As a parent, you know all too well the many kinds of headaches that can arise: from pregnancy-related pain to stress from crying babies or older kids. There’s also the chaos of DIY projects that can leave you with a throbbing head. Among these, you might have encountered a specific type of headache that worsens when you stand up — an orthostatic headache.
What is an Orthostatic Headache?
Orthostatic headaches, also referred to as positional or postural headaches, tend to intensify within 30 seconds of standing and typically improve when lying down. These headaches can occur daily or sporadically. According to Science Direct, they may accompany symptoms like neck pain, nausea, vomiting, changes in hearing, visual disturbances, discomfort between the shoulder blades, and sometimes even facial numbness or weakness.
The pain from an orthostatic headache often manifests in the back of the head, though it can also affect the front, one side, or encompass the entire head, frequently escalating throughout the day. The intensity can vary from mild to severe, and may include throbbing sensations, as noted by the Mayo Clinic.
Orthostatic headaches can sometimes be mistaken for migraines, which typically occur on one or both sides of the head and are exacerbated by movement, light, sound, or specific odors. Symptoms of migraines may also include nausea or vomiting. Activities that can worsen orthostatic headaches include:
- Coughing or sneezing
- Strenuous exercises
- Sexual activity
- Bending or lifting
- Straining during bowel movements
What Causes Orthostatic Headaches?
Various medical conditions can lead to orthostatic headaches, ranging from minor issues to more serious concerns.
CSF Leak
Cerebrospinal fluid (CSF) protects the brain and spinal cord. A leak can occur due to a tear in the protective layers, leading to insufficient cushioning of the brain and resulting in headaches. Severe leaks may cause complications like meningitis or seizures, and symptoms can include a persistent runny nose or ear drainage. CSF leaks are rare, affecting about five in every 100,000 individuals, and are more common among women in their 30s and 40s.
Postdural Puncture Headache (PDPH)
PDPH can stem from complications related to a lumbar puncture (spinal tap). Symptoms often resemble those of a CSF leak, including worsening pain when upright, nausea, neck pain, and dizziness. PDPHs are most prevalent in women aged 20 to 40.
Other Causes
Other factors contributing to orthostatic headaches may include dehydration, severe anemia, postural orthostatic tachycardia syndrome (POTS), colloid cysts, or brain tumors.
Duration of Orthostatic Headaches
The length of an orthostatic headache can vary significantly, lasting anywhere from five minutes to 48 hours.
Treatment Options
If a doctor suspects a serious issue, such as a CSF leak or tumor, they may use imaging techniques like MRI to diagnose the cause. Treatment will depend on the underlying issue. For CSF leaks, initial treatments may include rest, hydration, and in some cases, an epidural blood patch to seal the leak. PDPH is often treated with over-the-counter pain relievers and hydration while avoiding upright positions.
If POTS is the cause, management strategies such as wearing compression socks, increasing salt and water intake, or adjusting your sleeping position may help. For immediate relief, consider drinking fluids, resting, or using essential oils and cold compresses. Beverages like decaf coffee, fruit-infused water, green smoothies, and herbal teas can also be soothing.
Summary
Orthostatic headaches occur when standing and improve when lying down. Understanding the origin — whether it’s a CSF leak, PDPH, or another cause — is crucial for effective treatment. If symptoms persist, consult a healthcare provider for proper diagnosis and management. For more information on related topics, check out this resource on pregnancy and home insemination.