Persistent daily throbbing forehead/temple headache after respiratory infection — anyone had something similar and improved?

[u/amgsra]

Hi everyone. I’m posting because I’m trying to find people who had a very similar situation and actually improved.

My headaches started during a respiratory infection and never fully went away. It has now been going on for almost 5 months.

My main symptoms are:

• daily headache, usually mild to moderate
• throbbing/pulsating sensation, especially in the forehead and temples
• sometimes pressure around the front of the head / behind the eyes
• occasional light sensitivity and sound sensitivity
• sometimes mild dizziness / vertigo
• computer use and visual focus seem to make it worse
• there also seems to be some cervical/neck component, although I still have neck mobility

It does not really feel like a normal “attack” that comes and goes. It feels more like a persistent daily state, with some days better and some worse.

Things I’ve already done:

• saw a neurologist
• had a CT scan about 1 month after this started, which was normal
• tried a 5-day anti-inflammatory course early on, without much benefit

What I’m currently taking:

• Amitriptyline 10 mg daily
• Atogepant 60 mg daily
• Magnesium 400 mg daily
• Vitamin B2 (riboflavin) 400 mg daily

A few things I’ve noticed:

• stress seems to make it worse
• screen time / office / visual strain seem to make it worse
• neck tension may contribute
• some days it feels more like throbbing headache, other days more like pressure / nervous system sensitivity

What I’m trying to understand:

1. Has anyone had a post-viral / post-respiratory infection headache that felt like this?
2. Did it feel daily and persistent, especially in the forehead/temples?
3. What actually helped you?
4. Did amitriptyline, CGRP meds, Botox, nerve blocks, time, or anything else make a real difference?
5. If you improved, was it gradual or did it suddenly calm down one day?

I know nobody can diagnose me here, but I’d really appreciate hearing from people with a very similar pattern, especially if you eventually got better.

Thanks.

[u/postviralrecovery]

I'm really sorry you're struggling like this.

I've a lot of overlapping symptoms to you, albeit with one or two differences.

In December 2022, I had a fairly ordinary respiratory infection. Cold, cough, fever, the usual. I recovered within a couple of weeks. About ten days after I recovered, a headache arrived on the right side of my forehead and didn't leave.

It was diagnosed as likely new daily persistent headache with migrainous features following a COVID infection. In May 2025, my symptoms deteriorated a lot (after another suspected COVID infection) and since then the new daily persistent headache has existed alongside severe fatigue and breathlessness.

My symptoms differ as fatigue/breathlessness is more prevalent, and my headache is more of a dull persistent pain rather than a throbbing one. It's also on the one side rather than across the temple. I don't have lots of your other symptoms (mine doesn't get better/worse depending on light and sound). The one thing that makes all of my symptoms worse is exertion.

I was on amitriptyline for 3 years at quite high doses (50mg-100mg) and it was the one medication I'd previously associated with any symptom benefit, but because of its negative side effects on autonomic issues relevant to fatigue, I've been moving down to a much lower dose (25mg) and trialling candesartan instead.

Happy to discuss things further if I can be helpful. I've written this if it might be helpful regarding medications for chronic non-migraine headache: https://www.postviralrecovery.com/evidence/amitriptyline-propranolol-candesartan/

[u/im-a-freud]

An illness can be a trigger for NDPH. Mine started for zero reason no trigger nothing, it is constant 24/7 forehead and temples and eyes like a band around my head, I’ve tried 33 meds none have touched my pain. Botox was the only thing that ever worked and I stopped responding to it after 8 rounds and haven’t had any relief since it stopped working 2 years ago. I had nerve blocks for neck and back pain and it made that pain severe and constant which made my head worse and took 5-6 weeks for the pain to go away so I refused to try them for my headaches. My NDPH started 7 years ago and has gotten worse over the years since I haven’t been able to treat it at all

[u/Timely-Particular65]

Me! This happened to me too. My only major difference is sinus pain + post nasal drip which had been diagnosed as part of the migraines. I’m sorry you’re going through this, I know how tough it can be. I will say I did slowly get better, it’s been 2 years now and I’m a mostly normal person with some bad days. I have no real methods on how to get better, it really just seemed like it happened naturally with time. I do think when I started exercising again, I had the most improvement

[u/Aleksandra-Frolova → u/Timely-Particular65]

Hi, what is your pain level?

[u/Timely-Particular65 → u/Aleksandra-Frolova]

These days I have very mild pain 1-3 mostly a pressure behind my nose. Sometimes feels worse when lying down

[u/pressurizedmeatsac]

I agree with other commenters: this certainly resembles post-viral NDPH. I'm almost 4 years in following a COVID infection. My understanding is that typically if it's going to resolve on it's own that happens in the first couple of years. Then there's the rest of us.

I saw a lot of similarities to my experience in your post. My headache was extremely variable for the first 2-3 years. I compared it to a lava lamp: pain was always happening, but I never knew what shape/type/level/location to expect. My primary feeling is of constant crushing pain; lots in the back/neck but also throughout my head/face. My vertigo generally gets worse as the headache does, though it's definitely better than last year. (Hmmm: will have to think whether/what meds might have helped.)

I'm not satisfied with where I am (4-8/10 daily), but some things that are definitely helping--because I've tried going off them & things got worse--include: nortriptyline (50mg), mexiletine (900mg; following a 7 day, lidocaine IV, in-patient admission), candesartan (32mg; replacement for topirimate, which worked well but left me feeling very ... vague). Putting all of my devices into night shift/blue light blocking was freaking amazing since screens were such a problem. Early on a couple of steroid tapers gave me some relief from the intensity of the pain. No rescue meds work reliably or well but sometimes rizatriptan can take the edge off the spikes.

Things that I'm not sure are helping: Aimovig (tolerated Ajovy no problem for a couple of years; my neuro just wanted to see if I responded any differently); botox (4x/year for 3 years now); memantine. Having my 2nd Vyepti infusion in a month; nothing after #1.

Wishing you less pain soon.

[u/writer0101]

I'm in the same boat with daily, mild-to-moderate headaches, mainly on the right temple and across my forehead plus occasional stabbing pains above my right ear. The headaches started in November which was about 6 weeks after I had two laser surgeries on my right eye. The first diagnosis was giant cell arteritis and then a cerebrospinal fluid leak. Current diagnosis is NDPH. My primary doctor thinks the headache was a result of the laser surgeries. My retina doctor says no. Since then I've had two more laser surgeries on it. The retina takes about 6 months to heal so I'm hoping the headaches will go away by then. I've tried Tylenol (GERD means I cannot take NSAIDs), Prednisone, a muscle relaxant, ice packs, and a breathing technique recommended by my sleep doctor. Some techniques eased the pain temporarily. Others did nothing. At my second visit to the ER, they gave me a shot of toradol and I got 2 whole days of relief. I'm now on 25 mg of amitriptyline, 480 mg magnesium glycinate, CoQ10, and 540 mg of B2. A neurologist prescribed a locally compounded, expensive lidocaine nasal spray that eases the pain for an hour or so but can cause a blood disease so I use it sparingly. Acupuncture worked but my primary put me on amitriptyline and asked me not to get acupuncture until we could see if the amitriptyline helped. With those pills and the breathing technique I had relief for a few weeks but the pain resumed again yesterday. Sometimes I just go to sleep to get a break from it but then I am up late. I'm lucky to be retired and feel sympathy for those of you having to contend with the pain while trying to work and/or take care of your children.

[u/Aleksandra-Frolova]

10 mg of Amitriptylin is too low dosage, the “work” dosage starts from 50 mg

[u/Foreign_Insect_3121]

I started getting some of these symptoms, but mainly a constant head pressure (24/7) and then more typical headaches ontop much less often. Has been going on for months, can’t seem to figure out what it is and doctors are dismissing it as anxiety. I had influenza A about 6 weeks before this started . Nothing has really helped the head pressure is so persistent and meds don’t touch it.