Swimmer's headache, or supraorbital neuralgia

John C. O'Brien, Jr., MD

I recently saw a patient who complained of "painful hair." He had been swimming for 6 years and had recently developed pain and tenderness on the right side of his scalp. Palpating along the tender areas, I outlined the distribution of the right supraorbital nerve. Just prior to the development of the scalp pain, he had developed a leak in his goggles that allowed water to enter the orbital area, causing eye irritation. As he had done before, he tightened the goggle strap to stop the leak. He continued with the swim workout and subsequent workouts 3 to 4 times per week. After approximately 1 week, the scalp pain began.