Brief Answer:
Likely tension type headaches

Detailed Answer:
Good morning. My name is Dr. XXXXXXX Saghafi and I am the Director of the Headache Clinic and a Neurologist at the XXXXXXX VA Medical Center in XXXXXXX OH. Sorry that you have been suffering from what you describe as a dull ache or dull cranial pressure which seems to get worse with anxiety/stress and rubbing above your forehead.

Stress is the #1 cause of all forms of headaches and so it is of no XXXXXXX that you've mentioned a relationship between what you have and increases in your stress levels. The question as to why, at age 27, these headaches have decided to come on is a difficult one to answer and all I can say to that point is that for those with headache syndromes starting in the decade of the 20's is not uncommon for this type of ailment. Perhaps, a number of things have come together in your life from the point of view of work, family issues, social or financial forces and as a result you may have lifestyle changes from years ago that are "catching up" with you so to speak.

I could list many many triggers and risk factors but that wouldn't have as much merit right now as telling you the following items of importance.

1. The likelihood of your having something "worse" as you put it is extremely small just in terms of the statistics and numbers. I can be even more specific if you'd like. The percentage of headaches which are caused by something "physically wrong" INSIDE the brain or within the cranial vault itself is on the order of 0.18%. I hope you'll agree that even though that number is not ZERO....well, it's pretty darn close....however, no worries...we recognize that there is still yet a small chance that something could be causing this, right? THEREFORE, LOOK AT #2 below.

2. If these headaches have persisted or seem to be coming on more and more frequently without resolving you should consider seeing a neurologist and better yet one who is specially trained in headache management in order to determine first hand the need for you to have additional tests or diagnostic studies in order to determine if anything could be causing this condition that could be easily reversed.

3. You MUST significantly limit your use of over the counter medications for this condition as the overuse of such substances is KNOWN TO INCREASE the frequency and severity of such headaches. In other words, Tylenol, Advil, Motrin, Aleve, homeopathic preparations, ANYTHING which is to be used to treat single episode headaches must be used with caution and guidance in order to avoid what we call MEDICATION OVERUSE HEADACHES (MOH). This is also why I strongly suggest your seeing a neurologist since we are trained to avoid this type of complication in people who are just "starting out" with their headaches. Other providers may see fit to have you take any number of prescriptions on a daily basis which MAY or MAY NOT appropriate to your situation.

4. In order to fully document for any physician who may see you the most important features of your headaches so that the most appropriate interventions or medications can be chosen it is necessary you keep what is called a HEADACHE DIARY or HEADACHE LOG. I use these with all my clinic patients without exception and though it is MILDLY tedious there are literal "miracle stories" I can tell you about folks who took the time to organize their thoughts and symptoms into a cohesive way on a log which then, helped us bring their situation under control quickly and efficiently. I'm talking about people with headaches upwards of 10, 20, and even 30 years who had long lists of medications and couldn't even remember when they were headache free.

The Headache Diary is an indispensable tool that will put the answers to your problem right at the fingertips of the RIGHT PERSON who reads the results with interest. Again, Headache Specialists are the doctors who are most likely to appreciate and be experienced in the use of such a clinical tool.

Headache Diaries can be downloaded from the Internet or from the XXXXXXX Headache Society's website. Other extremely helpful resources are also available for free to the public on that organization's website to help understand one of the most common of all human ailments.

If any of what I've said has helped you understand your situation a bit more than before then, I'd very much appreciate your providing me with some written feedback and a STAR RATING.

Also, if you have no further questions or comments on this thread I'd also appreciate your CLOSING THE QUERY on your end so as to signal to the network that this case is ready to be credited, archived, and has been answered satisfactorily by myself.

If you would like to consider a live webcam medical consultation you may reach me through the following website. www.healthtap.com/drsaghafi

If you go to that site you can find out how to get in touch with me for a live on camera consultation at which time I can elaborate more on the Headache Log and even have one provided for you to start documenting things and making other recommendations. My hours for live consultation are Wed.-Sat. 3a-6a (Eastern Standard Time). Or you may continue to direct your questions to MY ATTENTION on this network at XXXXXXX SAGHAFI, MD and I will be happy to get back to you in a timely manner.

This consult required 38 min. of physician specific time for review, research, and final draft documentation for envoy.

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