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Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 19335
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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I have an ongoing upper back pain, tension like headache,

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Hi, I have an ongoing upper back pain, tension like headache, pressure behind my eyes, I feel lightheaded.
Hello from JustAnswer.
It will help if you could provide some further information.
What evaluation has been done for these symptoms thus far?
Have you tried any medicines for relief of these symptoms?
Do you have the ability to check your blood pressure at home?
Customer: replied 2 years ago.

I tried some painkillers but it didn't work. I do measure my blood pressure and it's normal.

What evaluation has been done for these symptoms thus far?
Which pain killers did you try? At what dose?
Could you check your blood pressure and pulse in a series of positions? First, when lying down, then sit up for one minute and check the blood pressure and pulse a second time, then stand up for one minute and check the blood pressure and pulse a third time. The issue for this is not solely whether it is in the normal range, but how much it changes from one position to another.
Customer: replied 2 years ago.

OK will do it but I am not at home now. What does it mean if difference in my blood pressure in different positions is high? Any link with my back pain?

Whether there is a significant change in the blood pressure has more to do with the lightheadedness.
Customer: replied 2 years ago.

It all started with a back pain, I had it all my life, it comes it goes but never suffered with light headed ness. It is more less constant, when I sit, walk. Have some pressure at the back of my head. Head ache is not severe, don't need painkillers, but I tried ibuprofen, only few times but it didn't help. Do you suggest pressure will be higher in different positions?

No, I am not suggesting that the blood pressure will change in different position, but it is a simple assessment that can be done at home.

As for the neck pain and headache, the most common cause of chronic neck pain and pressure in a young adult that started at a young age would be muscle strain or spasm. In fact, the most common cause of chronic or recurrent headaches without any neck pain is also from muscle spasm and tightness, which is called a muscle contraction headache.

Degenerative changes in the spine is also a common cause of these symptoms, but it is less likely for degenerative changes to cause pain that has started at such a young age.

There are several options that can be tried at home. An anti-inflammatory medicine, such as the ibuprofen or a similar medicine, naproxen, is a reasonable consideration, but if you have only tried it a few times, the next step would be regular use of an anti-inflammatory medicine. These medicines also work better at higher doses, up to 2400 mg per day of ibuprofen in divided doses or 1500 mg per day of naproxen. There are prescriptions strengths to make it easier to achieve these higher doses, but it also is an option to simply take an equivalent amount of the over the counter strength. It is also fine to also take acetaminophen, which can be used along with the anti-inflammatory medicine to augment the pain relieving action.

Local care is also reasonable. You mention that you have tried massage, but there are other local interventions, such as ice, moist heat, and stretching, that may be able to help.

If these interventions are not effective, then the other common options would require seeing your doctor, such as using a muscle relaxer or a variety of medicines that are used in chronic neck pain or muscle contraction headaches to prevent the pain.

If treating the neck pain and headaches is successful and relief of the pain also results in relief of the pressure and lightheadedness, then that would indicate that no further evaluation is necessary. However, it is also true that these symptoms could be unrelated, such as from allergies or an inadequate fluid status.

If I can provide any clarification, please let me know.
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