View Full Version : pressure and headache after diving

07-05-2009, 11:41
ok so i did my checkout dives to 60 ft. 2 days ago and everytime I ascend my ears KILL me. it hurts so bad and im ascending slowly with my instructor, whenever we did my decompression stop for 3 min. my ears are throbbing and then whenever I go up to the surface and get on the boat I have a headache for a few mins and then I guess my sinuses equalize and I'm fine. Will the ears throbbing go away after time? and my instructor said that it was normal for the first few dives and it would go away and im just makins sure. he said it was my sinuses and they might have clogged or something, Is there any way to prevent it?

and 1 more thing. whenever we were on the boat after my last NAUI certification dive whenever my ears equalized there was a little bit of blood coming out of my nose. he also said that was normal and would go away after time too.

so basically three questions

will my ears hurting go away after a few dives?
any way to prevent my sinuses from bleeding and clogging?
will the nose bleeding go away too?

sorry to ask so much but im just making sure cause I love diving butmy headaches are soo bad. plz help :smiley20:

07-05-2009, 17:27
Hey, so my experience while starting out was basically the same. A proper...Sloooooooow descent, probably a jigsaw descent, down a few feet, up a foot or 2 clear, down more, up less, equalizing the whole time(gently). Was my solution.

Are you skip-breathing(holding you intake breath, before exhaling)? This is a major contributor to headaches felt immediately upon leaving the water. Kinda like a hammer hitting you on the back of your head.

Blood from you nose can be from to forceful, and incorrect clearing technique. Or it could be from a mask squeezze, not equalizing your mask,by snorting a small puff into it(from your nose). Using Valsava probably, you may be pinching your nose and blowing too hard, to force a result(won't happen), this oftn results in a reverse block, which is what your describing(ear pain upon ascent). When this happens, you have to see-saw up (and prey!). In reverse. This reverse block can blow your eardrum, as can a improper descent.

Again I'm speaking from my experiences only, not a doc.

Contact Dan with these problems, and you'll get answers by dive medical people.

good luck. In time you can most likely work through this if it's not a physical limitation issue.

07-05-2009, 18:43
I know this is going to go against what most people are taught, and I am not a doctor but this works for me. About an hour before heading out I take a 12hr sudafed decongestant. Not always but I can usually tell when I get up in the morning if I can expect a problem. As I am usually the first in the water to set the anchor and others are waiting to get in the water the last thing I need is to have problems equalizing. Sounds like your problems on ascent are directly related to your clearing problems, I would guess that your sinus cavity is not equalizing properly

Jack Hammer
07-05-2009, 21:13
If your ears hurt you need to stop and change direction. Don't force them ever, you can do serious damage. I forced (once) my ears to equalize and later had frothy snot with blood in it in my nose (stupid) plus a head that lasted a few days. It took a few months after that til I could equalize normally again - lesson learned - the hard way.

I've found that when I have trouble I just go back up/down 5 feet or so and wait 10-20seconds to let my ears slowly adjust, then they start equalizing easily from that point. Just go slow, as slow as it takes.


07-05-2009, 23:02
Are you sure you didn't have a mild cold or congestion on these dives?

If you're having trouble equalizing on ascent, one thing you can try is a 'reverse valsalva' - basically pinch your nose and suck. However, ascending and descending s l o w l y and reversing direction at the first hint of blockage is a better idea.

You really don't want to force it, ever - if you're clearing vigorously on the way down you may be irritating your tubes to the point that it causes the problem on the way up. Maybe keep your next dives shallower, and work down to deeper depths as you become more comfortable with the clearing process?

Just my opinion, but significant ear pain isn't something that I'd want to take a wait-and-see approach on - I'd get a second opinion from DAN or a doctor with some diving-related knowledge...

07-06-2009, 07:01
as boats said I would call DAN and get their opinion.

07-10-2009, 04:06
I agree to call DAN with your specific symptoms, and go from there. One thing you'll find very beneficial is to practice the Valsalva maneuver in your day to day life. It will help keep your Eustachian tubes in shape for diving. Like any other part of your body, exercise them.

07-10-2009, 05:33
You're giving an almost text-book example of sinus squeeze. Blood coming out of your nose after a dive is never a good thing. If this happens everytime, I would definitely be very concerned. A bit of sudaphed might help. Is it possible you had some hayfever/allergy issues on the dive?

Jack Hammer
07-10-2009, 09:31
There is absolutely no reason to not wait when your ears won't clear. I've made people wait 2-3 minutes on descent when my ears had trouble clearing. I'd just go down a few feet, wait for them to clear and repeat. Just remember to point to your ears so your buddy knows whats going on. I've also been forced to wait a few minutes for other divers to clear.

Never once has another diver comlained or been upset with me that we took a few minutes on the way down to clear. Likewise, I've never minded waiting for someone else. Take your time and don't risk damaging your ears.


07-10-2009, 14:40
I've never had a bad thing to say to a diver with ear problems. I've been there and will be there again so I know what's going on. To me it's a true non-issue up to the point we have to turn the dive. Then the only issue is concern for my buddy.

Zeagle Eagle
07-11-2009, 21:34
Check with a Dive Doc. Get a professional opinion and have him look in your ears, nose throat etc. It is too risky to chance anything. Why ruin a good a good sport for yourself. It's probably nothing (sinus squeeze, mask squeeze etc) but why take a chance.

Zeagle Eagle
07-11-2009, 21:38
I googled this and found:

Nosebleeds are common in divers. Nosebleeds during descent are due to mask squeeze. Failure to equalize the pressure in the mask to match the water pressure creates a relative "vacuum" in the mask and nasal passages. This can make fragile blood vessels in the nasal membranes break. These nosebleeds can usually be prevented by slow descent and frequent equalization of the mask. If nosebleeds still occur on descent, they are due to "sinus squeeze" -- unequal pressure between the sinuses and the nasal passages. Decongestants such as pseudoephedrine (sample brand, Sudafed) can help.
Nosebleeds during ascent are usually due to congested sinus openings, causing "reverse" sinus squeeze. Higher pressure in a plugged sinus pushes the membranes around the sinus opening outward, causing a tear. Ascent nosebleeds can usually be prevented by slowing the ascent, and using decongestants prior to diving.
If nosebleeds consistently occur on one side (despite use of oral decongestants and proper ascent/descent speeds and mask equalization) you can try a decongestant nasal spray (sample brand, Afrin) about an hour prior to diving, used only in the nostril that bleeds. Expect some rebound congestion in that nostril about 18 hours later.
If a nosebleed doesn't stop promptly as you exit the water, pinch the entire soft part of the nose shut for 15 minutes. If blood runs down the back of your throat, or if bleeding resumes when you release the pinch, blow all blood and clots out of the nose, then spray the bleeding nostril several times with a decongestant spray. Then pinch the nose again for 15 minutes.
Diver's headache can have several causes. These include neck muscle headache, hyperventilation vascular headache, sinus headache, fume headache, tension headache, dehydration headache, hypertensive headache, and (worst case) decompression illness. The best treatment for any of these headaches is prevention. If you commonly get a headache while diving, try to identify the cause, then eliminate it.
Neck muscle headache: This headache usually starts at the back of the head, but can become generalized. It usually begins gradually after a couple of dives. It's caused by chronically tilting the head up during the dive -- for example, looking upward while swimming horizontally. The muscles where the back of the head meets the neck may be tender to touch. Ibuprofen (up to 800 mg every 6 to 8 hours) and ice packs can help.
Hyperventilation vascular headache: This is a pounding headache that can occur at any time during or after a dive. The cause is breathing more rapidly that you should (hyperventilation). So it's more common in free-divers than scuba divers. Reduced carbon dioxide levels during hyperventilation lead to constriction of the blood vessels of the brain. When the vessels relax again, they often dilate and throbbing pain begins. Sensitivity to light and nausea are common. Caffeine is often very helpful for this type of headache, when combined with ibuprofen, aspirin, or acetaminophen.
Sinus headache: This headache begins with congested sinus openings, so the sinuses don't equalize during descent or ascent. The pain is usually most intense in the face area, and often begins as an ache in the cheekbone, eye, or forehead. Besides ibuprofen (800 mg), use a nasal decongestant spray (example Afrin) to unplug the sinus. If blood and pus-like material come out your nose, you have progressed from sinus congestion to sinusitis -- and you will need antibiotics.
Fume headache: Diesel fumes. You need clean air.
Tension headache: "Ordinary" generalized pressure-type headache due to travel hassles, disrupted sleep patterns, and altered activity patterns. Treat with rest, fluids, and an analgesic such as ibuprofen or acetaminophen.
Dehydration headache: This headache throbs when you stand up. It seems to be better when you lie down. Often, you may have a "head rush" when you first stand up. The headache occurs because decreased blood vessel volume lets the brain "sag" down when you're upright. Alcohol, caffeine, and snug wet suits make this headache more likely. (Alcohol and caffeine act as diuretics, flushing extra water out through the kidney. Wet suits compress the veins of the skin, pushing blood into the central circulation. This fools the body into thinking there's too much fluid in circulation, so it orders the kidney to eliminate some -- which causes the familiar need to pee in the wetsuit.) Treatment is rest and lots of fluids.
Hypertensive headache: Some divers are sensitive to decongestant medicines such as pseudoephedrine (Sudafed) and phenylpropranolamine. The blood pressure can jump up significantly. Combine struggling with heavy tanks and cumbersome wet suits, and a hypertensive headache develops. This headache often comes on during the physical activity, and eases once you slow down. Have your blood pressure checked during the headache. If it's elevated, stop activity until it goes away. Avoid decongestants in the future.
Decompression headache: Any new headache after diving accompanied by a neurological symptom (blind spot, localized weakness, numbness or tingling, etc) should be considered a symptom of decompression illness until proven otherwise. You need immediate medical attention -- and probably a compression chamber.

07-29-2009, 10:46
thank you all of you for your help. I read up on it and after i posted im now pretty sure I had an ear squeeze and I think what ill do next time on ascent is go up VERY SLOWLY and wait until i actually feel my ears clear up before I ascend anymore. and if they start hurting Ill go down a few feet wiggle my jaw and lean my head left and right until I feel better.

everything you guys have said have been VERY helpful and I appreciate all of it. thanks :)

EDIT: not an ear squeeze a reverse squeeze cause my ears only started hurting on the way up

08-08-2009, 13:59
Ive had the ear problem a couple of times. I had an ear infection and didnt even know it. Sometimes you can have a middle or inner ear infection and have no signs or symptoms till you try to dive.

08-08-2009, 14:27
i recommend giving DAN a call on their question line and speaking with someone who can answer those questions. i also would ask them for a referral to an ENT who specializes in dive injuries. you could have several issues that may be causing the pain. get it checked out

08-15-2009, 11:28
There has been some great advice here. I guess some things that I would mention, besides a decongestant (I like benaydrl) an hour before a dive, when stuffiness is a possibility. Consider going at your own pace, and not being pressured. Equalize early and often, and do not anyone rush you. This is maybe more difficult in your checkout dives, etc. but you need to operate at your own pace, it may take longer for some than others. If people are rushing you, you can't enjoy it. Do what you need to do for you, and if that means taking an extra minute ascending or descending, then do it. You might also consider a purge mask... I like to breathe out of my nose, during a dive, which helps keeping things open and equal.