Primary Cough Headache

Primary cough headache is harmless and is not the result of other head or brain conditions. Headache pain goes away quickly, usually within 30 minutes. However, because symptoms are painful and disruptive, drugs to prevent this headache are sometimes considered.


What is primary cough headache?

Primary cough headaches are uncommon, harmless headaches that occur suddenly and are brought on by coughing, sneezing, blowing your nose, straining (such as when having a bowel movement), or laughing or crying vigorously.

Primary cough headache means the headache is caused by the cough itself, not by another condition. When a headache is triggered by cough but the headache is found to be due to a structural problem in the brain, the condition is called secondary cough headache. It’s important to see your doctor to determine the cause of your headache.


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Who is likely to have primary cough headache?

About 1 percent of the population experiences a primary cough headache over their lifetime. Both men and women can develop primary cough headache; however, the condition is more common in men than women. Primary cough headache usually occurs in individuals over 40 years of age.

Symptoms and Causes

What causes primary cough headache?

The exact cause of primary cough headache is not well understood. One theory is that coughing raises the pressure in the chest and abdomen, which in turn, increases the pressure in the brain.

Primary cough headache is harmless and is not the result of other head or brain conditions.


What are the symptoms of primary cough headache?

Symptoms of primary cough headache include:

  • Headache comes on suddenly after coughing or straining types of activities, such as having a bowel movement, laughing or crying vigorously, or sneezing or blowing your nose.
  • Headaches typically last from 1 second to 30 minutes (some patients may have headaches for up to 2 hours).
  • Headache pain is usually felt on both sides of the head, but can occur only on one side.
  • Pain level ranges from moderate to severe.
  • Pain is described as sharp, stabbing, explosive/bursting.
  • Headache pain is mostly located in the front and sides of the head.

Nausea, vomiting, sensitivity to light and sound are NOT commonly seen with this type of headache.

Diagnosis and Tests

How is primary cough headache diagnosed?

Your doctor diagnoses primary cough headache based on your symptoms and the results of brain scans (either by computed tomography [CT] or magnetic resonance imaging [MRI]) to rule out other causes of cough headache.

If the brain scan reveals a cause for the cough headache, this type of headache is called a secondary cough headache. Secondary cough headaches are more serious and are caused by such things as defects in the brain called Chiari malformations, brain tumors, weakened brain blood vessels (cerebral aneurysm) and other conditions.


Management and Treatment

How is primary cough headache treated?

Primary cough headache events usually resolves on their own. For most people, primary cough headache goes away completely within four years.

Because the headache pain goes away quickly, there is usually no need to treat each occurrence. However, because symptoms are painful and disruptive, ongoing preventative treatment is often considered. Indomethacin is the most common drug prescribed to prevent primary cough headache. Other drugs that can be tried and that have been shown to be useful include topiramate, methysergide, acetazolamide, propranolol, naproxen and metoclopramide.

What complications are associated with primary cough headache?

Rarely, individuals may continue to have primary cough headache episodes for years before they finally completely stop.


Can primary cough headache be prevented?

You can prevent primary cough headaches by:

  • Taking stool softeners to avoiding straining while having a bowel movement.
  • Getting a physical exam to check for lung or other upper respiratory problems and receive treatment for any conditions found.
  • Asking your doctor or pharmacist if any of your current medications cause cough as a side effect.
  • Avoiding other bending and straining activities such as lifting weights or other heavy objects.

Outlook / Prognosis

What is the prognosis (outlook) for people with primary cough headache?

In most cases, primary cough headache episodes resolves completely with 30 minutes.

Living With

When should I call my doctor?

Contact your doctor if you develop a moderate or severe headache when coughing. Your doctor can help you find effective ways to manage pain. They can also rule out more serious conditions that may be causing the headache.

Medically Reviewed

Last reviewed by a Cleveland Clinic medical professional on 11/27/2019.

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