Airplane headache: a scoping review of mechanisms and reported therapeutic strategies

Whether current diagnostic criteria are overly restrictive remains an open question and warrants formal validation. Therapeutic strategies, meanwhile, rely entirely on uncontrolled data. Randomized cross-over trials and mechanistic interpretation studies represent the most pressing priorities for future research.</p> <p>Some people get a sudden, severe headache during airplane flights, usually while landing, sometimes while taking off.

This is called “airplane headache.” The pain is often on one side of the head, near the eye or forehead, feels sharp or stabbing, and usually goes away within 30 minutes.</p> <p>We reviewed all the published research on this condition to understand how common it is, why it happens and what treatments have been tried. We found 33 studies, mostly reports on small numbers of patients. How often airplane headache occurs varies a lot between studies, from about 1 in 500 travelers to about 1 in 7, depending on who was studied.</p> <p>The most likely explanation is that rapid air pressure changes during flight irritate nerves in the face and sinuses in people who are prone to headaches.

Doctors currently do not have a single recommended treatment for this condition. The most commonly reported approach is taking an anti-inflammatory painkiller, such as naproxen, about an hour before the flight. Some people have also been helped by migraine medications, but this is based on very few patients.</p> <p>Airplane headache can cause real distress, including worry about future flights and, for some people, avoiding air travel altogether.

Because it is often mistaken for a sinus or ear problem, it may be underdiagnosed. Larger, well-designed studies are needed to confirm the best way to prevent and treat this condition.</p>