Persistant headache

[Monica3126]

I am a 31 year old woman and I have a headache that is not responding to OTC or prescription medication. It has lasted for two weeks now and I have also had two migraines during this time. I have a history of a chronic tension headache that started when I was 16 and  lasted for 13 years but eventually went away. I am being treated right now by my family doctor who has put me on muscle relaxers. The first medication  did not help at all so I am on day two of this new one. I am worried about what is causing this headache. I feel like there is something wrong. My head hurts all the time and nothing is helping to get rid of it. I feel a lot of pressure in my head and it is very tight. My neck also feels very heavy. I can keep it upright but it takes effort. I would like some advice on what could possibly be causing my history of a headache and what could I possibly do to help it. Thank you.

[Monica3126]

I forgot to mention that I am also experiencing pressure in my head with the headache at times. It does not occur all of the time but here and there.

[Monica3126]

Hi Dr Santos,

Thank you for your reply. I apologize for the late response as I have not felt well enough to be on the computer much lately.

I still have the persistent headache which has now gone on for two months. I also have nausea everyday and lately I have had low blood pressure. I am in constant pain.

I have had 3 CT scans since June and they have all come back clear. I had a lumbar puncture this past Monday but the procedure was unsuccessful. I ended up getting a post lumbar puncture headache afterwards and my back is still very sore almost one week later. I was supposed to get a second lumbar puncture since the first did not work, but it was ruled in my best interests not to at this time.

I am no longer taking muscle relaxers as they did not help. I am now taking Topamax and Reglan along with Butalbitol with caffeine and and acetaminophen. For pain which helps a little.

I have a referral to see a neurologist but due to the area I live in which is smaller, my appointment is not until the the end of September.

I am losing weight at a rapid rate these days probably due to the nausea, which is not great because I am thin and petite. At 4'11" I am now 94 lbs and still losing weight.

This illness has consumed my life. Most days I cannot get up and function normally because I am not well enough. I am having a hard time caring for my children ages 2, 10, and 13 because of it.

I am working closely with my primary care doctor but at this time I do not have a diagnosis. I will also start acupuncture soon and am hopeful that it will give me some relief.

Thank you.

[Dr Santos]

Hi,
What other symptoms are present and what were the initial diagnostic tests done?  This could be due to primary headaches such as cluster and migraine headache. It is important that the trigger is identified and avoided. If there were no imaging studies done in the past, this could also help rule out secondary or organic causes. Take the medicine as prescribed and if it persists, inform your doctor about this for proper management. Take care and do keep us posted.