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Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor
Category: Medical
Satisfied Customers: 60469
Experience:  MBBS MS. Post doctoral fellowship in Sports Medicine. General surgeon and sports medicine specialist
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Why do I have a persistent headache at the lower left back

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Why do I have a persistent headache at the lower left back of my head and what can I do to stop it? It’s been going on for a good number of weeks now.
Thanks

What are your age and gender?

What are the investigations and treatments done?

Do you have nausea, vomiting, neck stiffness, dizziness/vertigo, weakness in limbs/face, blocked/running nose, vision/hearing issue, a fever, scalp tenderness, jaw pain, fatigue, trouble walking?

Do you have anxiety, depression?

Customer: replied 14 days ago.
Thanks for your response.
I’m a 54 year old male.
I haven’t had any investigation and treatment done .
I don’t have any of the symptoms you mentioned.
However l, I notice it often occurs when I have the occasional one or two sticks of cigarette, even though sometimes es it does when I haven’t smoked.
To your question on whether I’ve anxiety or depression, quite possibly so due to some unusually difficult challenges over the last 9 months, even though I would’ve thought I was handling things well .

Thanks for the further information.

I am writing the answer for you and will get back to you in 5 minutes.

Unless you wish to speak in person, you can ignore the request for a phone call automatically generated by the website, not by me.

Thank you.

You do not have any red flags.

Your headaches can be due to;

1) Cervicogenic headache; age-related changes in the neck vertebral joints.

2) Tension headache.

Physical therapy of the neck will help significantly.

Most headaches are caused by the following:

Tension-type headache

Migraine headache

Chronic daily headache

Cluster headache

Chronic daily headache is not a type of headache but frequent headaches of various kinds. Most people with chronic daily headaches have a migraine or tension-type headache as the underlying type of headache. Tension headaches are the most common type of primary headache. So probably this would be the first to be considered in the differential diagnosis of your headache also. A tension headache is a headache caused by tense muscles in the face, neck, or scalp. These headaches give a feeling of tightness around the head. The neck muscles can also become sore and tight. Tension headaches can be caused by staying in one position for a long time, such as reading, playing video games, or using a computer.

Migraine headaches are the second most common type of primary headache. Cluster headaches are a rare type of primary headache.

There are other causes of headache also;

1) sinus headache

2) Medication overuse headache

3) Post-trauma headache; occurs after injury or accident.

4) Giant cell arteritis

5) Cervicogenic headache.

Usually, a doctor's examination is sufficient to ascertain the cause of the headache. But occasionally x-ray of the sinus and a CT scan or MRI of the brain may be needed, especially if the headache is persisting for long, is worsening, and is accompanied by symptoms like vomiting, vision disturbances, and imbalance. After the tension headaches, the commonest headache is migraine.

Following are the suggested treatment for chronic tension headache and cervicogenic headache;

1) Acupuncture

2) Mild massage

3) Correct posture of the neck during working.

4) Relaxation techniques like meditation.

5) Stretching exercises

6) Occipital blocks

7) Electrical stimulation

8) Therapeutic ultrasound

9) Hot/cold packs

10) Medications;

Dihydroergotamine

Reglan

Phenergan

Codeine

Oxycodone

Butalbital

Aspirin

Tylenol.

I wish your symptoms resolve soon.

I would be happy to assist you further if you need any more information.
Thanks for using JustAnswer.

Customer: replied 14 days ago.
I must add that the headache always occurs during my sleep and sometimes stops within an hour if me waking up, but other times could linger for most part of the day with a subtle but continuous nagging.

I hope, you could see the initial answer above.

Following measures would be helpful;

1) Neck care in the activities of daily living.

a) No working on the computer for more than half an hour in a single stretch. Same for TV/ IPad/ Mobile.

b) Monitors and televisions exactly in front (180 degrees).

c) Contour pillow: Should fill the hollow when lying on the back /straight or sideways. The principal is neck to be in the neutral position and supported. Available over the counter.

2) Soft Cervical Collar or Brace

3) Cervical traction

4) Anti-inflammatory analgesics like Ibuprofen etc.

5) Plenty of liquids.

6) Physical therapy: gradually increasing exercises from passive stretching to active ROM and against resistance regime.

7) Electrotherapy in the form of TENS, interferential and laser, and ultrasound.

8) Hot fomentation

9) Local analgesic patch/ointment/ spray.

10) Gentle massage.

11) Acupuncture

This is an exercise resource;

https://www.spine.org/Portals/0/assets/downloads/KnowYourBack/CervicalExercise.pdf

Customer: replied 14 days ago.
Thanks much.
Grateful

You are very welcome.

Wishing you a speedy resolution and all the very best in life.

It was a pleasure to assist you.

I sincerely hope that I have helped you and that I have earned my 5-star rating today!

Thank you.

Stay blessed.

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