Exploring Key Reasons Behind Pressure Headaches and How to Alleviate Them

Pressure headaches are commonly caused by tension, sinus congestion, or changes in altitude or weather.

Common causes

• Tension headaches.
• Sinus congestion.
• Altitude or weather pressure changes.
• Allergies.
• Dehydration.
• Eye strain.
• Migraine.

Relief

Warm compress, decongestants and fluids.

Pain relievers

OTC pain relievers.

See a doctor

If the headache is severe or persistent.

Emergency

Sudden worst headache, stiff neck or confusion. Call 911.

Common causes

Pressure headaches can arise from tension, sinus congestion, altitude changes, tight hats or goggles, caffeine withdrawal, high blood pressure episodes or exertion. Tension-type headaches cause a band of pressure around the head. Sinus headaches cause pressure around the cheeks and forehead, often with congestion.

• Many “sinus headaches” are actually migraines. A study in Archives of Internal Medicine found 88 percent of people self-diagnosed with sinus headache met migraine criteria.
• Cold stimulus headaches (ice cream headache) peak in 30 to 60 seconds.
• External compression headaches come from helmets or tight headbands.

Relief and red flags

Rest, hydrate, apply a warm or cool compress and use ibuprofen or acetaminophen as directed. Saline irrigation helps sinus pressure. See a doctor for headaches that are frequent or worsen. Seek emergency care for sudden severe headache, fever with stiff neck, confusion, weakness, vision changes or headache after injury.

Common causes

Pressure headaches come from tension, sinus congestion, migraines, altitude changes, straining and caffeine withdrawal. Tension type headache is the most common type, affecting about 40 percent of people.

Relief and red flags

Rest, hydration, warm or cold compress and over the counter analgesics as directed help. Seek emergency care for sudden severe headache, fever with stiff neck, head injury, confusion, weakness or vision loss.

Tension, sinus and altitude mechanisms

Tension headaches involve pericranial muscle tenderness and central sensitization. Sinus headaches are overdiagnosed: studies show most self described sinus headaches are migraines. Barometric pressure changes and altitude trigger headaches in a share of people. Caffeine withdrawal headaches begin 12 to 24 hours after last intake.

Treatment and prevention

Hydrate, sleep, regular meals, and limit stimulants. Over the counter analgesics work for episodes, but overuse for more than 10 to 15 days a month causes medication overuse headache. Preventive therapy considered for frequent headaches includes amitriptyline and CGRP drugs. Red flags like fever with stiff neck, vision loss, confusion and sudden thunderclap onset need emergency care.

Based on data from the American Migraine Foundation and the American Academy of Neurology