Head pain when ascending

[oncor23]

On rare occasion, I've experienced head pain when I ascend too quickly...say after going up ~10 ft in ~5 seconds. It gets my attention in a hurry. I stop my ascent...maybe drop a few feet, and the pain stops. That's it. I continue ascending at a slower rate and experience no further pain. The pain seems to be more back of the head, or whole head, rather than face or ear. I suppose it could still be ear related. As I said, it's rare that I screw up and ascend that fast, so it's only happened a few (maybe 2 or 3)times, not enough to allow me to give more details than that...such as how fast an ascent will trigger it, from what depth, from what time in the dive, etc. Okay, I do remember one time...on the sandy bottom at 73 ft watching an eel garden...went up to ~60 ft too fast and boom. Anyway, I haven't attempted to push the envelope to recreate the pain.

Any thoughts about what is happening? Yeah...I know it's too fast an ascent. I guess my concern is this...what happens if I get caught in an upwelling?

 

[Duke Dive Medicine]

Have you ever experienced this type of headache on descent, or do they only happen on ascent? How old are you, and are you under a doctor's care for anything? Are you taking any medications, either prescribed or OTC?

Pain with depth change is normally associated with some kind of barotrauma but as you noted, the pain is typically localized in the affected area, e.g. sinuses or ears. The headaches may simply be related to tension.

Another possibility is that you have a bony dehiscence between a sinus and your brain. It's an anatomic variance that is usually asymptomatic but can leave the brain vulnerable to infection or pressure change. It's impossible to verify without radiologic studies, but if you do have a bony dehiscence and your rapid ascent results in a transient pressure increase in a sinus, it could explain the generalized headache.

Of course if the headaches only happen when you ascend at 120 feet per minute, the best advice of all is to be mindful of your buoyancy and your ascent rate. Ascending that quickly greatly increases the risk of decompression sickness and pulmonary barotrauma as well.

Re the upwelling: you can encounter short, rapid depth changes hanging onto the ladder of a pitching boat, but unless you're diving in the surf zone or inside a vertical lava tube I think the risks of encountering that significant an upwelling in open water are pretty minimal. Maybe some of the more worldly divers here can speak to specific locations where this could happen.

Best regards,
DDM

 

[oncor23]

PM sent to Duke Dive Medicine. I checked my logbooks more carefully, found another dive where it happened...and the pain is better described as head discomfort with dizziness. That sounds more like barotrauma, I suppose. What's weird is I only get it at depth, not in shallow water. The pressure diffential is greater in the shallows...so why do I only seem to get this at depth? Wouldn't it make more sense if I had been down awhile, near deco...came up and then ascended too fast near the safety stop and got hit? Going down to 73...spend a minute (no where near deco)...rise too fast to 60...and that's where it happens. Seems weird.