External compression headache arises due to pressure caused by helmets, hats, goggles, or other wearable equipment. Reviewed by a board-certified neurologist. External compression headache, often referred to simply as compression headache, arises due to pressure placed on the temples and scalp. Helmets, hats, personal protective equipment (PPE), and goggles that are too tight are common causes of this
External compression headache, often referred to simply as compression headache, arises due to pressure placed on the temples and scalp. Helmets, hats, personal protective equipment (PPE), and goggles that are too tight are common causes of this headache. Generally, the pain resolves after what’s causing it is removed from your head. Pain medications will also help, if needed.
This article covers the basics of external compression headache, including its causes and how it’s managed.
Naturally, head pain is the primary sign of external compression headache. To be an external compression headache, though, you must experience at least two episodes of pain within an hour of sustained pressure on the head and the pain must resolve within an hour after the pressure is relieved.
The pain is described as:
External compression can also lead to attacks of primary headache disorders, including migraine and tension headaches. Knowing what’s setting them off and working to avoid these triggers is an important means of managing these conditions. In addition to an often one-sided, severe, and pulsing headache, migraines also cause a range of symptoms, including:
Primarily, external compression headaches arise due to pressure placed on the scalp, forehead, and face by wearing helmets, goggles, PPE, and anything else that requires a strap. While the exact mechanisms for this issue aren’t known, the pain can result due to:
The pressure at the root of these headaches is localized on the scalp and forehead. This can be caused by wearing:
Because healthcare workers have had to wear PPE throughout the COVID-19 pandemic, there has been a dramatic rise in external compression headache cases over the last two years.
The longer you wear something on your head, the greater your chances of bringing on pain. This is why external compression headaches are common in military personnel, construction workers, football and hockey players, and police officers. Additionally, biological women and those who experience migraines are at higher risk of developing these.
Because external compression headaches usually resolve on their own and typically don’t require medical intervention, the focus of diagnosis is to rule out other kinds of headaches or health issues.
When seeing a healthcare provider, you'll be asked about:
In cases of secondary headache—those arising due to other conditions—additional testing may be needed. This may involve:
Medical help typically isn’t needed, but over-the-counter (OTC) pain medications may be recommended to help with symptoms. These may include:
If the external compression headache leads to migraine attacks, your provider may prescribe triptans (such as sumatriptan, zolmitriptan, and rizatriptan) or ergot alkaloids (dihydroergotamine, ergotamine, and others).
Preventing external compression headaches means wearing helmets, masks, goggles, or hats that fit, especially if you need them for work or wear them for extended periods of time. Aim for a fit that is snug without being too tight and try different size options to see what works best. Take breaks from wearing them if you can.
While most headaches aren’t a sign of anything serious, they can be signs of significant problems. Get emergency help if you experience any of the following:
It’s also important to call your call provider if, along with headache, you experience:
External compression headaches arise due to pressure placed on the scalp and forehead. It’s a cause for concern if you wear helmets, hardhats, goggles, personal protective equipment, and anything else that compresses your head. Typically, the pain resolves within an hour of the pressure being removed.
Pain from an external compression headache is generally mild, dull, and concentrated in areas of increased pressure. External compression headaches can also trigger migraines, which cause more severe pain and other symptoms, such as nausea, vomiting, and light or sound sensitivity.
In most cases, external compression headaches resolve on their own, and medical treatment is rarely needed. However, OTC pain medications, such as Advil/Motrin (ibuprofen) or Aleve (naproxen) may help. If migraines arise, triptans and ergot alkaloid drugs may be prescribed. Get help if you experience severe symptoms, or are experiencing motor and neurological symptoms.
If you spend long hours wearing PPE, a helmet, hardhat, goggles, or anything else that puts pressure on your head, it’s important to be aware of how your head feels. While this type of headache isn’t dangerous, it can be very debilitating. This is why it’s important that what you wear or strap onto your head fits properly. Be sure to treat headaches promptly, too, and know when to seek help.External Compression Headache: Overview and More View Story