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Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 19458
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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Hi I sneezed with a blocked nose on Sunday morning, due

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I sneezed with a blocked nose on Sunday morning, due to the blocked nose the sneeze didn’t escape and sent a wave back into my head.

Then a pain erupted across the back / base of my skull. It felt like something burst or popped the pain felt almost like cramp across the back of my head so I waited for it to relax but this didn’t happen.

The pain remained in a band across the base/ back of my skull and throbbed with each heartbeat this lasted all day Sunday and Monday by Tuesday eth pain had subsided and become localised in one area on the right hand side base of my skull in line with the bottom of my right ear and about 2 inches across. It still throbbed and sent pain out across the skull.

It is now Wednesday and the pain is still there.

What have I done?
It will help if you could provide some further information:
What dose of the Nurofen/ibuprofen have you tried?
Have you tried any local treatments, such as ice or heat?

Customer: replied 4 years ago.

I have not tried heat/ ice


i have been taking standard over eth counter Nurofen/ Ibuprofen and i am on 50mg Tramadol tablets for a shoulder injury

Thank you for the additional information.

The most likely cause of this pain is from a muscle strain of the muscles at the base of the skull. With a hard sneeze, the muscles at the base of the skull will tighten to stabilize the head and can be pulled excessively, which may result in a muscle strain.

In actuality, there are muscle tightening that occurs at many sites in the body during a hard sneeze, and there can be a muscle strain at any of these sites, so it is not unique to the muscles at the base of the skull. But in this particular case, it apparently has occurred at the base of the skull.

Another common possibility, although less likely than a muscle strain, would be pressure in the mastoid sinuses. A hard sneeze can transmit pressure into the sinuses, and there are two sinuses, one on each side, immediately behind the ear. The bony prominence that is behind each ear contains the mastoid sinuses. If the sinuses accumulate pressure and fluid from the hard sneeze, it can cause pain in the sinuses, and this pain can radiate around the base of the skull.

There are a couple of interventions that can be done for this situation. As with other muscle strains, rest is important, and since these muscles will be used to stabilize the head during any significant straining, it is reasonable to avoid any activities that involve straining. Local care also may help. During the first couple days, ice is more important than heat, but after 2-3 days, heat is more important than ice. In addition, moist heat is more effective than dry heat. The ibuprofen is a reasonable medicine to help with a muscle strain, but it may require a higher dose. There is a prescription strength of ibuprofen of 800 mg, to be taken 2-3 times per day, but it is also OK to take an equivalent amount of the over the counter strength, realizing that there is ibuprofen in the Nurofen as well.

If you have any further questions or need clarification, please let me know.

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Customer: replied 4 years ago.

How long should the headache last? Its been a week now? Should I be worried?

The duration of the pain can vary significantly. The average time for complete recovery from a muscle strain is 1-2 weeks, but some can take more or less time. If the symptoms do not resolve, it is appropriate to be seen, as there are some alternative medicines that are available by prescription, but whether there should be worry about a serious condition, that would be extremely unlikely.

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