What is the nature of my headaches?

January 9, 2009 12:11 AM

I get headaches that start at the base of the back of my head, then seem to radiate over my brow. Warm compresses almost always help. What is the likely cause of this?

I've had this situation since I was a kid, off and on in varying degrees of intensity/re-occurence. I'm trying to determine if it's muscle based, sinus, stress, chemical, etc. The thought that a warm compress almost always helps I find curious and indicative of "something", but "what"?

There once was a time it was so bad that I wouldn't go out of town unless I knew the hotel room I was staying in had a microwave so I could heat up a moist towel....

posted by raikkohamilonso to Health & Fitness (9 answers total)

Tension headaches.
posted by ruwan at 12:18 AM on January 9, 2009

I have this EXACT same thing and it has been cured by physical therapy/manual therapy - with joint manipulation. The root cause of my headaches - which started at the back of my skull and went around to my eyebrow exactly as you describe - is that I have a tendency to slouch and let everything along the back of my neck and head get compressed which causes the muscles and bones at the base of my skull get mangled up and "locked". If it's really bad I go to the therapist to have it loosened up but if I can catch it early enough warm compresses and anti-inflammatories help a lot. And if I can remember to always elongate the back of my neck - sitting, standing, lying down - and drop my shoulders away from my head I can mostly avoid it all together.
posted by Theresa at 1:08 AM on January 9, 2009

I'm going through this shit RIGHT now. So, about 2 months ago, i got up for work, came downstairs and I was suddenly hit but THE most severe pain from the top of my head down the left side of my face and into my neck. I fell the the ground writhing for like 5 minutes. One of the pains where you're like 'if this shit don't stop in a few seconds, I'll pass right the fuck out'. I got up and sat on my couch for 15 more minutes. Then, me being me, I went to work. Came home... it happened again. After the pain subsided, I drove myself 2 minutes to the hospital where they did a CT scan and a spinal tap. The worst was ruled out. Went to see my doctor... then a neurologist who put me on B2 (takes 8 weeks to work) as he thought it was migraines. I think of migraines as a diagnoses when they don't really know what is causing the issues - like irritable bowel syndrome. Anyway, a week goes by and I wake up with an incredible pain on the back left side of my neck and then again in the front of my head. It lasts all day, so I goto my regular doctor who was pretty happy that he could press on my neck and cause severe pain in the front of my head... turns out its muscular. He gave me anti inflammatories and some strong muscle relaxants (which made me hallucinate big time and caused me to basically throw a full glass of chocolate milk on my couch. LOVELY. I was able to get off those after 5 days of changing my ways... Turns out 20 years of sleeping on my front with my head cranked to the right, sitting at a computer all day (for much of the last 20 years) and walking like an ape, finally caught up with me. I went out and bought a Tempur-Pedic pillow, an Obus Forme back rest and began seriously watching my posture... ten days on and I'm 100%. Actually, I have gone for a single chiro appointment. I really hope this helps.
posted by gman at 4:52 AM on January 9, 2009

I never underestimate tension/stress/anxiety in causing anything that hurts in my body, especially headaches and migraines, so I'd definitely think about that. Often the stress that manifests physically isn't even stress we're necessary conscious of (which is why it rears is head in the body in the first place).

The compress may help because you've come to associate it in your mind with something relaxing that makes your headaches go away, you know? What I mean is, it could just be that you stop to address the pain and take steps to relieve it that is helping, rather than whatever medical or physiological benefit is offered by a hot compress.

The other thing is that I've read in more than a few places that the majority of headaches are caused by dehydration. Do you get enough water/fluids throughout the day?
posted by Rudy Gerner at 7:03 AM on January 9, 2009

Nthing tension headaches. I'm dealing with this right now, caused by poor posture and sitting at a computer all day long. Since I'm trying to not rely on drugs, I've been through physical therapy, and one thing that seems to help a lot is chin tucks - five or so every hour. If, like me, you slouch forward at the computer and stick your chin out, this sort of reverses the action.
posted by chez shoes at 7:47 AM on January 9, 2009

I get fairly serious headaches like you describe on a regular basis, so much so that I have multiple bottles of Ibuprofen in different locations (work, home, jacket, suitcase for when I'm traveling, laptop bag). Some of the headaches are caused by stress at work, but I radically reduced my number of headaches by reducing my coffee intake to two cups a day. It really has worked.
posted by KokuRyu at 10:30 AM on January 9, 2009

My first thought was also tension headache. It is worth your while to begin some deep breathing exercises on a regular basis and to become more aware of how you hold yourself. In my many months of trying to rule out causes of my migraine, I realized how often I sit around, at home, "relaxed," gritting my teeth and bearing down on with my arms on arm rests, et cetera. I was completely oblivious of how much strain I carry around ALL THE TIME. Deep breathing helped me with this quite a bit.

Good luck. Headaches are miserable.
posted by thebrokedown at 3:28 PM on January 9, 2009

Question: does your pain wrap around one side of your head, or is it bilateral? The general rule is that one side = migraine, both sides = tension. But in my experience (I'm 45 and have a 30 year history of headaches) tension headaches can trigger migraines. If you are not light sensitive and are not hurling all day, it's unlikely you have a migraine.

Sinus headaches can make your whole head hurt, but there is usually an unmistakable focus of pain in your facial area, on one or both sides. There are nasty headaches that can be triggered by irregular consumption of caffeine - you have caffeine a few days in a row, and then the first or second day of not having it will give you a real kick in the head.

Tension headaches can be unbelievably awful. They can be triggered by many things, including poor posture, muscle strain, whiplash injury, sleep position, extreme stress, etc. Since they involve the muscles of the head and neck, the warm towels are helping relax the muscles - standard treatment that you discovered on your own. The heat does not have to be moist, however, and I've had good luck with one of those heat-in-the-microwave rice pillows.

Physical therapists have lots of medical training, and have been very helpful to me in the past. I have a severe prejudice against chiropractors, but that's just me. It's probably a good idea to visit an MD who has expertise in diagnosing and treating headaches, if you have insurance. There are various headache treatment centers around the country these days.

IANAD, etc, etc. I wish you the best.
posted by shifafa at 8:35 AM on January 10, 2009

Response by poster: Thanks to all. The "sleeping on my front with my head cranked over" is interesting, that's how I've always slept. The B2 comment is interesting as well; it seems a period where I've gone the longest without noticing them I also was probably most consistent about taking a multivitamin.

The warm/damp compresses I am quite certain are not psychological. If they are - well, I'm glad I believe it works. I'd add that some times when these headaches occur I think "I've taken ibuprofen... this will stop EVENTUALLY..." ... and it usually doesn't, until I do the "stand at the microwave with the buckwheat rice-compress" routine. The sooner I do it, the sooner it's over, usually.

The best reply I got was in email about occipital neuralgia, which seems to fit my symptoms well (including that sometimes photophobia is present). When I was a kid I was really into skateboarding and fell "numerous times", which might be relevant - seems like I've had these headaches since HS. Damage to C2 or that nerve would make sense based on what I've just read.

Thanks for the replies
posted by raikkohamilonso at 11:11 PM on January 12, 2009