When you're in the mountains to ski, hike, or just take in the view, you could get head pain from something called an altitude headache. It's a symptom of altitude sickness, which happens when you go to higher elevations.
The problem usually starts when you're 8,500 feet above sea level. About a quarter of all people get a headache when they reach that height.
Causes
It's not exactly clear what causes altitude headaches. There's less oxygen as you go higher, and your body may not get enough to nourish all your tissues, a condition called hypoxia. Although hypoxia is part of altitude sickness, doctors still aren't sure if and how it relates to symptoms like headache.
What experts do know is that the higher you go, the greater the odds of getting a headache. You can cut your chances if you gradually get your body used to the higher elevation. For example, if you live at sea level, you're more likely to get a headache when you travel to 8,500 feet than someone who already lives at the base of the mountain at, say, 5,000 feet.
How fast you go up a peak matters, too. An 8-minute ski lift to the top of the mountain is more likely to give you a headache than a leisurely hike over several days that climbs to the same height. Just beware of pushing yourself too hard at higher altitudes, as with running, climbing, or skiing, which also raises your headache risk.
Symptoms
Moderate headache pain typically starts as you get up to around 8,500 feet, most often on both sides of the head. You might notice that it worsens as you go higher or when you cough, push yourself hard, or bend over. Another clue that higher altitude caused your headache is that it goes away within 24 hours of getting back below 8,200 feet.
Headache is the most common sign of altitude sickness, and one may happen without other symptoms. But there are other typical problems with this illness. You may also feel tired, weak, dizzy, nauseated, and have trouble sleeping.
Prevention
If you're headed to a higher elevation, the best way to prevent an altitude headache is to go up slowly. You're much more likely to get sick when you go up more than about 1,600 feet per day, especially if your body is working hard.
It helps to drink plenty of water, 12 or more cups a day, as you head to higher elevations, and to increase the carbohydrates in your diet to around three-quarters of your calories. Tobacco and alcohol make it harder for your body to get used to higher altitudes, as can medications like barbiturates and sleeping pills. Talk to your doctor about your medicine if you're unsure.
Treatment
Getting to a lower elevation is the best treatment for altitude headache and altitude sickness in general. In more serious cases, it may help to breathe in some oxygen, which you can carry with you in small canisters, until you can get to a lower elevation.
If you tend to get altitude headaches, you may be able to help prevent them if you take medications like furosemide, acetazolamide (Diamox), or corticosteroids before you get to high altitudes. You'll need a doctor's prescription for these drugs.
Over-the-counter medications like ibuprofen or aspirin might help both before and after the headache starts. The migraine medicine sumatriptan also helps some people. Talk to your doctor about what drugs are best for you if you know you get headaches at higher elevations.