AboutJ.R. Strecker, B.S., D.C. Expertise I can answer questions related to the signs, symptoms, causes, types, management, treatment, and prevention of headaches and migraines. It is critical to accurately identify the type and cause of the headache to maximally reduce the frequency, duration, and intensity of the headache.
Experience I have extensive experience as a chiropractor in an integrated system. My background is mostly experienced with routine patient management of musculoskeletal disorders and pain management. I work closely with highly-trained anesthesiologists for pain management protocols, and I am also the chief chiropractor of an integrated clinic incorporating chiropractic, massage therapy, allopathic medicine, acupuncture, herbology, homeopathy, and naturopathic medicine. I typically integrate a combination of these aspects for both the wellness and pain management of my patients. I have treated patients at Venice Family Clinic, the nation’s largest free clinic and a teaching clinic for the UCLA medical system, in a heavily researched pilot program incorporating chiropractic and acupuncture with allopathic medicine. In my private practice, I also work alongside the chief medical director for student health at California State University – Los Angeles. Next to back and neck pain, headaches and migraines are the most common conditions I treat in my practice.
Organizations American Chiropractic Association.
California Chiropractic Association.
Publications Dr. J.R. Strecker’s Practice -- featured story (Front Page of Business Section), The Palisadian Post. Oct. 25th, 2007. (Dr. Strecker not the original author).
Education/Credentials Bachelor’s of Science, Human Biology (Cleveland Chiropractic College).
Doctor of Chiropractic, Cum Laude Honors (Cleveland Chiropractic College).
Awards and Honors Youngest chiropractor in professional history to graduate with a Bachelor’s degree
Past/Present Clients Consulting Chiropractor for Pharmaca Integrative Pharmacy – Pacific Palisades, CA
Expert: J.R. Strecker, B.S., D.C. Date: 2/15/2008 Subject: Headache above corner of eye while running
Question QUESTION: I recently took a trip on an airplane. At the time I was having pretty bad sinus problems. About cruising height, I felt pressure start to build up behind my right eye. It became very painful and I could not look out of my eye without my vision being distorted. After about 30 minutes, it started to fade and was gone an hour and a half before the plan touched the ground.
I had no problems with it until I came back from my trip. I enjoy running. I went for a run last night and a little over a mile into my run, the pain came back. By this time, my blood was pumping pretty good and I was breathing pretty hard. I had to stop running to keep the pain from escalating. After I stopped running and my blood pressure went down, I felt much better? Should I get this checked out? By the way, I do have a slightly stuffed nose at the moment, but I can breathe fine out of it.
ANSWER: Hello J.,
First off, thank you for trusting me with your health. I understand your pain and concern for this condition. Although I can’t be 100% certain without at least evaluating you, I believe I might have a pretty good idea about what is going on with your headaches. However, as a disclaimer, please do not take any of my advice without at least consulting with your doctor first. I always suggest printing this letter and taking it to your doctor for him or her to read, especially in your situation, because your signs and symptoms could be an indication of something more serious. Again, without evaluating you, there is no way for me to know.
With that said, it sounds like you might be experiencing a cluster headache. These are quite rare in the population. However, I have personally experienced a few cluster headaches myself. The few that I had all occurred all around a three week period, and an interesting thing (though it’s not noted in the literature for having this connection, so maybe it’s just a coincidence) is that one of mine occurred shortly after I had been flying as well while I was waiting at the airport with a layover. Cluster headaches can come very sporadically without warning or any rhyme or reason. They just happen out of nowhere, which can leave the patient very confused and frustrated, especially with little that seems can be done to relieve the pain or reduce the symptoms. Cluster headaches are EXTREMELY painful! However, if it happens again, notice if your eyes start tearing or nose starts running. And I did notice you mentioned the nose being currently stuffy. But during the attack, your eyes or nose might run profusely. I had never seen such a dramatic increase of tears flushing my eyes so quickly before. It truly was amazing when I experienced mine. This is usually a much clearer sign for this type of headache. Let me give you some of the classics for this headache: they usually occur late at night or in the early hours of the morning, most commonly around 2:00 AM (and no one really knows why, though there are theories), it is more common in men than women, there is the most intense eye pain or pain behind the eye (which matches your area of description), and as mentioned, the eyes will usually tear up or the nose will start running. You may even notice your eyelid drooping a bit during the attack. Perhaps you can relate, but when I had my first attack, mine was pretty classic. Though it may sound a bit intense, my experience was such that it felt as if I had a tiny bomb that was implanted on the backside of my eye in my brain the just blew up. I was so scared because it was unlike any pain I had ever felt before, and to me, headache was the last thing on my mind. And then after about 5-10 minutes, it just stopped – everything! Yours seems to have lasted a bit longer, but is still within the proper duration period for cluster headaches. It was the craziest thing. I identified the problem a few months later in my clinical neurology class.
Cluster headaches are considered vascular. So a very common recommendation for vascular headaches is to supplement with ~1,000 mg of Magnesium per day. Calcium is also sometimes recommended, and is even sold combined in the same pill as Magnesium. If you add Calcium, you should take about 1,200 mg per day. As a side note, your body cannot absorb Calcium without Vitamin D, so make sure the Calcium supplement includes Vitamin D. You may have to supplement the Calcium and Magnesium separately because of this.
There are some things that can trigger headaches in general. They have written books on “headache diets.” You want to avoid these things, obviously, if they are going to cause you to get a headache. But assuming your headaches are cluster headaches, there are thankfully only a few things that should be avoided. One factor is alcohol. If you are drinking alcohol (for some people, even in very small amounts) this could be triggering your headaches. There are no exceptions to this rule. If you drink, it has to stop so as to at least rule out this as a factor for your headaches. Also, a popular workout supplement NO2 can cause these headaches for some people. Nitroglycerine is a compound that is converted into nitric oxide, a powerful vasodilator. This might also be found in certain male-enhancement products. Athletes and weight-lifters will supplement with these for claims of increased energy and strength during their workout. And lastly, as is common with many headaches, especially migraines, any sort of noxious smell or aromatic substance can trigger your headache. So maybe it’s something in your house or room that has an aroma or perhaps a particular cologne you or a roommate wears that is triggering your headache.
Unfortunately, there is still much unknown about cluster headaches. And their pain intensity can be matched by few other things in life. Again, I want to reemphasize your need to follow up with your doctor to rule out more serious causes. If these recommendations provide you no relief, your doctor may prescribe you some medication. You may get referred to the neurologist as well. Being a chiropractor, one recommendation I would suggest is to look for a chiropractic diplomate of neurology. I know you said you don’t want to take any unnecessary medications for this condition, so you can find a chiropractic neurologist at this website: http://www.acnb.org/locator/index.php. This doctor will do all of the standard neurological evaluations that a medical neurologist will do, but they might take a slightly different approach for your treatment. Their training is among the top within the chiropractic profession.
Best of luck with this! And don’t give up. Give it some time, talk to your doctor, and see if the supplements help. Remember to also rule out any of the possible triggering factors.
Best,
Dr. J.R. Strecker, D.C.
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QUESTION: Wow, I did not expect such an answer. I truly appreciate the time and effort you've put into this answer and I'm sure plenty of other answers. Your case you described parallels my case pretty well. While I did not have an extreme amount of pain (1-10 10 being highest I'd say mine was about a 7), I did have extreme discomfort such as a pressure build up much like your explosion. My follow-up question: Other than while exercising vigorously, I do not receive these "cluster headaches" but on that rare occasion on the airplane. Is this a normal reaction to exercise (pertaining to cluster headaches)? It has been a month since the airplane incidence, and I have not had a problem since I started running again.
Answer Hello J.,
Your question brings up an interesting point. The thing about cluster headaches is we just don’t know enough about them. They are still very mysterious to practitioners, partly because there typically isn’t a clear way to predict them. In answer to your question, I have not seen anything in the literature showing a positive connection between their occurrences with exercise. But that doesn’t mean the two aren’t related. If anything, more research is needed. There are a couple things I would add to this, however. For example, I was taking the NO2 (nitric oxide) exercise supplement during the period I experienced a cluster headache. Since your headaches are occurring around exercise, make sure you’re not drinking some sort of energy drink, protein drink, or other supplement that might be hiding a nitric oxide component in the supplement. It’s best to be all-natural. If you aren’t taking anything, then I suspect there might be some connection to the classification of cluster headaches with your exercise. Again, I’m not sure as this needs more research. But as I mentioned, cluster headaches are considered vascular. (This is especially where the need for the Magnesium supplement comes into play). While you are working out, you blood vessels can release certain inflammatory mediators that might be provoking your attack. Is this your case? Who knows? But anything is possible. And because of this, try my recommendations in the first letter, because telling you to give up your exercise is not really a practical answer. Unfortunately, we just don’t know enough about them to effectively eliminate them from 100% of the population.
Again, let me reemphasize your need to check with a doctor. They may say the same things I said or even act puzzled, but it’s important to not accept my advice as the advice of your doctor. There could be other certain signs upon examining you neurologically or that show up in your history that I may never know about. These signs might lead your doctor to a different diagnosis.
