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.
Please note: Due to the limitations of email communication, I cannot answer questions seeking a potential diagnosis or a second opinion. Without exception, any answers given may be used for educational purposes only. If a question is asked, you, the questioner, inherently agree to not use the answer for any type of evidence against another individual or to outweigh the advice or opinion of another healthcare professional. You, the questioner, also inherently agree to remove Allexperts.com and its affiliates and the author of the answer, Dr. JR Strecker, DC, from any harm or liability.
Experience I have extensive experience with chiropractic in an integrated system. 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. I am currently focused on private 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
Question I have been experiencing a stabbing pain in my right temple and behind my right eye when standing for two days now. When I am lying down or slightly propped up for reading, there is no problem. When I stand up or try to shower, I have intense, intermittent(every few seconds) stabbing pains in my right temple. I have had no issues with feeling nauseous or problems with light or noise. I occasionally have a dull ache when lying down, but the frequency of that occurrence is very low. I have not been eating anything out of the ordinary, nor have I had any stressors or accidents. I just woke up yesterday morning with this problem. I took Advil and, later, Excederin to no avail. I have also been drinking water and eating regularly, just in case there was a problem with hydration or low blood sugar. I have read about migraines, clusters and ice pick headaches; the last of which seems to make the most sense. I have just found nothing related to the standing issue. Any suggestions before I pay for a very expensive, non-insured doctor visit? Thank you so much!
Answer Disclaimer: please do not take any of my advice without at least consulting with your doctor(s) first. If necessary, print this email in its entirety for your doctor(s) to read. In addition, please do not attempt to use this website or my advice as a substitute for your healthcare needs, as a substitute for the advice of your doctor, or as a substitute for any legal advice. There is no way a thorough health evaluation or assessment of any medical condition can be properly made via email. Please only use the contents discussed as a guide or tool to address your health matters with your doctor(s). If any of the information I provide conflicts in anyway with the information your doctor(s) provide, it is always best to default to the information provided by your consulting doctor(s) or to seek additional opinions from qualified, licensed healthcare providers as needed.
Hello L.,
Although I cannot say for sure and it is uncertain without an evaluation and history, it sounds like you might be experiencing orthostatic hypotension, which is the most common type of headache people notice when they stand. 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. In actuality, the pulsing or throbbing sensation is related to vascular headaches. For example, if you are lying or sitting down, the blood in your body will start to slightly pool in the lower parts of the body. It’s not typically significant since your body is fairly efficient at pumping your blood to all of the tissues. But it is an amount of blood that is significant enough to temporarily affect the upper regions of your body (your head) when you get up too rapidly. So when you stand up, gravity allows 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 downward in a waterfall. Thankfully, your body has blood pressure sensors (baroreceptors) that tell your brain that there is a slight momentary drop in blood pressure and not enough blood is being pumped back up to the brain for oxygenation. This is when you can experience a 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. This is when the dizziness subsides and you will feel normal. This is also when you’ll feel momentary throbbing in your head as your arteries are compensating and contracting a little harder to bring more blood into the brain. This is a normal reflex. But as we age, unfortunately, our bodies become less efficient and slower to normalize 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 raise the body up the stairs. Any time you get up too quickly from a chair or your bed, you can experience this. 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 again to make sure there isn’t some strange underlying cause for your experiences.
Check with your doctor and verify the following recommendations. Definitely make sure your body is well-hydrated. If there is not enough fluid in your blood, your blood can 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. 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. The same is true if you’ve been sitting for a long period of time. Again, double check with your doctor to make sure there's nothing else going on, and do not accept this answer as a diagnosis or remedy to your problem.
I hope this letter helps you a bit and provides you some guidance.
