Exercise Headaches

Headaches can happen during or right after intense physical activity. Activities like running, rowing, playing tennis, swimming, and weightlifting can sometimes trigger these headaches.

Doctors often categorize exercise headaches into two types. The first type, called primary exercise headaches, are typically not a sign of anything serious. They're not linked to an underlying health problem, and often, taking medicine can help prevent them. These headaches are usually harmless.

The second type, secondary exercise headaches, are different. They are caused by a problem inside or outside the brain. These problems could be serious, like bleeding or a tumor in the brain, or a problem with the blood vessels outside the brain, such as a heart condition like coronary artery disease. If you have a secondary exercise headache, you should seek immediate medical attention. This is important because these headaches need to be checked out by a doctor right away.

Exercise headaches are a common type of head pain. They're often described as a pulsing or throbbing sensation. These headaches typically happen while you're exercising intensely or right after you finish. Most often, the pain is felt on both sides of your head.

If you get a headache while or after exercising, talk to your doctor. It's important to call your doctor right away if the headache comes on suddenly or if it's a new kind of headache for you.

Why do some people get headaches during or after exercise?

Scientists don't know exactly why some people get headaches during or after exercise. One idea is that intense physical activity causes the blood vessels inside your head to expand. This expansion might put pressure on the nerves and tissues around them, leading to pain.

Exercise headaches can happen more often if certain factors are present. These include:

• Hot weather: Exercising when it's very hot can strain your body more, potentially leading to a headache. Your body works harder to stay cool, and this extra effort can trigger a headache. Dehydration is also a factor in hot weather. Not drinking enough fluids before, during, and after exercise can lead to headaches.

• High altitude: Thin air at higher altitudes means less oxygen. This can cause your body to work harder, and that extra effort can trigger headaches. People who live at lower altitudes may experience this effect more strongly. The change in air pressure can also play a role.

• Family history or personal history of migraines: If you or your family members have a history of migraines, you might be more prone to exercise-related headaches. Migraines are a type of severe headache, and factors that trigger one type of headache can sometimes trigger others. For instance, stress, lack of sleep, or specific foods can trigger both migraines and exercise headaches.

In short, exercising in certain conditions can make you more susceptible to headaches. Understanding these factors can help you take precautions to prevent them.

Headaches during exercise are more common in hot, humid weather or at high altitudes. If you frequently get headaches while exercising in these conditions, it might be a good idea to choose a different time or place to work out.

Sometimes, headaches only happen with specific activities. If you know which activities trigger your headaches, you can avoid them. A good warm-up before intense exercise can also help prevent these headaches. This prepares your body for the activity and may reduce the risk of a headache.

Doctors often recommend imaging tests to help figure out the cause of a headache, especially if certain conditions exist. These tests can help distinguish between a harmless exercise headache and a headache caused by a problem with the brain's structure or blood vessels.

If a headache starts suddenly and recently, and brain scans look normal, a spinal tap (lumbar puncture) might also be necessary.

A doctor might order imaging tests if:

• Your headaches last longer than a few hours. This is a key indicator that something might need further investigation.
• Your headaches come on very quickly, like a loud bang. Sudden, intense headaches could signal a serious issue.
• You're over 40 years old. While headaches can affect people of any age, age can be a factor in assessing the potential severity.
• You have other symptoms, like nausea, vomiting, or vision changes. These additional symptoms can suggest a more serious underlying cause.

Different imaging tests can help doctors see different things inside your head:

• Magnetic Resonance Imaging (MRI): This test uses a powerful magnet and radio waves to create detailed pictures of the brain's structures. It's useful for looking at the brain tissue itself.
• Magnetic Resonance Angiography (MRA) and Computed Tomography (CT) Angiography: These tests focus on the blood vessels in and around the brain. They help doctors see if there are any blockages, leaks, or other problems with the blood vessels.
• Computed Tomography (CT) Scan: A CT scan uses X-rays to create detailed images of the brain. It's particularly useful for finding bleeding in the brain or around it, especially if the headache happened within the last 48 hours. Fresh blood shows up clearly on a CT scan.

These tests can help doctors determine the best course of treatment for your headache.

If exercise is causing headaches and there's no underlying health issue, your doctor might suggest taking medicine regularly to prevent them.

Several types of medication can help. For example, some people find naproxen (like Naprosyn), phenelzine (like Nardil), or dihydroergotamine mesylate (like Migranal or Trudhesa) helpful.

If you know when your exercise headaches happen—like before a tennis match or a high-altitude hike—you could take the medicine an hour or two beforehand. But if your headaches are frequent and happen unexpectedly, you might need to take the medicine every day.

Some commonly prescribed medications are:

• Indomethacin: This is an anti-inflammatory medicine, often used to prevent headaches triggered by exercise.

• Propranolol (like Inderal or Innopran XL): This is a blood pressure medication that can also help prevent exercise headaches. It works by affecting the nerves and blood vessels, which can lessen the pain signals associated with the headaches.

These medicines can help reduce the frequency or severity of exercise headaches. However, it's important to discuss these options with your doctor to determine the best course of action for your specific situation. They can assess your medical history and recommend the most appropriate medication and dosage.