Why do I get awful headaches when I lay down?
May 22, 2021 9:01 AM   Subscribe

When I go to bed, I get super painful headaches where my head touches the pillow. If I stand up and walk around, the pain goes away. What gives? Details inside

I injured my neck 6 months ago pretty badly, I have seen several doctors, they said it was likely a muscle or ligament strain, and it will take time to heal. I have been doing my physical therapy and stretches and it has started to get a lot better, but for the past month, often when I lay down to go to bed, it starts to hurt a little bit, which induces an extremely powerful pressure headache. Most of the pain accumulates where my head touches the pillow, but if it gets worse, the pain wraps around towards my eyes.

The pain goes away if I get up and walk around, and comes back as soon as I lay back down.

I can sometimes, (but not always) reproduce the pain by bending over at the waist to touch my toes.

This happens almost every night, but occasionally I get a day or two in a row where I sleep perfectly fine and have no pain.

The doctors I saw were of no help for this issue, so I thought I’d ask y’all, maybe someone has experienced something similar and has a solution?

Thanks in advance.
posted by maxexam to Health & Fitness (10 answers total) 2 users marked this as a favorite
I'm no expert but that sounds like a trigger point? Do you have any physiotherapists that do dry needling in your area?
posted by speakeasy at 9:42 AM on May 22, 2021

Mess around with different width pillows. You probably have a very narrow range of neck angle that’s tolerable to you right now.
posted by St. Peepsburg at 9:54 AM on May 22, 2021 [3 favorites]

NYPG (not your pain guru:) but, and keep reading, don't lay down. First like St. Peepsburg said do all the pillows, actually a rolled up bath towel can make an effective pillow, especially right under the neck.

But to my point, climb into the bed on hands and knees offset from your final position. (prepare the covers so they can be adjusted and don't get in the way). Then inch lower and place the side of your head on the pillows then slowly sensing the shoulder muscles roll and lower and roll gently into position. Experiment, I can imagine multiple ways. but the laying down movement may be pulling a muscle ever so slightly so try different directions and shoulder movements. Use the upper arm to ease the movement. Exaggerate the slowness (I just came from a tai chi class and it's surprising how jerky we can be without knowing or noticing when there is not a pain trigger).
posted by sammyo at 10:17 AM on May 22, 2021 [1 favorite]

Possible it is unrelated to previous injury. Eg a relative had something similar that was related to undiagnosed blood pressure problems.
posted by Mitheral at 10:43 AM on May 22, 2021 [2 favorites]

Have you tried sleeping all propped up in a soft chair? I have had strains that were made worse by this, as well as better, and it might take a medical recliner to prop you up enough, but they do exist and a doctor or PT might have one you could try a nap in.

I have a recurring neck strain that sometimes wraps around to the eye and walking helps it, but the pressure-point thing hasn’t happened to me.
posted by clew at 10:46 AM on May 22, 2021

Consider acupuncture, osteopathy or orthobionomy.
These could help the neck injury get repaired.
posted by Mesaverdian at 11:38 AM on May 22, 2021

I used to have a painful spot where my head touched the pillow but it didn't happen when I first went to bed. It happened sometime later and the pain would wake me up. (I have an old neck injury. Plus I store so much tension in my neck and shoulders.)

I used a neck pillow which helped for a while. The pain got worse so I searched around for a better neck pillow. I found this Epabo pillow. Now, I have almost zero neck pain and I sleep so much better. They offer a 30-day return policy. It may take a couple of weeks for results but in my case, the change was pretty much immediate. I had to look at the photo in order to figure out which way the pillow goes. There is a small protrusion that should be supporting the neck. I recommend this pillow!
posted by goodsearch at 1:41 PM on May 22, 2021

Response by poster: These are all very good suggestions. I bought an Epabo pillow just now, it'll arrive tomorrow! I will get into the bed more carefully, and will incline my bed so I'm at an angle while I sleep. I will check my blood pressure but it's always been good at the doctors office. I guess I'll take my blood pressure at the time of the headache and see if it's high then.

Any other ideas?
posted by maxexam at 3:05 PM on May 22, 2021

I would be evaluated for idiopathic intracranial hypertension and potentially cervico-cranial instability. (I have experience with the opposite kind of orthostatic headache—the kind that improves when you lie down and is worse when you stand up—due to intracranial hypotension caused by a spinal CSF leak.)
posted by mothershock at 6:12 PM on May 22, 2021

It sounds a lot like something I’ve been dealing with. In my case, it’s a cervicogenic headache due to neck nerve compression.
posted by Tiny Bungalow at 8:52 PM on May 22, 2021 [1 favorite]

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