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Dr. Muneeb Ali
Dr. Muneeb Ali, Doctor
Category: Medical
Satisfied Customers: 7352
Experience:  MBBS, MD, MCCM. Currently working in Critical Care Medicine with 10 year experience in Medicine
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Female 81 having headaches along with left sholder and arm

Customer Question

female 81 having headaches along with left sholder and arm ache. Was in emergency room over a week ago and given medication for a bladder infection which she followed through no improvement to the headache even when taking aleve nor tylenol Help should we return to er..
JA: Is the headache episodic or daily? And what about nausea?
Customer: Headache is daily some times with nausea mostly feeling dizzy.
JA: Anything else in your medical history you think the doctor should know?
Customer: Recently with exams in er she appears to have normal vitals with everything they checked. They could not give any any explanation for the headaches.
Submitted: 1 month ago.
Category: Medical
Expert:  Dr. Muneeb Ali replied 1 month ago.


Welcome to JA and thanks for this question. Im sorry to hear aboutthe patient's symptoms. Now from what you are dwescribing there can be a few conditions which can cause this sort of headache in a person. the first cause can be that she could have severe muscle spasms which can lead to this sort of pain in the head as well as the shoulder. This would be best treated with muscle relaxants like flexeril or tinazidine along with increased intake of fluids like plain water and electrolyte rich fluids like gatorade. Another cause of this could be cervicogenic headaches which occur due to a problem in the cervical spine/neck. This could be causing compression of the nerves in the region which can lead to pain in the shoulder and the arm. This would be diagnosed with a MRI and a xray of the neck. Treatment can be with physiotherapy as well as steroid injections as well as other treatment measures.

Now if the headache is worsening over the last couple of days and is accompanied by nausea, vomiting or even numbness or weakness of the limbs, if these are present then a CT scan of the brain is required in this situation to rule out other more serious problems of the brain such as strokes or even a small bleed. Usually in these cases she would have severe headaches which would not respond tpo medications. Another cause can be a complicated migraine which can present in this manner as well.

However the main thing here is that if she is not responding to painkillers then she SHOULD be evaluated in the ER and at the very least get a neurological examination done and if necessary a CT scan of the brain.

Do you have any more questions?

Please leave a POSITIVE rating by clicking on the stars above, until you do i am not compensated for my time. You can continue to ask follow-up questions even after the POSITIVE rating. You can also ask questions from me directly by going on the link below,

Expert:  Dr. Muneeb Ali replied 1 month ago.

Would you like to know anything else? Any clarifications or additional questions that you might have, i would be happy to answer them for you. If done for now, please remember to leave a positive rating as that is the only way we are compensated for our time spent helping you. You can continue to ask follow-up questions even after the rating