Definition

What are exercise headaches?

Exercise headaches occur during or after sustained, strenuous exercise. Some activities associated with exercise headaches include running, rowing, tennis, swimming and weightlifting.

Doctors divide exercise headaches into two categories. Primary exercise headaches are usually harmless, aren’t connected to any underlying problems and can often be prevented with medication.

Secondary exercise headaches are caused by an underlying, often serious problem within the brain — such as bleeding or a tumor — or outside the brain — such as coronary artery disease. Secondary exercise headaches may require emergency medical attention.

How common are exercise headaches?

Exertion headaches usually strike in younger people, from adolescence through age 50. Please discuss with your doctor for further information.

Symptoms

What are the symptoms of exercise headaches?

The common symptoms of exercise headaches are:

Primary exercise headaches:

  • Are usually described as throbbing
  • Occur during or after strenuous exercise
  • Affect both sides of the head in most cases

Secondary exercise headaches cause:

Primary exercise headaches typically last between five minutes and 48 hours, while secondary exercise headaches usually last at least a day and sometimes linger for several days or longer.

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.

Causes

What causes exercise headaches?

Increased blood pressure in the blood vessels of the brain, which is called venous pressure. Primary exercise headaches are harmless. However, any underlying cause of the headaches must be ruled out first to ensure a more serious condition isn’t causing the pain. The International Headache Society requires that possible more serious problems are ruled out before diagnosing harmless primary exercise headache. See your doctor if you suffer from exercise headaches so that all other possible conditions can be ruled out.

Many times, with more serious disorders, the head pain is made worse by exercise but if the headache is actually caused by the exercise it is more likely to be a harmless exercise headache.

Exercise headaches are triggered by exertion or physical activities such as:

  • Weight lifting
  • Playing tennis
  • Running, particularly long distances
  • Rowing
  • Swimming
  • Scuba diving
  • Sexual activity

Risk factors

What increases my risk for exercise headaches?

There are many risk factors for exercise headaches, such as:

  • Exercise in hot weather
  • Exercise at high altitude
  • Have a personal or family history of migraine

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How are exercise headaches diagnosed?

Your doctor will likely recommend an imaging test, especially if:

  • Your headaches last more than a few hours
  • Your headaches strike suddenly, like a thunderclap
  • You’re older than age 40
  • You have other signs and symptoms, such as nausea, vomiting or vision disturbances

In these cases, different types of imaging tests can help your doctor verify that you have the harmless variety of exercise headache, rather than the type caused by a structural or vascular abnormality.

 

Magnetic resonance imaging (MRI). This test uses a magnetic field and radio waves to create cross-sectional images of the structures within your brain.

Magnetic resonance angiography (MRA) and computerized tomography (CT) angiography. These tests visualize the blood vessels leading to and inside your brain.

CT scan. A CT scan uses X-rays to generate a cross-sectional image of your brain. This test can show fresh or recent bleeding into or around the brain and is often used if your headache occurred less than 48 hours beforehand.

Sometimes a spinal tap (lumbar puncture) is needed as well, especially if the headache started abruptly and very recently and brain imaging appears normal.

How are exercise headaches treated?

If no underlying structural or vascular problem is causing your exercise headaches, your doctor may recommend medications to take regularly to help prevent the headaches.

  • Indomethacin (Indocin, Tivorbex), an anti-inflammatory drug, is commonly prescribed.
  • Propranolol (Inderal, Innopran XL), a blood pressure medication, also is used to prevent exercise headaches.

Other therapies, including naproxen (Naprosyn), phenelzine (Nardil) and ergonovine, have been reported to be effective in some people.

If your exercise headaches are predictable, you may be able to take a medication an hour or two before a scheduled event, such as a tennis match or a hike at high altitude. If your exercise headaches are frequent or unpredictable, you might need to take the preventive medicine every day.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage exercise headaches?

The following lifestyles and home remedies might help you avoid exercise headaches:

Exercise headaches tend to occur more often when the weather is hot and humid, or if you’re exercising at high altitudes. If you’re prone to exercise headaches, you may want to avoid exercising in these conditions.

Some people experience exercise headaches only during the performance of certain activities, so they may prevent their headaches by avoiding these activities. A warm-up prior to strenuous exercise also can help prevent exercise headaches.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Review Date: November 9, 2017 | Last Modified: November 9, 2017

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