External Compression Headache – Causes and Treatment

People who wear a certain type of headwear such as goggles or helmets, often develop external compression headache due to continuous pressure. This is also known as goggle headache or helmet headache. These people also show up with some other complaints such as painful scalp and irritated eyes. Pain is often located on both sides of head but is also experienced on one side of head and lasts as long as the headwear is not removed. It usually goes away within one hour of removing the headwear.

Symptoms of external compression headache

  • A steady, pressing pain that aggravates with the use of headwear
  • Painful scalp
  • Irritated eyes

The external compression headache is not associated with any other symptoms like nausea or dizziness. However, it can turn into a migraine as a result of a longer duration of exposure, in such cases, the symptoms of migraine will present.

Causes of external compression headache

Headwear can exert pressure on nerves externally, just under your scalp, causing external compression headache. The pain receptors transmit sensations from the face or head to the brain or to the nerves in the back of the head which causes a headache. The most commonly involved nerves are trigeminal and occipital nerve.

This does not occur in every case, if the headgear is ill-fitted, it would cause discomfort and thus headache.

Risk factors

  • People who wear certain head wears like helmets or goggles on a regular basis
  • Construction workers as they wear helmets
  • Swimmers
  • Chronic migraine sufferers
  • Female gender

Complications of external compression headache

Other than compression headache, ill-fitted goggles, and other headgear can cause several complications:

  • Swimmer’s migraine
  • Periorbital leukoderma
  • Periorbital purpura
  • Supraorbital neuralgia
  • Globe rupture
  • Eyelid neuromas


Most of the time the headache is diagnosed by the patient as they notice the development of headache within an hour of wearing the culprit headwear and go away as soon as the headgear is removed. However, to rule out certain underlying conditions, a detailed history of the onset, duration, associated symptoms, and aggravating and relieving factors of the headache should be taken.

Management of external compression headache

Management of this type of headache is very simple and conventional.


  • Avoid wearing an ill-fitted headgear.
  • Don’t wear the headwear for too long.
  • Careful placement of goggles or helmet should be administered.
  • If a certain type of headgear is causing the headache, you can use a different type. Such as you can use a soft rubber goggle.


Although the headache does not require any treatment. However, for an acute headache attack these medications can be taken:

  • Over the counter analgesic for pain relief
  • Excedrin or Sumatriptan for migraine

When to consult the doctor?

If the headache does not resolve even after taking off the headwear and taking the analgesic, you should book an appointment with your doctor and find out the mode of treatment suitable for you.


How do you diagnose an external compression headache?

The headache begins with wearing of headgear and resolves within an hour of taking it off.

Which nerves are most commonly involved in external compression headache?

Supraorbital and occipital nerves are most commonly involved.

What are the common headgears that cause external compression headache?

Swimming goggles, sports, construction or bike helmets, tight hats, hair-bands, and any other type of tight headgears.

Last medically reviewed on July 01, 2022.