Head pain when I bend over

Dear Alice,

When I bend down, or bend over, my head starts to pulse and sometimes it feels like it is going to explode. It can be unbearable. Once I sit down or stand up, the headache goes away. If I bend down extremely slowly, then I am usually OK.

I had this problem periodically in the past, it cleared up, but is a problem again. Any advice?

Balloon Head

Dear Balloon Head,

When someone develops a new kind of headache, or has repeated headaches that haven't been explained, it's always wise to see a health care provider, who can help pinpoint a cause and hopefully provide reassurance that the headache doesn't represent some serious condition.

About 90 percent of people have at least one headache every year, often with no apparent cause. Headaches can also occur as a chronic condition; migraine headaches are an example of this. Some headaches are symptomatic of some other medical condition, such as a sinus infection or high blood pressure. Least frequently, headaches can signal more serious conditions, such as brain tumors or abnormalities of the blood vessels in the brain or the brain structure.

The sudden, but painful, headache that you describe has some characteristics of a sinus headache (the description of onset while bending over, and the pressure sensation you seem to be describing), and some characteristics of a positional, exertional, or cough headache (which can also be brought on by crying, singing, having a bowel movement, or other bouts of exertion). They can be quite painful, even though they usually only last 30 seconds to two minutes. Some people experience severe headaches following orgasm.

Your health care provider will ask you questions to try to figure out what's causing your headaches. For example:

  • How old are you?
  • Do you have any other known medical conditions?
  • Do you take any medications?
  • Do you have any other symptoms? Fever? Nasal drainage? Dizziness? Ringing in your ears? Face pain? Vision changes? Nausea? Sensitivity to light?
  • Exactly where is your headache located? On one side of your head or on both sides?
  • Exactly what activities prompt headache for you?
  • You mention having had this same kind of headache in the past; when? How long did that go on?

Your health care provider may recommend some testing to make sure that there isn't a serious cause for your headaches. Magnetic resonance imaging (MRI) provides detailed pictures of your brain that reveal the presence of most serious abnormalities.

Once you and your health care provider are reassured that there isn't a serious underlying condition causing your headaches, there may be some helpful treatments available. If you do have a sinus infection, antibiotics can clear it up. If you're diagnosed with exertional headaches, you might be given some medicine to help prevent them. Some medications that are used for exertional headaches include indomethacin (an anti-inflammatory medication), ergotamine (a medication that is also helpful against migraines), or propanolol (a beta-blocker that is also used for high blood pressure and for migraine headaches).

Headache clinics are available at some hospitals. For more information, check out the National Headache Foundation web site.

Hope you find more permanent relief soon.

Last updated Mar 19, 2015
Originally published Apr 11, 2003

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