It is common for a positional headache to begin when a person is sitting or standing, and to subside within a short period of time when the person is lying down. Orthostatic, postural, and low-pressure headaches are all terms used to describe positional headaches.
Positional headaches are commonly caused by leaks of cerebrospinal fluid (CSF), however other diseases may also be to blame. These include conditions affecting the connective tissues, bones, and nervous system.
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Symptoms, causes, and treatment options for positional headaches are discussed in this article.
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Most people with positional headaches experience more severe pain when they are standing up, but the pain subsides after lying flat for 20–30 minutes.
It is not uncommon for those who suffer from positional headaches to experience a slight headache in the morning that gradually worsens over the day.
Positional headaches may fade away or weaken with time, although this is not unheard of.
Most people with positional headaches report experiencing pain in the back of the head, however it is possible to experience discomfort in the front, on one side, or throughout the entire head. Positional headaches cause discomfort that is described as:
- severe
- pressure-like
- throbbing
- pounding
- stabbing
- aching
Headaches might be worsened by certain behaviors and hobbies. These are some examples:
- When someone sneezes or coughs.
- grueling physical activity
- sex-related actions
- crouching down
- lifting
- reaching
- A bowel movement that causes one to strain
Causes
Positional headaches can be caused by a variety of factors.
CSF leak
Intracranial hypotension, or low spinal fluid pressure in the head, is a common cause of positional headaches. In most cases, intracranial hypotension is caused by a depletion or imbalance in CSF.
Meninges, the unique membranes that surround the brain and spinal cord, act as a cushion for CSF. During movement, these meninges keep the brain and spinal cord away from bony structures.
CSF can leak into the body when the meninges are damaged, resulting in reduced fluid volume and pressure.
The location of the brain can shift as a result of this change in pressure. As a result, the brain is more likely to come into contact with regions in the head or spine that are sensitive to pain.
Most people have positional headaches while they are sitting or standing up straight, although this isn’t always the case. Due to the large volume of circulating CSF surrounding the spinal cord and the fact that CSF levels decrease even further while someone is standing or sitting, this is a common occurrence. Positional headaches might occur as a result of this.
Before looking into alternative possibilities, a doctor will often rule out a CSF leak.
Cervicogenic headaches
Rather than the head, structural issues or disorders affecting sections of the neck can cause positional headaches.
If, for example, you’re having issues with the:
- the discs between the vertebrae
- tissues that are linked together by a connective tissue
- cells, tissues, and organs
- the joints of the facet
- Muscles of the bones and joints
Postural orthostatic tachycardia syndrome
The autonomic nerve system, which is responsible for controlling such vital functions as heart rate and fluid balance, is malfunctioning in people with this illness.
An abnormally high heart rate and blood pressure when standing can be caused by postural orthostatic tachycardia syndrome (POSS). It can occur if a person with a disabling disease, such as a CSF leak, is forced to lie down for an extended period of time.
Diagnosis
First, a doctor will rule out the possibility of CSF leaks. This is done by asking about the patient’s symptoms, going over the patient’s medical history, and requesting diagnostic tests to be performed.
MRI and CT myelography scans can be used by clinicians to detect CSF leaks.
Around 80% of the time, MRI scans indicate normal CSF leak patterns using strong magnetic fields. Meanwhile, CT myelography scans utilize a contrast dye and specialized X-rays to provide comprehensive images that can detect damage, anomalies or leakage.
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A Trendelenburg test can also be ordered by a doctor to rule out POTS. To perform this procedure, the patient must lie flat on an exam table with the head slowly being lowered and raised as the examination progresses. A doctor will monitor the patient’s heart rate and blood pressure during this procedure.
Treatment
Positional headaches can be treated with a variety of methods, depending on the underlying reason.
The intensity and location of a CSF leak influence the treatment options.
Patients with mild to moderate CSF may benefit from a variety of dietary and lifestyle changes, such as:
- catching some shut-eye or lying down
- consuming a lot of water
- fluid treatment by intravenous infusion
- prevent heavy lifting and other stressful activities
- if possible, refraining from mild straining movements like coughing or sneezing
- consuming caffeine or receiving it intravenously
- giving ginger items a go (for nausea)
- eating a well-balanced, nutritious diet
- meditating or practising yoga are examples of mind-body approaches.
- trying acupuncture
- compressing the abdomen using an abdominal binder
Some mild-to-moderate CSF symptoms, on the other hand, may improve on their own without the need for treatment.
Medication
CSF leaks can be alleviated with the use of certain drugs.
However, researchers have yet to verify the efficacy of most of these methods. However, a number of these drugs may have major health hazards, including the chance of paralysis.
The following are examples of drugs that may be used to treat symptoms of CSF leakage:
- theophylline
- ondansetron and other antinausea drugs
- Non-opioid analgesia
Epidural blood patch
Epidural blood patches may be necessary for people who have CSF leaks (EBP). An injection of 10–100 milliliters of a patient’s own blood into the epidural area of the spinal canal is performed in this operation.
The outer layer of the meninges gets a patch, which reduces the leak of CSF.
To find the leak, the doctor will use EBP, but if they are unsure of where it is, they will use it in the middle or lower spine instead.
Experts aren’t sure why this approach appears to be effective in preventing CSF leakage. But at the absolute least, it appears to alleviate symptoms and support the diagnosis.
4–6 weeks after having an EBP operation, people should avoid intense activities or bending over.
Symptoms are normally relieved immediately, but the effects of blood patching can wear off, necessitating more treatments.
Surgery
Doctors may undertake surgery if the leak is severe or chronic, or if the exact location of the leak is known. A variety of factors influence the type and scope of surgery that is performed.
Tumors, deformities, and cysts may necessitate the use of many surgical techniques in order to be removed or repaired.
Managing symptoms
POTS has no known cure. It is possible, however, to improve circulation by raising blood volume and regulating the flow of blood.
There are a number of drugs and lifestyle changes that can help with this, including:
- adding more water to the diet
- exercising on a regular basis with a moderate intensity
- adding more salt to your diet
- an excessive salt diet while using fludrocortisone
- midodrine at a very low dose
- taking beta-blockers
Risk factors
Positional headaches are tough to avoid unless you practice proper safety, maintain healthy habits, and address any underlying health concerns.
The most prevalent cause of positional headaches is a CSF leak, which can be brought on by a number of distinct risk factors. These are some examples:
- excessive or frequent sneeze or coughing
- putting up excessive effort while participating in physical activities
- Rides on roller coasters and other activities that cause rapid changes in position
- lumbar punctures and other medical procedures
- aberrant pockets of tissue known as fistulas
- Chiari malformations and polycystic kidney disease are two examples of illnesses that are passed down genetically.
- head, neck and spine tumors or cysts
When to see a doctor
Prompt diagnosis and treatment of the disorders that produce positional headaches can lessen the risk of serious complications.
If positional headaches are accompanied by any warning indications of CSF leaks or POTS, seek immediate medical attention.
CSF leaks can cause a variety of symptoms, including:
- vomiting and diarrhea
- soreness or stiffness in the back of the neck
- sensitivities to both sound and light
- a lack of stability
- a ringing in the ears, a muted sound, or complete hearing loss
- discomfort in the area of the shoulders
- fog of the mind
- vertigo
- discomfort or numbness in the face
- or numbness in the arms or lower extremities
- seeing twice or with a haze to one’s sight
- ache in the chest or back
- fatigue
- alterations to the flavors of various foods
- discharge from the nipple
- When you move positions, you may experience rapid fluctuations in your heart rate or blood pressure.
- standing up causes dizziness and fainting
Ideas on What Causes Headache While Sitting on a Recliner
Prolonged sitting can contribute to dehydration since the body isn’t moving and sweating, which can lead to a loss of electrolytes. This problem can be alleviated by staying well-hydrated. As a precaution, steer clear of caffeinated beverages like coffee and soda.
You can overwork your muscles and joints if you sit in one posture for an extended period of time. Keep your body moving by getting up and down every 20 minutes. Take a few minutes to do some light exercise, such as a few stretches. If sitting for lengthy periods of time is causing you back pain, you may want to consider investing in a lumbar support office chair.
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When you’re sitting at your desk, remember to keep your back straight! As a result, hunching over when typing can lead to neck and back pain, as well as stress in the shoulders. When you’re working, avoid hunching over or crossing your arms.
Your workstation should be at a height that does not strain your neck or back when you’re working.
Is Sitting in a Recliner Bad For Me?
It’s not that sitting in a recliner is harmful for you, but if your chair doesn’t have adequate lumbar support, it may be quite uncomfortable. If you’re sitting in a recliner and getting headaches or neck pain, consider stretching every 20 minutes.
Work on your laptop standing up and then lie down for a few minutes to give yourself a break from sitting for long periods of time.
Is sitting in a Recliner Bad For You?
Does it make sense to use the recliner if you’re experiencing neck pain or headaches? Try to get up and stretch every 20 minutes if you can!
Work on your laptop standing up and then lie down for a few minutes to give yourself a break from sitting for long periods of time.
Are Lazy Boy Recliners Bad for Your Back?
No, not if you want to keep your back in a relaxed position. If sitting in a recliner causes you pain or headaches in your neck or back, consider stretching every 20 minutes.
Work on your laptop standing up and then lie down for a few minutes to give yourself a break from sitting for long periods of time.
In order to maintain proper posture when working on the computer, you can either place your elbows on your knees and clasp them in front of you, or you can use a lumbar support pillow. Always keep your back muscles working!
Hemorrhoids can be caused by sitting for lengthy periods of time, so get up every 20 minutes or so to move around.
Can Sleeping in a Recliner Cause Blood Clots?
Blood clots cannot be caused by lying in a recliner while asleep. In the beginning, there may be some discomfort, but as you become used to your new position, this will diminish.
As long as your neck and head are supported when sitting in the recliner then it should be fine for sleep purposes too! A few pillows propped up against the headboard will help you sleep better if that doesn’t work.
As long as your neck and head are supported when sitting in the recliner then it should be fine for sleep purposes too! A few pillows propped up against the headboard will help you sleep better if that doesn’t work.
What do I need to know before buying a recliner?
If you’re sitting in a recliner with your neck and head supported, you should be safe to sleep in that position. In the event that you don’t have access to a headboard, you can place several pillows up against it to improve your posture and allow you to sleep more comfortably.
Keep in mind that if you have a bad hip or knee, you’ll need a lot of room to get in and out of the chair.
Second, look for a pillow with arms, which will provide additional head and neck support if necessary. If not, a cushion will do!
Keep the recliner in a good position. Ideally, it should be just right in terms of firmness and softness, yet still provide adequate support.
Get a chair with armrests instead of a footrest. They can also be used for viewing television and reading in bed.
Features of a Recliner
- Relaxing in a recliner is both relaxing and supportive of the back.
- Whether you use a chair in the bedroom, the living area, or even for reading, the choice is entirely up to you.
- If you don’t want to sit in an armchair all day, a recliner is a terrific option.
- Additionally, they fold up small enough to fit in a small space when not in use.
- There is no better time than the present to invest in a product that will make your life more convenient.
- As an alternative to sitting, reading or relaxing, they are quite adaptable!
Investing in a recliner is one of the best investments you can make.
Summary
When a person is standing or sitting erect, they get positional headaches, which normally subside when they lie down. Most commonly, they are caused by CSF leaks and POTS, which are both extremely rare.
Sometimes, however, lifestyle changes, drugs, EBP procedures, surgical repair, or some combination of these are all that are needed to stop the leakage.
Treatments for most CSF leaks are effective, although some patients may still experience symptoms and disabilities even after multiple treatments have been performed..
Although there is no treatment for POTS, patients can reduce their symptoms with lifestyle adjustments with blood pressure and volume medications.
Severe or persistent headaches that worsen or disappear when you change positions should be discussed with a physician as soon as possible in order to avoid further issues.
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