Wondering Why Your Head Feels Heavy? These 8 Reasons Might Explain the Sensation
After a long day or a big night out, it’s not uncommon to have a headache. But if you find yourself wondering why your head feels heavy, there are a few factors to consider. In truth, there are a variety of reasons why your head feels heavy. “The first thing we need to identify is what you mean by ‘heavy?’ That can be different things, including sensations such as pain, fatigue, dizziness, fogginess, and nasal congestion or pressure,” says Matthew Wright, P.A.-C, R.D., a certified physician assistant and primary care provider, and faculty member at Rutgers University School of Health Professions, Physician Assistant Program. “Then we’d take a thorough history, asking about any other symptoms you may be having.”
Other questions your provider may ask include: When it started; if it’s gotten worse since it began; what brings it on; if anything makes it better or worse; when it occurs; and how severe is the discomfort? “The answers help us narrow down what is most likely to be causing this sensation, which will help us determine if we need tests and imaging, as well as potential treatment plans,” says Wright.
Here are the most common reasons that your head feels heavy.
Allergies
“I hear this complaint frequently, and it’s often associated with allergic rhinitis,” says Devon Stutzman, D.O., family medicine physician with Cooper Care Alliance, Cooper University Health Care. “It’s also described as pressure or tightness, and it may be accompanied by many other symptoms.” These include sneezing, itchy eyes, watery eyes, and a drippy or itchy nose (but without fever). The symptoms may recur at the same time every year, or they can be constant throughout the year.
Allergies can be diagnosed by an office exam and a patient’s history. “We treat conservatively by offering a trial of a nasal steroid spray, especially if there’s congestion, and an oral antihistamine such as fexofenadine, cetirizine, or loratadine,” says Dr. Stutzman. “I also suggest people keep a journal about what they eat or have been around to see if they can figure out a potential link.” If you don’t get relief from these medications, you may be referred to an allergist for testing to identify specific allergens or allergy-causing substances.
Upper Respiratory Infection
Many different viruses cause upper respiratory infections. Symptoms may include headache, sore throat, fever, cough, and wheezing. “During the history, I’ll also ask if you’ve tested for COVID or have had contact with any sick people,” says Dr. Stutzman.
If you have an upper respiratory infection, your provider will recommend supportive care to help you feel better, says Dr. Stutzman. That includes rest, saltwater gargles, oral lozenges, hot showers or baths to loosen up mucus, and use of a neti pot to thin secretions.
If it’s COVID, you may receive an anti-viral medication, but that’s used mainly in people most at risk, such as those who are older than age 65 or people who are immunocompromised. “The medication interacts with many medications and has many side effects, such as a metallic taste and diarrhea, so it’s not always prescribed for everyone,” says Dr. Stutzman.
Sinus Infection
If a cold gets better, then suddenly worse, you may have developed a sinus infection. Cold symptoms improve in about a week, but a sinus infection is suspected when symptoms drag on for more than seven to 10 days. The signs include pain in the cheeks, eyebrows, and forehead, with pressure in your sinuses that may feel worse when you lean forward, says Wright.
Despite what you’ve read, the color of your mucus isn’t very helpful for determining whether it’s actually a sinus infection. “We focus more on the duration of symptoms and facial pain,” says Wright. If you have a sinus infection, you’ll likely receive antibiotics such as amoxicillin or doxycycline. Over-the-counter medications such as acetaminophen for pain, an antihistamine such as fexofenadine for drippiness, and lots of fluids can help you feel less miserable.
Medications
Some medications may cause you to feel odd, including a sensation of a heavy head or fogginess, says Wright. If you’ve recently started a new medication (or supplement), talk to your healthcare provider about potential side effects and alternatives. Medications that may cause sensations of head heaviness include antihistamines, muscle relaxers, antidepressants, and some anti-seizure drugs, pain medications, and beta blockers.
Concussion
If you’ve recently had a head trauma, such as being rear-ended in a car accident (even a minor one), hitting your head during sports participation, or a fall, you may have a concussion, says Dr. Stutzman. Signs may include headache, dizziness, memory loss, trouble concentrating, or nausea and vomiting. These symptoms may worsen in bright light or with physical or cognitive activity.
Your healthcare provider will examine you for signs of a concussion, including checking that your pupils are dilating normally on both sides and that your strength is similar on both sides.
You won’t need imaging such as a CT scan unless there was a loss of consciousness (in which case, you’re usually taken from the accident site directly to the ER), says Dr. Stutzman.
Care includes physical rest for several days, reduced work or school responsibilities to provide cognitive rest, and no sports or other strenuous activities for up to two weeks. You should resume activities gradually, and cut back again if symptoms recur with activity, says Dr. Stutzman.
Muscle Strain
With all those hours at the computer (or hunched over your phone), you may experience a feeling of heaviness or tightness in your upper back and neck due to muscle strain. This also may be accompanied by a tension headache, which is a squeezing head pain. Stress also can exacerbate the sensations.
Muscle pain can be identified in-office, and you may receive a prescription for physical therapy to learn stretches and strengthening exercises to relieve discomfort and prevent future episodes, says Wright. Hot baths or showers, a heating pad that increases blood flow to the area to reduce muscle spasms, and over-the-counter pain medications may help.
If you have recurrent muscle pain because you spend too much time seated, get in the habit of changing positions frequently, such as using a standing desk, says Wright. In addition, if your workplace has an occupational therapist, have your workstation evaluated to see if ergonomic changes can be made.
Anxiety and Depression
If your symptoms don’t match any of the above, your healthcare provider may screen you for mental health concerns, says Wright. Depression and anxiety disorders may cause you to feel weighed down, fatigued, irritable, sad, or unable to enjoy the activities that usually make you happy. Changes in eating and sleeping patterns are other common symptoms. Treatment options include therapy, medication, or a combination of both.
Other Underlying Issues
In rare cases, head heaviness may be a sign of a more serious condition, such as a brain tumor. “This is rare, and you’d typically also have other neuromuscular symptoms such as decreased strength on one side or pupils not reacting normally,” says Dr. Stutzman. Your healthcare provider will evaluate you for other potential causes of head heaviness first. Then if your history merits it, you may need imaging tests such as an MRI.
The bottom line is that any symptoms that persist or concern you should be checked out by your provider. “The Internet can be a great tool for research, but don’t jump to the worst-case scenario. A feeling of head heaviness can be caused by a wide array of causes,” says Wright. “If you’re worried, get evaluated.”
You Might Also Like
