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
A few months ago I started to experience a very strange feeling that occurs almost every time I move from a sitting to a standing position and start to walk. The sensation is as if my head and neck are throbbing with pressure and I have to stop walking and stand still for a few seconds to make it stop. Oddly, this pressure build-up is occasionally preceded by a feeling of blood being drawn out my head first. Sounds are muffled in rhythm with the pulsations and I sometimes feel as if I will pass out, but never do. There is no pain.
My doctor has no idea what this could be. Having done a bit of research myself, my best guess is I have some form of "orthostatic intolerance" -- maybe "orthostatic hypertension". Any ideas?
Thank you,
Phil
Answer
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Hello P.,
I’ll start by sharing with you some relatively good news. Your condition is pretty common and can affect everyone in the population. It’s usually not a major problem with little to be concerned about. It sounds like you're right; it sounds exactly like orthostatic hypotension. Hypotension (rather than "hyper-") means a drop in blood pressure, which is what happens in the head upon rising too quickly. Basically, what that means is when you rise too rapidly from a seated or lying position, you create a momentary change in your blood pressure which can make you feel dizzy or make your head throb. For example, if you are lying or sitting down, the blood in your body can pool in the lower parts of the body to a very minor degree. It’s not typically significant since your body is efficient at pumping your blood to all of the tissues unless there is some underlying pathology. But it is an amount of blood that is significant enough to temporarily affect the upper regions of your body (your head) when you rise too rapidly. So when you stand up, gravity will cause more blood to fall into the lower portions of your body. It’s a simple mechanism that works the same way gravity causes water to flow downwards in a waterfall. Thankfully, your body has blood pressure sensors (baroreceptors) that tell your brain that there is a slight drop in blood pressure and that not enough blood is being pumped back up to the brain for oxygenation. This is when you will experience the dizziness, lightheadedness, or throbbing sensation. So then a reflex is created. The brain registers the lack of blood in the upper body, and consequently, tells the arteries to squeeze harder (slightly elevating the blood pressure) to bring the extra blood pooling in the lower areas of the body back up to the brain and compensate for the original momentary drop in blood from the head/neck regions. This is also when you’ll feel momentary throbbing in your head as your arteries compensate and contract a little harder to bring more blood into the brain. Until your arteries compensate for the change in blood pressure, you will experience the dizziness and throbbing, but it should not last too long. This baroreceptor reflex is completely normal. But as we age, unfortunately, our bodies become less efficient and slower at normalizing the blood flow and pressure homeostasis. So, orthostatic hypotension can be encountered much more commonly in the older population. You can also sometimes encounter this when climbing stairs as the blood goes to the muscles of your legs to ascend your body up the stairs. Any time you get up too quickly from a chair or your bed, you can experience this, especially if you start walking quickly after you get up. Though symptoms can increase a bit in the elderly, young people experience this, too. However, if it starts occurring more and more frequently with greater intensity, you might want to check with your doctor to make sure there isn’t some strange underlying cause for your symptoms.
A recommendation I would make is to make sure your body is hydrated. If you are chronically dehyrdated, there may not be enough fluid in your blood, causing your blood to become hypovolemic (a lower than normal volume from lacking fluids). Another thing that is important is to slowly rise from the seated position. If you are getting out of bed, go to the seated position first and wait a minute or two while your blood pressure normalizes. Then slowly get out of bed after sitting a bit. When you go to the standing position, wait another moment or two before walking to wherever it is you're going. If you’ve been lying down a long time and get up too quickly, you could even faint if your baroceptor reflex is not efficient enough, so keep this in mind if your symptoms are severe.
Again, if your symptoms get worse, then go get a second opinion. It's a good idea to get your blood pressure checked. If you have low blood pressure, your symptoms will increase than in a person with 120/80. There are natural supplements you can take if doctor finds you have low blood pressure.
Best of luck with this and I hope this helps!!
Dr. J.R. Strecker, D.C.
