Dear Ask The Doctor: For about a week now I have had almost constant shoulder and neck pain. Sometimes its so bad it gives me a headache and makes me nauseated. Today I actually vomited. I'm not sure if the vomiting is related to the pain but I'm getting worried. What could be the problem?
Dear Patient: Your description most likely correspond to a tension headache, which is generally a diffuse, mild to moderate pain that's often described as feeling like a tight band around your head, above your eyes, may radiate to neck and shoulders by muscle tension and may produce nausea. A tension headache is the most common type of headache. Managing a tension headache is often a balance between fostering healthy habits, finding effective nondrug treatments and using medications appropriately. The exact cause is unknown, but sustained contraction of the muscles of neck, face and scalp may contribute to cause the pain. Potential triggers include the following: Stress, depression, anxiety, poor posture, and jaw clenching, working in awkward position or holding the same position for a long time. The risk factors for tension headache: being a woman (90% of woman experience tension headaches during their lifetimes); also they are more common in middle age people. Sometimes, Rest, ice packs or a long, hot shower may be all you need to relieve a tension headache, but if these are not enough try some of these suggestions: manage your stress level (relax techniques, meditation); Applying heat or ice to sore muscles may ease a tension headache. Which treatment to apply is a matter of personal preference. Good posture can help keep your muscles from tensing up. It places minimal strain on your muscles, ligaments, tendons and bones. Good posture supports and protects all parts of your body and allows you to move efficiently. When standing, hold your shoulders back and your head high. Pull in your abdomen and buttocks and tuck in your chin. When sitting, make sure your thighs are parallel to the ground and your head isn't slumped forward. Pain medications don't cure headaches; they just relieve the symptoms temporarily. Over time, painkillers and other medications may lose their effectiveness or they might even cause headaches. To avoid the development of medication overuse headaches, don't use over-the-counter pain relievers for more than nine days a month. In addition, all medications have side effects. If you take medications regularly, including products you buy over-the-counter, discuss the risks and benefits with your doctor. Also, remember that pain medications aren't a substitute for recognizing and dealing with the stressors that may be triggering your headaches. Using medications in conjunction with stress management techniques may be more effective than is either treatment alone in reducing your tension headaches. Additionally, living a healthy lifestyle, meaning getting enough sleep, not smoking, exercising regularly and eating healthy foods, may help prevent tension headaches.