For some people, sustained and strenuous exercise may result in an exertion headache during or after working out. In most cases, an exercise-induced headache is benign and will go away with limited intervention. However, it's possible that this type of headache could be from an underlying condition.
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Types of Exertion Headaches
There are two types of exertion headaches that can happen during exercise: primary or secondary.
Primary exertion headaches do not have an underlying cause and therefore are not dangerous, even if they are painful, says Greg McLauchlin, MD, an assistant professor of neurology and section head of general neurology at Baylor College of Medicine in Houston. Why they happen is not known. According to the Mayo Clinic, researchers speculate that it may have something to do with strenuous exercise dilating the blood within the head.
Secondary headaches are caused by an underlying condition, possibly a serious one, Dr. McLauchlin says. Causes can include a brain tumor or blood vessel abnormalities in the brain, among others, says Mayo Clinic.
Talk with your doctor if you experience exercise-related headaches. Dr. McLauchlin says headache with exertion is itself a red flag, so exertion headaches should be evaluated by a physician until serious underlying causes are ruled out.
Headache pain brought on by exercise may start during or after a workout. According to the American Migraine Foundation (AMF), a primary exercise headache typically:
- Occurs on both sides of the head
- Feels like throbbing
- Can lasts anywhere from 5 minutes to 48 hours
These headaches may also feel like a migraine. Primary exercise headaches are more common in places with high altitude or hot weather, though they can happen anywhere, according to AMF.
If you have a secondary exercise headache, you may have the same symptoms as a primary one, but you can experience other, more serious symptoms as well. According to the Mayo Clinic, other symptoms can include:
- Throwing up
- Loss of consciousness
- Seeing double
- Having a rigid neck
Causes of Exercise Headaches
The exact cause of primary exercise headaches is not known at this time. However, you have a higher risk for developing a primary exercise headache if you're exercising at high altitudes, in hot weather or have a personal or family history of migraines, according to the Mayo Clinic.
These headaches can also occur during periods of especially intense exercise, such as sustained sessions of running or weightlifting, according to the National Institute of Neurological Disorders and Stroke (NINDS).
If you experience a secondary headache during exercise, another condition is responsible for the pain. According to the Mayo Clinic, possible underlying conditions that your doctor will check for include:
- benign or cancerous tumors in the head
- sinus infection
- abnormalities in the structure of the head, spine or neck
- blood vessel abnormalities in or leading to the brain
- bleeding in the brain
Treatment and Prevention
If you experience a headache during exercise, you should talk to your doctor as soon as possible. Usually, the headache will subside within a few minutes, but it could last for up to 48 hours, NINDS says. Even if the pain goes away, you should still see a doctor to rule out underlying causes.
Dr. McLauchlin suggests trying to prevent primary headaches by warming up slowly before exercising and staying well-hydrated. If you experience primary exercise headaches, your doctor might recommend certain medications that could help prevent them. Indomethacin is a nonsteroidal anti-inflammatory drug (NSAID) available by prescription that may help to relieve headache pain that comes from exercising, according to NINDS.
If your doctor suspects secondary headaches, you will need to have tests and imaging studies to look for possible causes. Treatment options will vary, depending on the underlying condition that's causing your headaches.
Read more: Pressure in the Head During a Workout
- American Migraine Foundation: “Primary Exercise Headache”
- Mayo Clinic: “Exercise Headaches”
- Greg McLauchlin MD, assistant professor of neurology and section head of general neurology, Baylor College of Medicine, Houston
- National Institute of Neurological Disorders and Stroke: "Headache: Hope Through Research"
Is this an emergency? If you are experiencing serious medical symptoms, please see the National Library of Medicine’s list of signs you need emergency medical attention or call 911.