Can I get a headache when flying?

This is the 4685th article of Da Yi Xiao Hu

Some people get headaches when they get on a plane. Why is that? Today we're going to talk about "headaches caused by plane travel."

With the improvement of living standards, it is no longer a new thing to take a flight during holidays. Crossing mountains and seas and taking a leisurely trip has become part of many people's daily life. However, some people cannot enjoy the flight journey. No matter how close the distance is, as long as they sit on the plane, they will have an unbearable headache. The degree of headache is generally severe, usually occurring on one side of the head or around the eyes, and can only be relieved after the plane lands.

1. What are headaches associated with air travel?

Foreign surveys and studies have shown that 8.3% of airplane travelers experience headaches due to airplane travel. Most of them occur during the landing process, and one-third of patients have accompanying symptoms. The most frequent accompanying symptoms are restlessness and unilateral tearing, while nausea or photophobia and phonophobia are generally rare. Some patients can also experience headaches similar to those due to airplane travel during diving and rapid descent, suggesting that this headache may be caused by an imbalance between the sinus pressure and atmospheric pressure.

2. How to diagnose?

According to the latest version of the International Classification of Headaches, a person who meets the following criteria can be diagnosed with "headache attributed to air travel":

A. At least 2 headaches that meet Criterion C

B. Occurred during airplane travel

C. At least 2 of the following 3 items are met:

1. Headaches only occur when flying

2. Meet one or both of the following two conditions:

a) Headache that worsens during takeoff and/or descent before landing

b) The headache is significantly relieved within 30 minutes after the aircraft takes off or lands

3. Severe headache, with at least 2 of the following 3 items being met:

a) Unilateral headache

b) Orbital frontal pain (sometimes radiating to the top of the head)

c) Pin-stinging pain (sometimes throbbing pain)

D. Not better explained by another ICHD-3 diagnosis.

In fact, it is not difficult to see from the diagnostic criteria that this special type of headache only occurs during airplane travel under specific circumstances, and the headache is closely related to the takeoff or landing of the plane. It is also important to note that about 10% of patients experience headaches on different sides each time they fly, and the headache may spread to the top of the head, or there may be throbbing headaches. In addition, sinus-related problems should be excluded.

3. How to treat it?

The treatment of headaches caused by airplane travel is similar to that of migraines. Analgesics such as nonsteroidal anti-inflammatory drugs (NSAIDs) can be given during acute attacks. Typical representatives include ibuprofen, diclofenac, indomethacin, aspirin, acetaminophen, headache powder, and painkillers. Specific analgesics such as triptans include sumatriptan, zolmitriptan, and rizatriptan. Use medication as soon as possible when the headache is mild at the beginning of the attack. If nonspecific analgesics are ineffective for a single attack, specific analgesics can be tried after a few hours, or if nonspecific analgesics are ineffective for several attacks, specific analgesics can be given.

Now that you know these little bits of knowledge, flying may not be so scary anymore. Start preparing for your next trip!

Author: Jilin University Second Hospital

Department of NeurologyMan YuhongChief Physician