Headaches are common after a long day or a long night out. However, there are a few things to think about if your head feels heavy and you are wondering why. In fact, your head feels heavy for many different reasons. What do you mean when you say “heavy?” is the first thing we need to determine. According to Matthew Wright, P.A.-C, R.D., a faculty member at the Rutgers University School of Health Professions, Physician Assistant Program and a certified physician assistant and primary care provider, “that can be different things, including sensations such as pain, fatigue, dizziness, fogginess, and nasal congestion or pressure.” After that, we’d take a detailed history and inquire about any other symptoms you might be experiencing.
Your healthcare provider may also ask you the following: When it began; if it has deteriorated since the beginning; what causes it; if anything improves or degrades it; when it happens; and just how bad is the pain? According to Wright, “The answers help us narrow down what is most likely causing this sensation, which will help us determine if we need tests, imaging, and possible treatment plans.”
The most common causes of your head feeling heavy are listed below.
Allergies
Devon Stutzman, D.O., a family medicine physician at Cooper Care Alliance, Cooper University Health Care, states, “I hear this complaint frequently, and it is frequently associated with allergic rhinitis.” It can also be referred to as tightness or pressure, and it may be accompanied by numerous other symptoms. Sneezing, itchy eyes, watery eyes, and a runny or itchy nose (without fever) are all symptoms. The symptoms may recur annually at the same time or remain the same throughout the year.
A patient’s history and an office exam can help diagnose allergies. According to Dr. Stutzman, we treat conservatively by providing a trial of an oral antihistamine like fexofenadine, cetirizine, or loratadine and a nasal steroid spray, especially if there is congestion. I also advise keeping a journal about what you eat or where you’ve been to see if you can find a connection. You may be referred to an allergist for testing to identify specific allergens or substances that cause allergies if these medications do not alleviate your symptoms.
Upper Respiratory Infection
Upper respiratory infections are caused by a wide variety of viruses. Headaches, sore throat, fever, cough, and wheezing are all possible signs. Dr. Stutzman adds, “During the history, I’ll also ask if you’ve tested positive for COVID or been in contact with any sick people.”
According to Dr. Stutzman, if you have an upper respiratory infection, your doctor will recommend supportive care to help you feel better. This includes taking a neti pot to thin secretions and taking saltwater gargles, oral lozenges, hot showers or baths to loosen mucus.
You might be given an antiviral medication if it’s COVID, but this is only used on people who are most at risk, like people over 65 or with compromised immune systems. Dr. Stutzman explains, “The medication is not always prescribed for everyone because it interacts with many medications and has many side effects, such as a metallic taste and diarrhea.”
Sinus Infection
You may have a sinus infection if your cold gets better but then suddenly gets worse. The symptoms of a cold go away in about a week, but if they persist for more than seven to ten days, a sinus infection may be the cause. According to Wright, the symptoms include pain in the cheeks, eyebrows, and forehead, as well as pressure in your sinuses that may become more pronounced when you lean forward.
Contrary to what you may have read, the color of your mucus is not particularly useful in determining whether or not you have a sinus infection. According to Wright, we concentrate more on the duration of symptoms and facial pain. Antibiotics like doxycycline or amoxicillin are likely to be prescribed to you if you have a sinus infection. You can feel less miserable by taking painkillers like acetaminophen and antihistamines like fexofenadine and drinking a lot of fluids.
Medications
According to Wright, taking certain medications can make you feel strange things, like having a heavy head or being confused. If you just started taking a new supplement or medication, talk to your doctor about possible side effects and other options. Antihistamines, muscle relaxants, antidepressants, some anti-seizure medications, painkillers, and beta blockers are some of the medications that can make your head feel heavy.
Concussion
According to Dr. Stutzman, you may have a concussion if you have recently suffered a head trauma, such as being rear-ended in a car accident (even a minor one), hitting your head while participating in sports, or falling. Headaches, dizziness, memory loss, difficulty concentrating, nausea, and vomiting are all possible symptoms. These symptoms may get worse in bright light or when you exercise or think.
Your doctor will check for signs of a concussion, such as whether or not your pupils are dilating normally on both sides and whether or not your strength is the same on both sides.
Dr. Stutzman says that unless there was a loss of consciousness, you won’t need imaging like a CT scan. In that case, you usually go straight to the emergency room from the accident site.
In order to provide cognitive rest, care includes physical rest for several days, reduced work or school responsibilities, and up to two weeks without sports or other strenuous activities. According to Dr. Stutzman, you should gradually resume activities and reduce them again if symptoms recur with activity.
Muscle strain
Due to muscle strain, you may feel heaviness or tightness in your upper back and neck after spending a lot of time at the computer or hunched over your phone. A squeezing headache, also known as a tension headache, may accompany this as well. The sensations can also be made worse by stress.
According to Wright, muscle pain can be diagnosed in the office, and you may be given a physical therapy prescription to learn stretches and strengthening exercises to alleviate discomfort and prevent future episodes. A heating pad that increases blood flow to the area to reduce muscle spasms, hot baths or showers, and over-the-counter painkillers may be helpful.
According to Wright, if you spend too much time sitting down and experience recurrent muscle pain, you should get used to changing positions frequently, such as by using a standing desk. Also, if your workplace has an occupational therapist, have your workstation looked at to see if you can make any adjustments to make it more comfortable for your posture.
Depression and apprehension
According to Wright, your healthcare provider may screen you for mental health issues if your symptoms do not match any of the aforementioned criteria. You may experience feelings of being weighed down, exhausted, irritable, sad, or unable to enjoy the activities that normally bring you happiness when you have depression or anxiety disorders. Other common symptoms include changes in eating and sleeping habits. Therapy, medication, or a combination of the two are all options for treatment.
Other Fundamental Problems
Head heaviness may indicate a more serious condition, such as a brain tumor, in rare instances. According to Dr. Stutzman, “this is rare, and you would typically also have other neuromuscular symptoms like decreased strength on one side or pupils that do not react normally.” First, your doctor will look for any other possible causes of your heavy head. Then, you might need imaging tests like an MRI if your past warrants it.
The bottom line is that your doctor should look into any persistent or worrying symptoms. While the Internet can be a useful research tool, do not assume the worst. According to Wright, a variety of factors can result in a feeling of head weight. Examine yourself if you are concerned.