Headache on a plane: the one that arrives on descent

Most flight headaches are ordinary: dry air, no water, too much coffee, a bad night before an early departure. One is not. A short, savage, one sided headache that appears as the aircraft comes down is a recognised type of its own, and it behaves so distinctively that you can usually identify it from your seat.

Why this happens on a plane

Descent raises the pressure around you faster than the air spaces in your head can equalise. If a sinus cannot keep up, the difference produces pain: stabbing, usually on one side, usually around or above one eye. It peaks during descent and normally goes within half an hour of landing. That timing is the signature. Motion sickness headaches build slowly with the bumps and come with queasiness. Dehydration headaches sit dull across the whole head. This one arrives with the descent and leaves with it.

What to do right now

1. 1

   Start equalising early, before the discomfort. Swallow, yawn, or pinch your nose and blow gently against it.

2. 2

   Sit up and stay awake through the descent. Sleeping through it means you stop swallowing.

3. 3

   Chew gum or sip water steadily from the top of descent.

4. 4

   Hold a warm hand or a warm cloth over the painful spot if it is around the eye or cheek.

5. 5

   If the headache came with queasiness during turbulence rather than on descent, treat it as motion sickness: look outside, cool air, head still, and a session through any headphones for about 90 seconds.

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Preventing it next time

• Do not fly with a heavy cold or blocked sinuses if the trip can move. That is when it happens.
• Ask a pharmacist about a decongestant before descent if you must fly congested, and check it against your other medicines.
• Drink water through the flight and keep alcohol and heavy coffee out of it.
• If it happens on every flight, tell your doctor. Repeated descent headaches are worth investigating rather than enduring.

When to see a doctor

A short headache that clears after landing needs no more than a mention to your doctor if it keeps happening. Seek urgent care for a headache that is the worst you have had, one with fever and a stiff neck, one with weakness, numbness, confusion or slurred speech, or one with sudden loss of vision. Any headache that starts in the air and is still severe hours after landing should be assessed.

Common questions

Medically informational; not a substitute for a doctor's advice. Persistent or unusual symptoms deserve a clinical evaluation.