Brief Answer:
As described? Medical visit NOW? Likely not necessary, HOWEVER

Detailed Answer:
Typically, I counsel my patients who have never had headaches that if there is a unique pain of the head described as THE WORST HEADACHE one's ever had accompanied by ANY of the following symptoms: nausea, vomiting, neck pain, FEVER, significant light and sound sensitivity, sudden and severe VERTIGO with or without TINNITUS (ringing/noise in the head) EQUALS immediate ER or Doctor's visit. In your case, though your headache clearly doesn't seem mild...it also doesn't possess any of the clinically significant warning signs I've described that could point to something "bad" going on inside the head. Instead this seems to be a simpler version of either an atypical migraine headache without the classical migraine features such as nausea, vomiting, etc. or what I believe it is more likely looking like which is an OCCIPITAL NEURALGIA/NEURITIS. It could also be a TENSION TYPE of headache by virtue of absence of migrainous symptoms and pain in the back of the head (possibly a bit of the neck or shoulders???). I have very little suspicion of this being related to your sinuses since the origin of the pain is in the back of the head. That is not consistent with a sinus drive headache, nor are the other symptoms described. You may have a viral or cold like headache, and the fatigue you describe is consistent with a viral syndrome. Otherwise, the most common cause of occipital neuralgia seems to be chronic neck tension, osteoarthritis of the cervical spine or scalp/other subcutaneous infectious causes.

You may wish to try some OTC medication according to labeling instructions such as EXTRA STRENGTH TYLENOL or EXCEDRIN for migraine, heat or ice on the back of the head or nape of the neck. Try a relaxing massage of the originally painful area. I DON'T RECOMMEND CHIROPRACTIC MANIPULATION for anything where neck discomfort is concerned...this is potentially dangerous and can result in very severe complications.

You could also try something on the order of ibuprofen or DICLOFENAC in an OTC form so long as you follow label instructions and are very careful and cognizant of OVERUSING these medications which can easily lead to a very unwanted condition of MEDICATION OVERUSE HEADACHES. Typically, using more than 15 doses of simple analgesics such as OTC's can lead to an escalation in severity and frequency of otherwise, treatable headaches leading a chronic situation which becomes worse and more refractory to simple treatments. So, again, your use of these drugs should be limited to label instructions and even then, some times you have to be careful since these directions can be misinterpreted to the point where even something like Tylenol or Aspirin can be OVERTAKEN and OVERUSED to potentially cause MORE headaches.

I would say that if this current headache doesn't resolve or evolves into something that starts looking like a migraine that just won't go away despite the use of anti-inflammatory medications and OTC muscle relaxers in the next 24-48 hrs. then, you will need to see a physician (preferably a neurologist or HEADACHE SPECIALIST).


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This query has utilized 35 min. of research and response time on behalf of this patient.

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