EXTREME pain during descents!


New Member
I was commuting about 2 weeks ago. During descent right around the 10,000' ding, I felt pain so bad in the back of my neck and back of my head that I could not move my head and it was painful just to keep my head up. I thought I was having a muscle spasm and it felt like the muscles were contracting. It also felt like I was pulling 7+ G's and I couldn't move my neck, but unlike pulling G's, this was associated with sharp pain. It went away just before landing.

After a 2 week vacation, I commuted to work. On the descent, just before the 10,000' ding, the pain hit out of nowhere. It lasted for a couple minutes. Again, I felt like the aircraft was pulling positive G's. I immediately tried massaging my neck and doing whatever I could to avoid screaming/crying while sitting there in my uniform. It was truly one of the most painful things I have ever encountered. Again, it felt like some kind of muscle spasm, but it traveled up the back of my neck to the back of my head and i felt tightness in my throat. Instantly I felt a headache. But my forehead felt fine. 5 minutes later, it went away instantly. So I thought, okay, must be stress or something. I did some searching and I thought it was related to my tight collar constricting the carotid artery. I don't know if this is accurate, just one theory I have.

So I went to work and made the following observations:

Leg 1: Cruised at 32,000 feet. During descent around 14,000 feet and a cabin altitude of 1,300 feet, it hit me instantly. The cabin rate was 300 fpm. Aircraft was doing about -1200 fpm. I went straight to massaging my neck hoping that would help. My neck instantly tightened up. It went away going through 6,000 feet and a cabin altitude of 1,000 feet.

Leg 2: Cruised at 31,000 feet. During descent at 13,000 feet, I felt it again. Same thing, it felt like I was in a centrifuge pulling a bunch of positive G's because my neck was so heavy and stiff it was nearly impossible to turn my head. I just pushed through it knowing it'll be better soon. It got better around 6,000 feet.

Leg 3: Cruised at only 19,000 feet but the cabin altitude never exceeded 1,000 feet. No pain on descent.

I decided to call out sick until I figure out what to do next.

What I know:
- Its not aircraft specific. It's happened on multiple aircraft types
- It happens on descent only when the aircraft goes to the upper flight levels.
- I am relatively healthy, in my upper 20's, and not sick with any cold or anything like that
- No pain in the climb.

I've done online research but I cannot seem to figure this out. I'm not even sure what kind of doctor to see. Thanks


Dergs favorite member
I’ve had this, or something similar happen to me a couple times as a passenger. The pain travelled to the front of my head/sinuses and felt like someone was stabbing my eyeball from inside my head. It was completely crippling. Relief seemed to start almost as soon as the door opened. The only thing I can think of is that the descent outpaced the decompression of the aircraft or vice versa, but that’s complete speculation.

I bought one of those sinus washes and use it just before I go on any flight now and I haven’t had it happen since I’ve been doing that. I’m thinking that even if my sinuses seemed clear (ie breathing no problem through my nose) that for whatever reason a blockage occurred at some point that isn’t noticeable at sea level but is during decompression.


New Member
So I flew another trip today. First 3 legs went fine. No issues at all.

Leg 4 however, descending through 20,000 feet with a cabin altitude around 3,300 feet with the cabin descending at 300 fpm, I felt it come back. It wasn't nearly as bad as yesterday.

We cruised at FL380 and had a cabin altitude roughly around 6,500 feet.

Upon reaching 7000 feet MSL, the cabin was around 500 feet and and doing 0fpm. Thats when all my pain went away. So the pain goes away when the cabin stops descending but there's still some soreness as if my muscles are strained.

The pain was solely in the back and side of my neck where the side and back of the neck meet.

Touching the back of my head with my hand was extremely painful.

And no issues on leg 1-3 today. Just leg 4. I was still able to do my job. It's just a lot of pain when the cabin is descending below 3,300 feet.
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Well-Known Member
While your symptoms aren't classic for barotrauma or sinus issues, the fact that it worsens as you descend still makes it the most likely cause. If your symptoms persist an evaluation by an Ear Nose and Throat (ENT) physician could shed light on your problem.

Best Regards,

Aaron Florkowski MD
FAA designated AME