You don’t have to have COVID-19 to have a Coronavirus related headache. Headaches in the age of Covid may be related to the virus itself but are likely a result of stress and its effect on your occipital nerves.

Headaches are a very nonspecific symptom and can occur from a great many sources. Viruses such as the flu or the common cold can cause headaches. While headaches are not one of the symptoms most associated with COVID-19, it is certainly possible that a patient with Coronavirus could suffer from headaches. That said, a headache as a solitary symptom is not likely to require concern for COVID-19. 

Even without any underlying illness, headaches seem to be more common in this age of COVID-19. This is likely because of the stress that our public health, political, and economic uncertainty has provided. In times of stress, it is quite normal to experience headaches. These headaches are often accompanied by tight muscles in the head and neck and shoulders and can be explained in the same way that tension headaches and many migraines occur.

When we are under stress, it is natural for our muscles in the upper back, shoulders, neck, and head to “hold the tension“ and tighten up. It is through exactly these muscles that the occipital nerves travel.  These tensions and compressions that the muscles apply to the nerves cause nerve irritation, and these nerves in turn send distress signals to the brain, which are interpreted as headaches.  Many migraine headaches are produced by this same mechanism, and patients with chronic tension headaches almost always have these irritated nerves to blame.

For those who are experiencing occasional headaches during these COVID-19 times, relief may come from over the counter medications such as Tylenol or Advil, or may require something stronger that can be prescribed by a doctor.  Some patients who are more susceptible to stress may find help with drugs called anxiolytics or antidepressants.  Some patients, however, have chronic headaches that are only made worse by these tense times.  These patients may suffer from a number of headache syndromes such as migraines, tension headaches, cervicogenic headaches, or chronic daily headaches.  Patients with these chronic headache diseases can find that times of stress and tension only make their baseline headaches worse.

Many patients with chronic migraines or tension headaches or these other types of ongoing pain problems can also find help by seeing a primary care doctor, neurologist, or headache specialist.  Drugs such as triptans like Imitrex may be tried, or even some of the newer migraine medications like Aimovig or Vyepti or Emgality may be tried to help provide headache relief.  Some patients, however, find no headache relief with these or any other drugs.  In patients like these, to get rid of these migraine headaches and tension headaches, the occipital nerves need to be freed from the compression and constriction that the stressed muscles create.  

Migraine surgery is not for common or occasional headaches.  However, patients who have chronic migraine, tension headaches, occipital neuralgia, or any of these other long term headache conditions who cannot find relief with other means can look to this outpatient procedure for hope.   With a short surgery, Dr. Lowenstein can find the occipital nerves and physically release them from the compressing muscles, padding the nerves with fat and providing long term headache relief.  More information on nerve decompression surgery including the expectations associated with this short procedure can be found here or by calling the Migraine Surgery Specialty Center at 805-969-9004.

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