Cough Headache

What is a cough headache?

A cough headache is head pain that occurs after coughing, sneezing, laughing or straining. A cough headache can last anywhere from a few seconds to 30 minutes, on average. Some can last up to two hours. These headaches aren’t common. Most cases are harmless, but some may have a more serious cause.

What are the types of cough headaches?

There are two types of cough headaches:

• Primary cough headache: A primary cough headache isn’t the result of an underlying condition.
• Secondary cough headache: An underlying condition causes a secondary cough headache. About half of all people who experience a cough headache have a secondary cough headache.

It’s important to see a healthcare provider to determine the cause of your headache.

What are the symptoms of a cough headache?

Symptoms of a cough headache may include:

• Head pain that happens suddenly after coughing or straining and goes away shortly after.
• Head pain on one or both sides of your head (usually the front and sides for primary and back for secondary).
• A dull, sharp or stabbing pain (mild or severe).

Less common symptoms of a cough headache include:

• Feeling dizzy or unsteady.
• Fainting.
• Numbness in your arms (secondary only).

What causes a cough headache?

A cough headache happens suddenly after:

• Coughing.
• Sneezing.
• Blowing your nose.
• Straining (like during a bowel movement or lifting weights).
• Laughing.
• Crying.

The exact cause of a primary cough headache isn’t well understood. Experts think coughing raises the pressure inside your chest and abdomen (belly), which increases the pressure in your brain.

Most causes of a secondary cough headache happen due to a growth abnormality in your brain. One of the most common is Chiari malformation type I. This occurs when brain tissue in the lower back part of your skull extends into your spinal canal (the base of your skull). It’s the area of your brain that regulates your balance.

Other causes of a secondary cough headache include:

• Brain tumors.
• Low cerebrospinal fluid (CSF) pressure.
• Cerebrospinal fluid leak.
• A buildup of excess CSF in your brain (hydrocephalus).
• Brain blood vessel weakness (cerebral aneurysm).
• Blood collecting outside of brain tissue (subdural hematoma).

What are the risk factors for a cough headache?

Cough headaches can happen to anyone at any age. However, primary cough headaches usually affect people after age 40 and secondary cough headaches most often affect people before age 40.

What are the complications of a cough headache?

Cough headaches can interfere with your daily routine and your mood. This can prevent you from functioning and feeling your best.

Secondary cough headache causes can be dangerous, sometimes life-threatening. If you experience a sudden headache without a known cause, contact a healthcare provider.

How is a cough headache diagnosed?

A healthcare provider will diagnose a cough headache after a physical exam and testing. During the exam, your provider will ask about which symptoms you’re experiencing, how often they happen and how long they last.

Testing can help your healthcare provider determine if an underlying condition caused your headache (secondary cough headache) or rule out conditions with similar symptoms. Your provider may offer tests like:

• A lumbar puncture.
• A CT scan (computed tomography scan).
• An MRI (magnetic resonance imaging).
• Blood tests.

How do you get rid of a cough headache?

Primary cough headaches go away on their own, usually after 30 minutes. Because these headaches don’t last long, you won’t need to treat them every time they happen.

If you have frequent headaches that are painful and disruptive, a healthcare provider may suggest preventive medications like:

• Acetazolamide.
• Indomethacin.
• Propranolol.
• Topiramate.

Your provider will explain the side effects of these medications before you start taking them.

Some cough headaches go away after a lumbar puncture (diagnostic test), which removes a small sample of cerebrospinal fluid from the area around your spinal column (subarachnoid space).

You may need surgery to repair a structural issue that’s causing your headaches. Your surgeon will tell you which type of procedure you’ll need and what to expect.

Can a cough headache be prevented?

You may not be able to prevent cough headaches. But they can often be treated by removing the cause.

The best way to prevent cough headaches is to avoid coughing. This is easier said than done. Everyone coughs sometimes. If you know certain activities make you more likely to cough a lot (and trigger a headache), try to avoid them as often as possible. It also isn’t realistic to stop yourself from expressing emotion, like laughing or crying, even if it may cause a headache.

If you cough or strain often, a healthcare provider can help you find solutions, which may include:

• Having an exam and tests to check for and treat upper respiratory issues or allergies that cause frequent coughing.
• Taking stool softeners to avoid straining during bowel movements.
• Checking with a healthcare provider or pharmacist to see if coughing is a side effect of a current medication you take regularly.
• Finding ways to stay active that don’t involve straining (like weightlifting).

What can I expect if I have a cough headache?

Most cough headaches resolve on their own. Some may last longer, but it’s less common. Treatment isn’t necessary for primary cough headaches unless they happen frequently and disrupt your daily routine. Many primary cough headache episodes last for several years before going away completely.

Secondary cough headaches usually need treatment with surgery. Some causes can be life-threatening. A healthcare provider can help you find a treatment option that works best for your situation.

How long does a cough headache last?

A cough headache usually lasts for 30 minutes or less. They can last for a few seconds or minutes up to a couple of hours (in rare cases).

When should I see a healthcare provider?

Contact a healthcare provider if you develop a sudden headache when coughing. Your provider can diagnose the cause and help you find ways to manage pain and other symptoms.

What questions should I ask my healthcare provider?

You may want to ask your provider:

• What type of cough headache do I have?
• Do I need diagnostic testing?
• Which type of treatment do you recommend?
• Are there side effects of treatment?

A note from Cleveland Clinic

Coughing can be disruptive. Feeling a headache after a cough can really interfere with your day and your mood. Even though they’re temporary, a cough headache can be a frequent annoyance or a sign that something’s wrong. You don’t have to just “deal” with headaches. Your healthcare provider will diagnose what’s causing pain and suggest treatments to help you feel better.