Exertion Headaches

What is an exertion headache?

An exertion headache (also known as exercise headaches) involves pain during or immediately after physical activity. It comes on quickly and goes away in a few minutes or hours, but can last as long as a couple of days. But there’s usually no underlying disease or disorder.

What activities might cause an exertional headache?

Examples of activities that might trigger an exertion headache include:

• Coughing or sneezing.
• Having sexual intercourse.
• Running or doing aerobics.
• Straining to go to the bathroom.
• Weightlifting.

Because exercise is a common culprit, exertion headaches are often called exercise headaches or weightlifter’s headaches.

What causes an exercise headache?

When you exert yourself, your body needs more blood and oxygen. Scientists believe an exertional headache occurs when an activity causes veins and arteries to expand to allow more blood flow. That expansion and increased blood pressure create pressure in the skull, which causes the pain.

What are the symptoms of headache after a workout?

Symptoms of an exercise-induced headache often include:

• Neck pain.
• Pain on one or both sides of the head.
• Pulsating or throbbing.
• People sometimes describe exertion headaches as “the worst headache of their life.”

Sometimes the headaches feel like migraines and involve:

• Effects on vision, such as blind spots.
• Nausea and vomiting.
• Sensitivity to light.

How long do exertion headaches last?

Most exercise headaches last five minutes to 48 hours and happen for a period of three to six months.

How are exertion headaches diagnosed?

Anyone who has severe or frequent headaches should seek medical attention. Most exertional headaches aren’t caused by an underlying disease or disorder. But a healthcare provider may order some tests to rule out possible causes:

• Angiography to examine the blood vessels, usually computed tomography angiography (CTA) or magnetic resonance angiography (MRA).
• MRI to take pictures of the brain.
• Spinal tap (lumbar puncture) to take a sample of fluid from the spine for testing.

If tests don’t find an underlying cause, the healthcare provider can diagnose exertion headaches if you have had at least two headaches that:

• Were caused by physical activity.
• Started during or after physical activity.
• Lasted less than 48 hours.

How is an exercise headache treated?

Exertional headaches usually can be treated the same way as regular headaches. Some medications that may help include:

• Prescription NSAIDs such as indomethacin for short-term use.
• Beta-blockers, such as nadolol and propranolol for longer-term use or those who can’t take NSAIDs.
• Over-the-counter NSAIDs, such as naproxen, but only for short-term use.

How can I prevent a headache after exercise?

The best way to prevent exercise-induced headaches is to avoid the activity that triggers them.

But if that’s not realistic, you can try different strategies to lower the chances. For example:

• Avoid activity in extreme temperatures, too hot or too cold.
• Don’t work out in altitudes you’re not used to.
• Drink plenty of water so you are well-hydrated.
• Get enough rest every day, including eight hours of sleep.
• Mix up your exercise routine. Try another type of activity and see if it triggers a headache.
• Warm up and cool down properly, and build intensity slowly over time.
• Wear sunglasses if it’s bright outside and moisture-wicking clothes if it’s hot.
• Eat a healthy diet, and avoid processed foods or foods with preservatives in them.

Some studies suggest that certain supplements can help prevent exertional headaches, such as:

• Coenzyme Q10.
• Feverfew.
• Magnesium.
• Riboflavin (vitamin B2).
• Boswellia (a natural anti-inflammatory if indomethacin is not well-tolerated).

What is the outlook for people with headaches after exercising?

Headaches after exercise don’t last long. Most are gone within a few minutes or hours, and they generally don’t last longer than 48 hours.

Although the episodes repeat, they usually resolve on their own in three to six months.

When should I seek medical attention for an exertion headache?

Although exertional headaches are generally not a sign of a problem, you should talk to a healthcare provider if:

• Your headache is severe and sudden.
• Your headache lasts longer than two days.
• You also experience sleepiness or confusion.
• You faint (syncope).

A note from Cleveland Clinic
Exertion headaches involve pain during or immediately after physical activity. They come on quickly and go away in a few minutes or hours, perhaps as long as a couple of days. There’s usually no underlying disease or disorder, but you should talk to a healthcare provider to rule out any problems. Medications and other strategies can help you prevent and treat headaches, which usually stop happening after a few months.