Picture this: you’re in the middle of a great run, or maybe you’re pushing that last rep at the gym. You’re feeling strong, energized. And then BAM! A sudden, throbbing pain explodes in your head. If this sounds familiar, you might be dealing with something we call an exertion headache. It’s a surprisingly common thing I hear about in the clinic.
So, what exactly is an exertion headache? It’s pretty much what it sounds like – a headache that pops up during or right after you’ve been physically active. It can come on really fast and, thankfully, often disappears within a few minutes or hours. Sometimes, though, it can stick around for a day or two. The good news? Most of the time, there isn’t a serious underlying problem causing it.
What Kinds of Activities Can Bring These On?
It’s not just about super intense workouts, you know. Even things like these can trigger an exertion headache:
- A really strong cough or sneeze. Who knew?
- Sexual intercourse.
- Running or high-impact aerobics, of course.
- Straining a bit too much on the toilet (yes, really!).
- Weightlifting – this one’s so common it’s sometimes called a ‘weightlifter’s headache’.
What’s Going On In My Head? The Science Bit, Simplified
It’s a fair question! When you’re exerting yourself, your body is working harder, right? It needs more blood, more oxygen. We think what happens with an exertion headache is that the blood vessels – those tiny veins and arteries – in your head expand to get more blood flowing. This expansion, along with a temporary bump in blood pressure inside your skull, can create that feeling of pressure and pain. Makes a bit of sense, doesn’t it?
Signs and Symptoms of an Exertion Headache
How do you know if what you’re feeling is an exertion headache? Well, the main clue is that it’s linked directly to physical activity. You might feel:
- Pain that creeps into your neck.
- A throbbing or pulsating sensation in your head.
- Pain on one side of your head, or sometimes it’s on both sides.
Now, for some folks, these headaches can feel a lot like a migraine. If that’s the case for you, you might also notice:
- Changes in your vision, perhaps seeing blind spots or funny patterns.
- Feeling quite nauseous, or even actually vomiting.
- Being extra sensitive to light – you just want to be in a dark room.
Most exertion headaches are relatively quick to pass – anywhere from five minutes up to about 48 hours. It’s also not uncommon for people to experience them in episodes, maybe for a period of three to six months, and then they just…stop. Weird, right?
Figuring Out What’s Going On: Diagnosis
Now, this is important: if you’re getting severe headaches, or they’re happening often, it’s really best to come see us or another healthcare provider. While most exertion headaches aren’t a sign of something serious, we always want to be thorough and make sure.
To rule out other possibilities, we might suggest a few tests. Nothing too scary, usually:
- Angiography: This is a way to get a good, detailed look at your blood vessels. We might use something called a CT angiogram (CTA) or an MR angiogram (MRA). These are just special types of scans.
- An MRI (Magnetic Resonance Imaging): This machine gives us very clear pictures of your brain.
- A spinal tap (lumbar puncture): This one sometimes makes people nervous, but it’s often less uncomfortable than it sounds. We take a small sample of the fluid from around your spine to check for certain things that could cause headaches.
If all these tests come back clear and don’t show an underlying problem, then we can usually diagnose exertion headaches if you’ve had at least two headaches that:
- Were clearly brought on by physical activity.
- Started either during the activity or right after you finished.
- Didn’t last longer than 48 hours.
Making it Better: Treatment for Exertion Headaches
Okay, so how do we treat these pesky things? Often, we can manage exertion headaches much like we treat other common headaches. Some options we might discuss in the clinic include:
- Prescription NSAIDs (that stands for non-steroidal anti-inflammatory drugs) like indomethacin. This is usually for short-term relief when a headache strikes.
- Beta-blockers, such as nadolol or propranolol. These can be helpful for longer-term prevention if the headaches are frequent, or if NSAIDs aren’t a good fit for you for some reason.
- Over-the-counter NSAIDs, like naproxen. Again, we generally recommend these for short-term use, just to get you through.
We’ll always sit down and talk through the best approach for you and your specific situation.
What to Expect (The Outlook)
The outlook for people who get headaches after exercise is generally pretty good, I’m happy to say. Like I mentioned, they usually don’t hang around for too long – a few minutes or hours, and typically no more than 48 hours.
And even though they might come and go for a while (those episodes of three to six months), these often resolve on their own. So, there’s definitely light at the end of the tunnel!
Can I Prevent These Workout Headaches?
That’s the million-dollar question, isn’t it? The most straightforward way to prevent an exertion headache is, well, to avoid the specific activity that triggers it. But I know, I know – that’s not always practical or what you want to hear, especially if you love your workouts!
So, here are some things you can try to lower your chances of one popping up:
- Try to avoid exercising in really hot or very cold weather, if you can.
- If you’re heading to a higher altitude than you’re used to, give your body a bit of time to adjust before going all out.
- Drink plenty of water! Staying well-hydrated is so important for so many things, including this.
- Make sure you’re getting enough rest. Aiming for around eight hours of sleep a night is a good goal.
- Maybe shake up your exercise routine a bit? Sometimes a different type of activity won’t trigger a headache. It’s worth a try.
- Always, always warm up before you start and cool down properly afterwards. And build up the intensity of your workouts gradually – don’t go from zero to hero overnight.
- If it’s bright out, pop on some sunglasses. If it’s hot, those moisture-wicking clothes can really help you stay more comfortable.
- Focus on a generally healthy diet. Try to steer clear of too many processed foods or those with lots of preservatives, as these can sometimes be triggers for some people.
Some folks also find certain supplements helpful. There’s some suggestion that these might help prevent exertion headaches, though we always say, please chat with us or your doctor before starting anything new:
- Coenzyme Q10
- Feverfew
- Magnesium
- Riboflavin (which is vitamin B2)
- Boswellia (this is a natural anti-inflammatory that some people try if indomethacin doesn’t agree with them).
When Should I Definitely See a Doctor?
While exertion headaches are often benign (meaning not harmful), there are a few ‘red flags’ we look out for. Please do get in touch with a healthcare provider right away if:
- Your headache comes on very suddenly and is extremely severe – what we sometimes call a ‘thunderclap’ headache. It’s like the worst headache of your life, instantly.
- A headache lasts longer than two days.
- You also feel unusually sleepy or confused along with the headache.
- You actually faint or pass out (the medical term for this is syncope).
Take-Home Message: What to Remember About Exertion Headaches
Alright, let’s quickly recap the main points about exertion headaches so you’ve got them clear:
- They happen during or right after physical activity – that’s the key link.
- The cause is likely due to blood vessels in your head expanding a bit too enthusiastically.
- Symptoms often include a throbbing pain, sometimes with neck pain or even those migraine-like features like light sensitivity.
- Most exertion headaches aren’t serious, but it’s always wise to get checked out by a doctor, especially if they’re new for you, very severe, or happening frequently.
- Treatment can involve simple pain relievers you can buy, prescription medications, or strategies to prevent them.
- Prevention often involves modifying your activity, staying really well-hydrated, and sometimes certain supplements might be considered.
- And please, always see a doctor for those ‘red flag’ symptoms like a sudden, severe onset or if you faint.
A Final Thought
Dealing with any kind of headache can be truly frustrating, especially when it interrupts something you enjoy, like exercise, or just your day-to-day life. But remember, you’re not alone in this, and we’re here to help figure things out and get you feeling better. Take good care of yourselves.
