What Causes Pressure And Pain In Back Of Head And Eyes Along With Fatigue?

Posted on Wed, 15 Jul 2015

Question: Not sure if i should be concerned or this is nothing. As background - I've had vertigo (Benign positional) on and off for a month but I have felt like it was gone since Sunday. This afternoon all of a sudden i felt pressure and a little pain in the back of my head (really the area where the neck and head connect) plus pressure on my eyes and sudden fatigue . As the afternoon went on the eye pressure and fatigue got better and I also took one aspirin. While the pain/pressure in the head is better new symptoms have started. First i have a tightness in both checks. Second i am getting random pains/tightness in my legs - thighs of both legs. Basically its a feeling of tightness in an area the size of a hand. Since this is occuring on both sides of my face and legs I am not too concerned its a stroke - unless you tell me otherwise - but wondering what could cause it and whether i should be going to the hospital or ignore it.

Answered by Dr. Noble Zachariah (4 hours later)

Brief Answer:
Likely to be due to cervical spondylosis

Detailed Answer:
Hello,

Welcome and thanks for your query.
I understand that you have been having neck problems for sometime.
A likely cause is cervical spondylosis, which is due to wear and tear of the vertebrae of the neck. This affect the intervetebral discs which prolapse and exert pressure on the upper spinal cord and cause disturbances in the nerves and blood supply of the brainstem. The facial tightness is as a result of the involvement of the 5th or 7th cranial nerve and the tightness in the legs are due to the effect on the long tracts.
The normal hemiplegia/ hemiparesis that one describes as strokes affect the anterior brain circulation and is not the issue here as you have very rightly suspected.
This is the posterior circulation, the symptoms of its involvement are usually vertigo or unsteadiness / ataxia and symptoms affecting the face and other areas and involves both sides often.
It would be better if you could undergo a MRI examination of the neck and brainstem. If the symptoms are not progressive , you may take a regular appointment but if the symptoms are progressive, it would be better to go to the ER.
Do get back to me if you have more queries.
Best wishes,

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Noble Zachariah (9 hours later)

Thank you. I do have some follow-up questions. First when I've had a similar pain in the area between the neck and head with some face tingling in the past, it is usually been on only one side, alrhough this time it was on both sides of my face and in my legs. In addition, as it happened this time, when I wake up in the morning the pain and all the tingling is gone. I am wondering if the cause therefore could be something other than what you suggested above. I note that your potential diagnosis actually seems to cover the symptoms I get on a frequent basis but I want to ask whether there might be other causes. For example, I know I've gotten pains in the past when either a muscle or tendon has swollen and rested against a nerve. That is a more localized pain but if the muscle was resting against a nerve in the neck area I thought it might be able to send the pain and tingling in more directions. I was also wondering if it could be an anxiety attack.

Answered by Dr. Noble Zachariah (1 hour later)

Brief Answer:
Welcome

Detailed Answer:
The pain and tingling are caused by pressure as you suspected, but not from muscle outside but from prolapsed disc inside the spine. It can also occur with thickened ligaments binding the vertebrate less often.
Multiple sclerosis can produce similar symptoms which last longer and in younger people.
Anxiety can produce numbness and tingling through hyperventilation but they are usually in the hands and legs.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Noble Zachariah (2 days later)

Another follow up. No pain or tingling for 3 days. Since i get this on a regular but not continous basis and can go weeks without an attack, do you still think your diagnosis is most probable? An What is the right kind of doctor for the follow up? A neurologist? Orthopodist? Rheumatologist? Or another kind?XXX

Answered by Dr. Noble Zachariah (4 hours later)

Brief Answer:
Yes

Detailed Answer:
It does not exert constant pressure at the beginning and the symptoms vary with position.
MRI of the cervical spine will make matters clear.
You could consult a neurologist and if not available an orthopaedic.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar