Exercise headaches occur during or after sustained, strenuous exercise. Some activities associated with exercise headaches include running, rowing, tennis, swimming and weightlifting.
Doctors divide exercise headaches into two categories. Primary exercise headaches are usually harmless, aren't connected to any underlying problems and can often be prevented with medication.
Secondary exercise headaches are caused by an underlying, often serious problem within the brain — such as bleeding or a tumor — or outside the brain — such as coronary artery disease. Secondary exercise headaches may require emergency medical attention.
These headaches may cause:
Primary exercise headaches typically last between five minutes and 48 hours, while secondary exercise headaches usually last at least a day and sometimes linger for several days or longer.
If you experience a headache during or after exercise, consult your doctor. Call your doctor right away if the headache begins abruptly or if it's your first headache of this type.
The exact cause of primary exercise headaches is unknown. One theory is that strenuous exercise dilates blood vessels inside the skull.
Secondary exercise headaches are caused by an underlying problem, such as:
You may be at greater risk of exercise headaches if you:
Exercise headaches tend to occur more often when the weather is hot and humid, or if you're exercising at high altitudes. If you're prone to exercise headaches, you may want to avoid exercising in these conditions.
Some people experience exercise headaches only during the performance of certain activities, so they may prevent their headaches by avoiding these activities. A warm-up prior to strenuous exercise also can help prevent exercise headaches.
Your doctor will likely recommend an imaging test, especially if:
In these cases, different types of imaging tests can help your doctor verify that you have the harmless variety of exercise headache, rather than the type caused by a structural or vascular abnormality.
Sometimes a spinal tap (lumbar puncture) is needed as well, especially if the headache started abruptly and very recently and brain imaging appears normal.
If no underlying structural or vascular problem is causing your exercise headaches, your doctor may recommend medications to take regularly to help prevent the headaches.
Other therapies, including naproxen (Naprosyn), phenelzine (Nardil) and ergonovine, have been reported to be effective in some people.
If your exercise headaches are predictable, you may be able to take a medication an hour or two before a scheduled event, such as a tennis match or a hike at high altitude. If your exercise headaches are frequent or unpredictable, you might need to take the preventive medicine every day.
You're likely to start by seeing your family doctor or a general practitioner. In some cases, you may be referred to a neurologist. It's good to be prepared for your appointment. Here's some information to help you get ready for your appointment, and to know what to expect from your doctor.
Preparing a list of questions will help you make the most of your time with your doctor. For exercise headaches, some basic questions to ask your doctor include:
Don't hesitate to ask any other questions that come up during your appointment.
Your doctor is likely to ask you a number of questions, such as: