Hey.

I have a problem with flying. During descent, I sometimes get this horrible pain behind one of my eyes. It's this radiating pain that originates from what feels like a knife behind my eye. I assume it's to do with the pressure on the flight, and indeed it feels like my head is just about to explode and my eye pop. It comes very quickly when starting descent, and leaves just as quickly on landing (except I can sometimes feel like a shadow of the pain for a while afterwards, but nothing to complain about).

Its really painful (the most pain I've ever been in for sure), and I pretty much just sits there rocking back and forth with my hand putting pressure over my eye. At this stage, I'm to focused on getting through the pain to really do anything else, like answering people talking to me.

So anyway, before my last flight I went to my local GP to try and get some help, and she seemed very unimpressed by what I was going through. She suggested chewing some gum etc, which obviously does nothing at all. I'm not in some normal minor discomfort that happens to the average joe when flying, I'm in immense pain. Hopeless.

After googling, I found some other people with the same symptoms, and I stumbled upon the phrase "cluster headaches". So reading the wikipedia on this condition, the symptoms sounds pretty much spot on. Except for the frequency of the "attacks" and the random onset, because in my cause it is definitely not random at all.

So despite that, could this still be cluster headaches I'm suffering from, and where should I take it from here? I'm only getting this on the descent of flights, and it doesn't happen every time (maybe 40% of the time). It happened for the first time maybe 10 years ago and the last time was 6 months ago. I have never experienced anything like this under any other circumstances.

Thanks for the help.

tompa wrote on Feb 5^th, 2011 at 10:06pm:

Hey. I have a problem with flying. During descent, I sometimes get this horrible pain behind one of my eyes. It's this radiating pain that originates from what feels like a knife behind my eye. I assume it's to do with the pressure on the flight, and indeed it feels like my head is just about to explode and my eye pop. It comes very quickly when starting descent, and leaves just as quickly on landing (except I can sometimes feel like a shadow of the pain for a while afterwards, but nothing to complain about). Its really painful (the most pain I've ever been in for sure), and I pretty much just sits there rocking back and forth with my hand putting pressure over my eye. At this stage, I'm to focused on getting through the pain to really do anything else, like answering people talking to me. So anyway, before my last flight I went to my local GP to try and get some help, and she seemed very unimpressed by what I was going through. She suggested chewing some gum etc, which obviously does nothing at all. I'm not in some normal minor discomfort that happens to the average joe when flying, I'm in immense pain. Hopeless. After googling, I found some other people with the same symptoms, and I stumbled upon the phrase "cluster headaches". So reading the wikipedia on this condition, the symptoms sounds pretty much spot on. Except for the frequency of the "attacks" and the random onset, because in my cause it is definitely not random at all. So despite that, could this still be cluster headaches I'm suffering from, and where should I take it from here? I'm only getting this on the descent of flights, and it doesn't happen every time (maybe 40% of the time). It happened for the first time maybe 10 years ago and the last time was 6 months ago. I have never experienced anything like this under any other circumstances. Thanks for the help.

  You don't have cluster headaches.

           Potter

I agree.  Definitely not cluster headaches.  Be thankful for that!  My mom has the same problem you do though when she flies.  Doctors told her the same thing about chewing gum and all that.  Nothing really helps her either.  She just suffers through it.  Sounds like the pressure to me.  I had that happen one time when a plane was landing, but it was in my ear.  It definitely hurts and sucks that you have to put up with it every time.  I hate flying (for other reasons) and avoid it.  I hope you find out what your problem is. :)

Oh, and my mom wear earplugs.  I don't know if your doctor told you to try that or not.  She says it helps some.  She wears them during the whole flight.

Certainly does not sound like Clusters, although it sounds like it hurts like hell! Clusters are a  different beast altogether, in their duration, frequency and  associated symptoms. The treatments we use tend to concentrate on arterial constriction, oxygen, imitrex, caffiene and taurine, none of which would really help the kind of pain you're enduring.

Wishing you a little luck on your research and diagnosis. Head pain of any type sucks! :(

Joe

Congrats Tompa, sounds like you do not have clusters!  If it is only on descent while flying then it is probably some sinus issues that can be common to flight.

I spent many years as a pilot and the pain you describe is exactly why we were not allowed to fly with a head cold in the military.  People still would occasionally and sometimes a blown out sinus would result.  I heard it was very painful and felt like getting stabbed by an ice pick.

So what I would do if I was flying while slightly clogged was drink tons of water to get my sinuses moist.  On descent I would hold my nose, close my mouth and gently blow out until I felt the ears popping.  **Don't do this hard or too quick as other problems can result**. 

Don't bother doing that while climbing out as the pressure works the other way and the hold the nose trick doesn't work. 

Commercial airliners only take the cabin altitude up to 5,000-7,000 ft or so.  They descend gently but can still cause some problems for people with sensitive sinuses as you know.  Quite different than being in a dive bombing pattern without much pressurization.

Also, since I am not a Dr. and don't know your specific sinus issue, the hold the nose and blow technique may be too much for your sinuses, so you may want to consult a professional (otherwise known as don't blame me if it doesn't work right).  Works great for my sinuses but everyone is different.

--The Shaggy 

Tompa,

From your description, it sounds more like a sinus squeeze than anything else.  If that's the cause of the pain, the simple solution is to start doing the valsalva maneuver during descent.  Do it as soon as you feel any pressure build up in your ears as the aircraft descends from altitude for landing. 

In other words, close your mouth, pinch both nostrils closed, point your chin up as high as possible then try to exhale with moderate force while tipping your head from side to side.  Trying to swallow also helps stretch the eustachian tube open. 

In the old days... The flight attendants used to pass out a small box containing a couple Chiclets chewing gum prior to descent as chewing them and swallowing helped open the eustachian tube to equalize the pressure differential.

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The valsalva maneuver is usually done to force air through the the eustachian tube into the middle ear to equalize pressure.  The same maneuver can also help equalize pressure in the sinus cavities as they drain into the nasal passage.  SCUBA divers and military pilots do this on every descent. 

Anything that reduces nasal passage inflammation should help prevent a sinus squeeze and the pain you're experiencing.

Hope this helps.

Take care,

V/R, Batch

I've always called them 'landing headaches' and yes, they hurt like hell. A big one is just like a CH and can be anything up to K7.53 but thankfully they last only a few minutes.

Oddly, I've never had one while sky-diving.

Thanks for all the friendly advise everyone :)

After reading a bit more on this forum, I feel relieved that it's not a sign of getting cluster headaches at least, I have no idea how you guys manage to handle getting attacks like this several times per day.

So far all info I've found in how to relieve my condition (incl this thread) is chewing gum, taking decongestant, doing valsalva, nosespray, cleaning ears and wearing earplanes ear plugs.

So far I've tried all except the last one with no significant difference from what I can tell, but I'll keep trying I guess. I might see if I can try and persist with doing valsalva despite the pain next time (I usually stop very quickly since it never seemed to do anything and it's hard to focus on anything at that stage).

I should also mention that I have not felt sick or congested or anything like that when this have happened, I must just have the worst eustachian tube and sinuses. Oddly, I rarely get sick or have a cold, I still haven't had any reason to use any sick leave from my current job since I started there about a year and a half ago.

I've also been scuba diving once (although not very deep) and skydiving, both of which caused me no pain whatsoever.

EDIT next time I fly is in October.. was looking at tickets which made me worry about this already :P Not looking forward to it

EDIT and water! I'll make sure to drink plenty of water next time as suggested, had no idea that it could help with sinus problems. Definitely couldn't hurt.

Batch wrote on Feb 6^th, 2011 at 10:22am:

In the old days... The flight attendants used to pass out a small box containing a couple Chiclets chewing gum prior to descent as chewing them and swallowing helped open the eustachian tube to equalize the pressure differential.

Air New Zealand always at the start of the descent pass out boiled sweets just for this reason, which I've been enjoying on the 7 flights I've done in the last 4 weeks.

I've had zero trouble with CHs whilst flying although I did get one soon after landing last Friday which was about my usual time for getting them so almost certainly nothing to do with flying.

Yes you are right and I have exactly the same problem. I used to think may be the airline is problem, so I tried all airlines in India and now I have had this headache with all the airlines. I too have this problem 40% of the time. Earlier a doctor told me to chew gums as soon as the descent was announced. It helped in reducing the intensity of the pain, but last week even the chewing gums did not help and I suffered a lot, even today a shadow of the pain is still there above my left eye.
I will check if earplugs help, and try drinking water, though I must admit I have a problem with nasal tract, they get clogged easily in Indian environment, and I have ear pains periodically ( once every 2 years).
Your post helped me in knowing that this problem may have a solution. Thanks.

I don't know.  According to the classical diagnosis schemes, you're not suffering from CH.

These schemes put much weight on the attack patterns and effects like red eye and running nose.

For me personally it is the pain that is the critical. It's taste and smell, so to speak.  I have in fact experienced "single attack cycles" several times.  Who dare tell me that those attacks were not CH because hey, they gotta come in clusters?

According to the diagnosis schemes those attacks must have been something else. Single lone wolf attacks doesn't go well with the name. Of course they were not something else. The CH pain is very different from any other headache I've encountered. It just can't be confused with anything else. Any CH sufferer will recognize a CH attack even if it's just 0,5% of its full strength. Naming it A shadow, but still CH. The rest of the world however, GPs and MDs included, may very well confuse CH with something else,  especially if it doesn't fit perfectly to their kind of funny diagnosis schemes.

As CH is poorly understood scientifically and it's causes still a mystery, I can't go binary and respond yes/no to your question. If its is CH it is surely atypical. A. But that is not unheard of.  In the year 2000, a Norwegian neurologist, P Gulbrandsen, published an article in Neurology on a 22 years old male having all the outside symptoms of CH 1-3 times daily, but no pain. Later he also had the pain. But actually, his patient suffered from painless CH - forcibly challenging the schematic pathophysiology of CH.

CH may very well prove to be a family of conditions. In fact it is likely. Even among the CH diagnosed, the experience vary very much, and treatments that are successful for some, have no effect on others.

The story of CH is still in the making.

Going from London to Seattle late March a year ago, I had a similar experience.  Shortly after departing the pain occured and I had no abortive available.
That was the first time I was flying in a cycle. A humbling experience. If pressure triggerd it? I don't know. But I was pain free the entire week on US soil, and also on the plane home. A few days in Norway, and it returned with anger and misery until I read about D3 etc in this brilliant forum and got rid of it in a matter of days.