joanek,

Excellent diagnosis. The issue here is a pressure imbalance between the sinus or innner ear and the external environment.

As a plane descends the ambient pressure increases. Imagine your sinus or inner ear as a balloon, as external pressure increases on the relatively lower pressure air of the balloon the balloon shrinks. (you've seen your potato chip bag expand as your plane climbs, right?) Inside your head, the lining of the sinus is the balloon. Effectively, that lining is attempting to shrink, pulling away from the skull. That's why it hurts.

How to fix this? Generally if everything is working correctly, the human body will equalize the pressure on its own. However, if you're congested or your eustachian tube is small or clogged it's going to need some assistance. One method is called val salva. To do this inhale a breath, pinch your nose, close your mouth and do as if you are breathing out with slight, gentle force, but do not exhale. This will force air into your sinus and the inner ear. Don't over do it. Just a modest push is all that's needed. You'll feel your ears push out a bit and your cheeks should blow up a bit also. If it's your eustachian tubes, tilting the head from side to side while performing the val salva will help to stretch the tubes out. Remember...val salva.

Oh, good posts on this topic. A thought; I think that about half of the posts are referring to general sinus/nasal pressure imbalances, etc. That is NOT what I am referring to.

I.e., I have skied dozens of times, and have experienced rapid decompression in aircraft several times. Meaning that I do understand the general pressure issues and the standard chew gum, pinch your nose and blow, etc., type of suggestions. These all work for pressurization issues.

The other half of the posters to this issue know what I am referring to. The knitting needle through the eye pain is way beyond any decompression that I ever experienced. In referencing the broken leg above, let me say that the pain in the eyeball was the rough equivalent to when the rescue workers were prying the car door off of my leg and grinding the open bones into the opposing door. While I only passed out one time during the process...I wish that it had been for the whole time.

That eyeball feeling is roughly the same. Ain't fun and it is my belief that this is not the same as the general decompression type gig. Just my two cents.

butcher bird: it really is all connected. I don't know of a url, but I know there's a website that'll give you the cross section of a head---and you'll see how general congestion in the sinus-ear area can give you the feeling that your eye is about to explode. I seem to remember two different sinus cavities ...maxillary and something else???? All in that general area that can give you pain anywhere from your forehead to your upper jawline.

Folks familiar with sinus headaches know that pain--- the simple description would be that things have swelled to capacity and are pushing on everything around them.

[This message has been edited by joanek (edited 06-28-2001).]

Here's a link to a site with some good info and explanations of sinus and inner ear problems.

http://www.sinuscarecenter.com/

Click on Patient Brochures and you'll get a list of different sinus problems as well as an explanation for what happens when you are congested, including an article on Air Travel.

Wow! I'm glad I brought this up -- there seems to be quite a compadre of fellow sufferers.

joanek - I would agree with Butcher Bird that there are two different kinds of problems being discussed here. While both "related", certainly, to sinus blockage/pressure, I was more curious to find out what caused (and how to avoid) the specific ailment mentioned in the first message. That is, the sharp knife-stabbing pain above my right eye.

I've tried the "general" remedies (such as val salve -- mentioned above) and those doesn't seem to help. Similarly, the pain doesn't dissipate for hours after you land.


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"What do you mean you didn't get miles for that?!"

Well, I have a slighty different problem that really bothers me only sometimes. If I forget to take my claritin, when the plane starts to go down, I start sneezing and then my nose runs like a faucet for about two days. It is awful.

Does anyone getting those dreadful sinus headaches drink 'TONIC WATER' during the flight?

I have experienced that a couple of times, it is awful. I read through the posts here and a lot of it makes sense. I have always thought it was either related to the changing pressure on the descent or passing through the clouds - in the 3 or 4 times it happened to me, it seemed those factors were usually present - except for the time heading to JNB at 41,000 feet that I felt it a bit mid-flight. I think it also affects my sinus allergies so that when the allergies are at their worst, the pressure is worse.

Johnny P is down with it. Yes, the sinus issues/cavaties are all related. Still, I am telling you that this is different. General sinus issues/decompression, etc., are mildly uncomfortable. Say, about a 1.5 on the Butcher Bird scale of general irritability/pain. Never had any pressurization, sinus, etc., issues above a 2, maybe.

This issue screams up to about an 8.5 or 9.0 on the pain scale. One time I actually sat in the seat with tears slowly trickling down my face as we landed. Somehow this has to be a different issue, IMHO. If not, then sinus pain has an unusual pattern of severity. 100 times at 1-2 (BB pain scale), zero occurences of 2-8, and then three jabs with the icepick at the 8.0-9.0 range. These occurences hurt for hours afterwards, and one time the burst blood cells in my eye stayed around for two weeks.

Great discussion!

I'd say I've had 4 5.0's in the 2 1/2 years I've been traveling constantly. Wish there was a way to predict them - my seatmates probably think I'm going crazy. I've never had a hint of congestion before taking the flights.

Wow! Can't imagine the 8.0 and 9.0s!!

I hate the thought of taking meds for every flight but I might have to if it happens again. And - I always hydrate a LOT during flights (which is why I always get an aisle seat )

Good luck to all you sinus people!



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While I am not a doctor, I don't believe there is another reasonable explanation for this other than a sinus problem. If this occurs frequently, then my suggestion is that you see an ENT and ask him to order a CT scan. The CT scan can reveal blockages (such as polyps) and constrictions that prevent your various sinus cavities from properly draining. Endoscopic sinus surgery can be performed to correct these problems.

Actually, I did speak with a general practitioner on this (read above for his suggestions). As per my first post (3rd total for this thread), this has only happened three times in 15 years of flying. So, maybe three times out of five hundred.

Hence, it is not common. But, when it does strike the pain is really unforgetable. I was being serious when I compared the pain to that of having my leg bones being ground into an auto's door. That was in a severe auto wreck that resulted in a double compound fracture to my left leg (i.e., both lower leg bones broke through the skin and were ground into the door). About the same level of pain, actually.

OK. No more posts from moi on this topic. To those who have experienced it, to quote our ex-Pres, "I feel your pain".

after probably 70 flights ive felt this at the "9" level once and maybe a "5" level twice...while it likely deals with the sinus cavities, etc...the feeling is completely different from the feeling of being "plugged up"...it makes you want to bang your head against the plane to make the sharp pain stop.....someone should ask an airline agent next time they fly im sure they have experienced it or know about it....

If others can remember their flights, perhaps we can see if there is a trend on certain A/C.

I've had a 10 out of 10 on the pain scale only once Dec. 23, 1998. An AA F-100 going ORD-YOW, heading home for X-Mas. Nothing until about 8,000 feet, than it hit like a sledge hammer between my eyes. I had my head against the window with tears streaming uncontrollably down my face. I have never felt anything like it. I had the worst headache until the next morning, and was dizzy for most of the hour long ride home. Also for interest sake, just want to throw in the wether. On this trip, I left MIA at 7PM, where it was 80F and humid, ORD was about 10F, while YOW was -40F and cold/dry around midnight. Does a 120 degree temperature swing in 5 hours contribute to this?????

I've had a few other times where I could feel it coming on, but very mild at the least. These other few times, I pressed my finger between my eye-brows and felt the pain. But didn't feel anything else other than that.

My ex-wife suffered from this on a Delta 727-200 DEN-DFW a few years back. She had a sinus infection that she didn't even know about, but when we were on final to DFW she tapped me on the shoulder and had the most horrible look on her face. I didn't know what to do except push the call button, and fortunately the Delta FA knew exactly what to do: she climbed over me and held her thumbs tight against my ex's forehead until we were on the ground. For the rest of the day my ex said she felt like she'd been hit with a hammer. Daze