flexible neck muscles. You must start
- Physiotherapy of neck muscles
- Do daily neck exercise
- You can apply Diclofenac gel over local pain site
- Hot fomentation will also relieve tightness and crack sound.

Please let me know about your Ent and Ophtha consultation. I will then guide you further about your headache if there will be no relief.

Hope you will understand it. If any doubt, do let me know.
Thanks. Take care

Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Ishu Bishnoi (18 minutes later)
Ok i am just very concerned that this is something imminent that i should be extremely concerned about. Sometimes the pains are so shocking. I never had any sinus problems before. I do not have the band around my head feeling but it is more of a pressure throughout my entire head especially when leaning down or backwards.

It is constant through the whole day. I get the shocking pains 10 times or so that throws me into panic attacks. What are the chances this is something very serious?
doctor
Answered by Dr. Ishu Bishnoi (13 minutes later)
Brief Answer:
Serious headache possibility

Detailed Answer:
Hi XXXX, welcome back.

After going through your question, it seems that your headache is most likely "stress headache" and less likely due to "eye disease".

It is most probably not due to serious disease because of

- Your CT head was normal

- Your headache is generalised. Serious illness like brain tumor or vascular malformation cause focal headache on one side.

- There is no vomiting

- There is no focal deficit like vision loss, weakness

Thats why you should not worry about any serious illness. Still if you feel, you can ask your doctor for MRI brain (plain) to rule out any brain lesion.

For stress headache relief, you can follow few steps
- Sleep daily for 8 hours
- Avoid mental stress
- Do meditation and yoga to relieve anxiety and stress
- You can take tablet Acetaminophen and paracetamol combination for pain relief.
- If still no relief, you can take tablet Naproxen after proper prescription
- Avoid work in dim light, continuous work on laptop/mobile

Hope it will give relief to you. If still any doubt, do let me know.

Thanks. Take care.

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Ishu Bishnoi (4 minutes later)
Ok would a ct scan have picked up a tumour or aneurysm? Unruptured. That is my main fear .
doctor
Answered by Dr. Ishu Bishnoi (30 minutes later)
Brief Answer:
CT scan is one of the best investigation for tumor and aneurysm

Detailed Answer:
Hi XXXX, welcome back.

CT scan can pick tumor very easily. Unruptured tumor can be picked by CT head, but small aneurysm may be missed.

Best investigation for tumor is
- MRI brain (plain and contrast)

For aneurysm is
- CT Angiography of brain vessels.

Your headache does not seem to be from tumor or unruptured aneurysm.

Hope it will give you correct information. If any doubt, do let me know.
Thanks. Take care
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Ishu Bishnoi (55 minutes later)
Ok thank you. I am just very concerned. I feel nauseous all day i guess that could be due to anxiety and very faint.

This is going in for a month now so i would assume if it were an unruptured it wouldnt last this long?

The pains are so random it doesnt make sense thats the real concern and a lot of the time can be based upon movement. I do have discharge of phlegm and it is usually thick or white/yellow. When i cry i notice that i get very congested and my nose is always making clicking sounds .
doctor
Answered by Dr. Ishu Bishnoi (46 minutes later)
Brief Answer:
Anxiety disorder, URI problem and headache

Detailed Answer:
Hi XXXX, welcome back.

The persistent nausea, in absence of abdominal problem, is most probably due to anxiety and panic disorder. It will be relieved by anxiolytics.

Unruptured aneurysm does not cause headache until it is larger enough. Unruptured aneurysm mostly present with mild dull pain and some focal deficit like vision loss, nerve palsy. In your case, the headache is having episodes of intense pain. It does not match with aneurysm. To further confirm, you should get CT Angiography brain.

Nonspecific random headache is most commonly stress headache. I have described its features in previous answers, try to correlate with it. Another favouring point is normal CT head.

If you are having complaint of phlegm along, kindly get

- Throat examination done
- X ray chest
- sputum culture sensitivity

It will rule out upper respiratory infection. If there is infection, it can be treated by antibiotics, antiallergic and steam inhalation.

During crying, it is normal for nose to be congested. It happens due to parasympathetic system activation. The clicking sounds are due to nasal mucus and sudden opening/closing of nasal cavity. Don't worry about it.

Hope it will clear your doubt.
If you need any help, do let me know.
Thanks. Take care.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Ishu Bishnoi (23 minutes later)
Ok. I apologize for all the questions but as far as the commwnt about my pain being severe it is not always severe. Today it is throbbing behind my right eye every once and a while. Nothing to horrible like the ice pick pains i had earlier on my left side.

This is more of a throbbing consistent pain behind my right eye above the socket almost. It happens a lot upon movement lately and deep breathes. If instomp my foot i will feel it. Does that change anytjing?
doctor
Answered by Dr. Ishu Bishnoi (8 hours later)
Brief Answer:
Throbbing headache management

Detailed Answer:
Hi XXXX, welcome back.


There is no need to apologise. You are having pain and you are worried. It is ok and I can understand this.

As the pain is throbbing and behind right eye, please consult ophthalmologist to rule out "Glaucoma". Simple intraoccqular pressure check can rule it out.

Another possibility can be "right side Migraine". Migraine is one side headache and occurs behind eyes. Its acute attack can be treated by taking either one or combination therapy as mentioned below

- Tablet Diclofenac sodium
- Tablet Naproxen with domperidone
- Tablet Ergotamine
- Tablet Sumatriptan

You can take any of above medication after proper prescription.
One more advise - Kindly get MRI brain with MRAngiography done to rule out any kind of vascular and tumor pathology. It will be very helpful.

Thanks. Take care. If you need any help, do let me know.
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Ishu Bishnoi (17 hours later)
For instance just now i had a severe burning pain top back of my head. Felt like a burning wet tingling lasted 10 seconds or so. A lot of pain is generating from my neck and base of skull
doctor
Answered by Dr. Ishu Bishnoi (11 hours later)
Brief Answer:
Current pain episode management

Detailed Answer:
Hi XXXX, welcome back.


As your are having burning pain, you can follow few tips to get relief

- Take rest
- Avoid bright light
- Take tablet Amitrityline or combination of it with Pregabaline after proper prescription
- If no relief, you can take Tablet Ergotamine or Sumatriptan after proper prescription.
- Neck massage will help in relieving pain at back of neck.

If still any doubt, do let me know. I will be happy to help you.
Thanks. Take care.

Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
Answered by
Dr.
Dr. Ishu Bishnoi

Neurologist, Surgical

Practicing since :2007

Answered : 901 Questions

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Suggest Treatment For Headaches While Having Anxiety

Brief Answer: Cause of headache and eye pain Detailed Answer: Hi XXXX, thanks for asking from HCM. I can understand your concern. The sharp pain behind eyes with headache can be due to few reasons like - Myopia or hypermetropia - As the pain is especially located behind eyes, the cause of pain can be eye disorder like poor visual acuity (myopia or hypermetropia). Kindly consult ophthalmologist for : visual acuity testing it can be suspected more if pain occurs after trying to focus your eyes, visual blurring. - Glaucoma - It is another eye disorder which can cause severe pain in eyes and headache. It means increased eye pressure. It can lead to severe eye pain watering from eyes photophobia (fear from light) visual blurring Ophthalmologist will rule it out. - Frontal and maxillary sinusitis - Long standing pain around eyes and back of eyes are very commonly due to air sinus infection. The frontal and maxillary sinus infection can become chronic if there is history of allergy/repeated common cold/deviated nasal septum. It can be suspected in you if you are having heaviness in head, post nasal discharge, history of allergy. For this, you need to consult ENT specialist. Long standing sinusitis sometimes require nasal endoscopy treatment. - Stress headache - If all other organic causes have been ruled out, it can be the cause. It is one of the most common type of headache. This involves frontal part, gives band like sensation around forehead, more pain after focusing eyes/mental stress/lack of sleep, no vomiting, no visual blurring. It is more common in case of anxiety or depression. For you, my advise is to rule out ENT and Ophtha causes and then we can think about stress headache. The neck pain and crack sound are suggestive of poorly flexible neck muscles. You must start - Physiotherapy of neck muscles - Do daily neck exercise - You can apply Diclofenac gel over local pain site - Hot fomentation will also relieve tightness and crack sound. Please let me know about your Ent and Ophtha consultation. I will then guide you further about your headache if there will be no relief. Hope you will understand it. If any doubt, do let me know. Thanks. Take care