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What Casues Recurring Headaches?
Question: I've been having headaches for a number of weeks. They typically start in the afternoon/evening at a skin-deep level, either on the sides of my head over my ears, or in the front above my eyes. They end up being in the temples and fairly pounding, especially if I bend over or cough or sneeze. Drinking a beer or glass of wine seems to exacerbate them. Four Advil capsules knock them out, as does simply going to bed at night. I never have them in the mornings. I also have noticed constant ringing in my ears, but I think that's been going on for a long time. My wife has a blood pressure checking machine, and I have been checking mine several times a day. It's typically fairly low in the mornings (about 121/70), but tends to go up as the day goes on (137-153/65-75), which leads me to believe the headaches are blood pressure related. I'm 57 years old, pretty active, including sporadic exercise, and I'm 6-0, 175 lbs. Thanks!
Brief Answer:
Probable Tension type headache.
Detailed Answer:
Hello. I read your question carefully and I understand your concern.
The description of the headache most probably is of the kind which is called tension type headache. It is the most common kind of primary headache (primary meaning it isn't a consequence of an underlying disease). It is associated with muscular and psychogenic factors so it is often exacerbated by stress.
Treatment consists (apart from painkillers like the one you are taking), also of prevention by stress relaxation techniques, exercise and stretching, regular sleep and eating schedule. If these measures don't work and Advil is often required then prophylactic treatment with a class of drugs called tricyclic antidepressants has shown good effect and could be prescribed by your doctor (the fact that it is an antidepressant doesn't mean that you are depressed, they are also used for other purposes like prevention of headaches in your case).
As for the blood pressure values you are mentioning... they are abnormal, if persistent, treatment and a low salt diet should be considered. It can't be excluded to play a role, but however it is less likely for those values to cause a headache. Also consider the fact that Ibuprofen (Advil) you use has been at times related to a mild rise in blood pressure (though less frequently than other drugs of its class). Stress could influence blood pressure as well.
If nothing works however or new symptoms arise, a neurological evaluation for neurological deficits and the need of head imaging exams is advisable.
I remain at your disposal for further questions.
Probable Tension type headache.
Detailed Answer:
Hello. I read your question carefully and I understand your concern.
The description of the headache most probably is of the kind which is called tension type headache. It is the most common kind of primary headache (primary meaning it isn't a consequence of an underlying disease). It is associated with muscular and psychogenic factors so it is often exacerbated by stress.
Treatment consists (apart from painkillers like the one you are taking), also of prevention by stress relaxation techniques, exercise and stretching, regular sleep and eating schedule. If these measures don't work and Advil is often required then prophylactic treatment with a class of drugs called tricyclic antidepressants has shown good effect and could be prescribed by your doctor (the fact that it is an antidepressant doesn't mean that you are depressed, they are also used for other purposes like prevention of headaches in your case).
As for the blood pressure values you are mentioning... they are abnormal, if persistent, treatment and a low salt diet should be considered. It can't be excluded to play a role, but however it is less likely for those values to cause a headache. Also consider the fact that Ibuprofen (Advil) you use has been at times related to a mild rise in blood pressure (though less frequently than other drugs of its class). Stress could influence blood pressure as well.
If nothing works however or new symptoms arise, a neurological evaluation for neurological deficits and the need of head imaging exams is advisable.
I remain at your disposal for further questions.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Thank you, Dr. Taka. I really do not feel that I am under abnormal stress. I enjoy my job, and this has been a relatively tension-free several months, both in my job and in my relationships. I do have new glasses, with a slightly different prescription for nearsightedness and astigmatism. However, the new prescription has me seeing sharply. Any chance it's somehow related to the new glasses? Thanks!
Brief Answer:
Possible depending on relation in time to headache.
Detailed Answer:
Eye strain is a known cause of headache. The characteristics of that headache are similar to tension type headache which is understandable since both have been related to muscle tension at their source.
So if the beginning of this chronic headache coincides with the new glasses, that could be a factor (yes, even if you see sharply with them) and you should discuss the issue with the ophthalmologist because eye strain headache should subside inside a couple of weeks.
If the headache was present before the glasses change though, the most probable diagnosis is still tension type headache.
I repeat though that if the above mentioned measures don't work, especially if you haven't occasionally experienced similar headaches in the past and since you report no exacerbating factors in your life, brain imaging should be scheduled (CT or MRI).
Possible depending on relation in time to headache.
Detailed Answer:
Eye strain is a known cause of headache. The characteristics of that headache are similar to tension type headache which is understandable since both have been related to muscle tension at their source.
So if the beginning of this chronic headache coincides with the new glasses, that could be a factor (yes, even if you see sharply with them) and you should discuss the issue with the ophthalmologist because eye strain headache should subside inside a couple of weeks.
If the headache was present before the glasses change though, the most probable diagnosis is still tension type headache.
I repeat though that if the above mentioned measures don't work, especially if you haven't occasionally experienced similar headaches in the past and since you report no exacerbating factors in your life, brain imaging should be scheduled (CT or MRI).
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
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