Is Headache a Concern during or after a Dive?

Do you suffer from a headache?

If this situation occurs after each dive, or during a dive, it may be down to one of the following factors;


Often found among novice divers with little experience. Anxiety may be caused through insecurity or fear of water, which is not uncommon among scuba divers. Often anxiety occurs when being exposed to an underwater environment that you are not fully prepared for. Novice divers, who embark on dives with experienced divers often feel under pressure and anxious. A classic problem is to clench the mouthpiece tightly throughout the dive. This reflex action leads to tension around the jawbone, skull and cheeks. Ill-fitting mouthpieces or heavy regulators may cause jaw fatigue. Teeth or tooth-fillings may also cause unevenness while holding the mouthpiece. Tension is the common cause of headaches; it shows up with pain at the back of the head, neck region and over both sides of the head.

Tight scuba gear

Mask straps drawn so tight, it leaves a visible imprint of the mask skirt around the divers to face, after the dive. This is often seen with inexperienced divers and is another common cause of a headache. A tight mask strap causes pressure around the head, like wearing glasses that are too small. Do not wear a tight mask strap to prevent water leakage in your mask. If the mask does not fit, get one that does! A headache caused through tight mask straps will begin some minutes into the dive and increase as the dive continues. After the dive and the mask is removed, a headache will slowly disappear.

Wetsuit collars or drysuit neck seals

A collar or seal that fits too tightly around the neck is another cause of a headache. Veins that run to our skull and brain may become compressed, which results in the blood flow slowly being cut off. This problem could possibly lead to the retention of carbon dioxide. If the collar or neck seal is very tight, compression of the carotid sinuses in the carotid arteries in the neck is possible. In this case, we would endure a reflex drop in blood pressure and even sudden unconsciousness – this is the carotid sinus reflex. Any straps, or BCD’s that are too tight around the chest or restrict the respiratory organs can cause a build-up of dioxide and a headache.

Sinus squeeze and nasal problems

If the diver has problems with allergies, infection or nasal blockages, this can lead to airway congestion between the sinuses and nose. If air cannot freely pass between the sinuses and nose, the diver will suffer. As the diver descends, sinus barotrauma as the pressure increases is highly likely. A common area for sinus squeeze is the forehead, which relates to the frontal sinuses. Pain in the eye is due to ethmoid sinus squeeze. Pain in one or both cheeks, including the teeth, is often the maxillary sinus. A squeeze is often relieved on the ascent, other than the diver has a reverse block. A reverse block results in the opposite, as trapped air may cause a headache on the ascent. Nasal blockage or allergies that cause nasal problems, it is better not to dive until it has cleared or been treated.

Neck problems

Poorly fitted masks or large, buoyant masks may lead to neck problems. Accidents such as whiplash injuries to the cervical spine, or other head or neck trauma, quite commonly result in headaches while diving. Divers, who adopt an extended neck position may suffer from neck muscle spasms and compression of the neck spinal nerves. This again causes tension and a headache. Position and trim in the water play a vital role, along with a relaxed body position rather than a cramped and stiff one. Read more on position and snorkelling here.


For sensitive divers, this may cause a throbbing headache. It often occurs at the front of the head, very similar to the “brain-freeze” experienced when rapidly eating ice cream. A headache which starts in cold water, may occur immediately or come on slowly as the body gets cold. A Full Face Mask helps here and is cosy and warm to wear.  A hood may help or prepare your face by splashing water onto it before the immersion takes place. Coldwater headaches may take some hours to relieve, a warm drink and a hood after the dive often help.

Carbon dioxide build-up

This problem may occur with an unnatural pattern in airway management. This type of headache often increases as the dive continues. Carbon monoxide contamination in breathing gases will cause a severe headache. If this is the case, check out the contamination source or switch gas providers.

Carbon dioxide headaches are severe and throbbing. This form of a headache not always relieved by painkillers and can last for hours after the dive. Other gases responsible for headaches are carbon monoxide following air supply contamination. CO2 toxicity following deep diving on oxygen-enriched mixes or after using pure oxygen rebreathers.

The sun or glare from the water surface

Being on the surface for a prolonged period of time or sitting on a boat’s deck without sunglasses may cause a headache. Glare off the water can cause the scalp and forehead muscles to spasm.

Acute neurological decompression illness

Symptoms such as a headache after a long or deep dive with heavy nitrogen or other inert gas loads. It may be due to arterial gas embolism post lung barotrauma. As the diver surfaces, a headache will begin within minutes, this is an extremely serious symptom when it’s due to inert gas overload. It is usually accompanied by other manifestations of central nervous system bubble injury. Weakness or paralysis, confusion and abnormalities of sensation may occur. For treatment, immediate surface mask oxygen, urgent contact and discussion with a diving doctor. Emergency recompression therapy is absolutely essential.

Migraine headaches

Research shows, that individuals with re-occurring migraine headaches should not dive. Furthermore, if accompanied by neurological problems, it can be very difficult to distinguish between AGE and cerebral decompression. Patients with a problem, which associate with an already known neurological problem before the dive, make a diagnosis very difficult indeed.

If you wish to dive but are unsure if you are fit to do so, here is a medical questionnaire for you to view. All questions must be answered with a truthful Yes or No. If you answer a question with YES or are in doubt about the answer, speak to your doctor and get a medical clearance that states you are fit to scuba dive.

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