What are exertion headaches? 

Wellbeing

According to The Migraine Trust, 20-40% of people who experience migraines find that exercise contributes to migraine attacks. 

GP from LloydsPharmacy Online Doctor, Dr Bhavini Shah (GMC:7090158), explains the symptoms, causes and dangers of exertion headaches, as well as treatment options. 

What is an exertion headache?

Exercise or workout headaches are part of what’s medically known as primary exercise (exertional) headache. This is a rare type of headache that causes a throbbing head pain, during or after any form of sustained exertion.

Slightly different from normal headaches, they’re usually a sign from your brain that you’ve overexerted or overworked yourself. These headaches can range from a subtle pain to a more severe throbbing and are usually worse the more you’ve pushed yourself. However, some people get exertion headaches without ever experiencing a migraine. 

Which activities cause exercise headaches?

Exertion headaches can be a response to any kind of overexertion and can sneak up during various physical activities that get your blood pumping. We do not know what causes exertion headaches. Some research suggests that it might be related to blood vessels inside the skull becoming dilated during a strenuous activity. 

Seven common activities that might trigger exertion headaches

Here are seven common activities that might trigger exertion headaches:

1. Running: Fast-paced jogging or sprinting, especially in hot weather. 
2. Weightlifting: Heavy lifting or high-intensity strength training. 
3. Swimming: Intense swimming sessions, especially in cold water. 
4. Rowing: The strenuous effort involved in rowing can sometimes lead to exertion headaches. 
5. Tennis or other racket sports: The rapid movements and the intensity of racket sports can be a factor. 
6. Cycling: Long-distance cycling or uphill biking. 
7. Hiking or climbing: Particularly at higher altitudes. 

Exertion headaches can occur during any type of exercise or overexertion. However, they’re more likely to occur if you suddenly increase the intensity of your workout, begin without warming up, or exercise in extreme temperatures. 

Five symptoms of exertion headaches

Symptoms of overexertion headaches can be like other headaches and migraines, so be sure to tell your doctor not just what you’re feeling, but also when you feel it. 

1. Throbbing pain: A strong pulsating sensation, usually on both sides of the head.
2. Quick onset: The pain typically starts during or shortly after intense physical activity.
3. Short duration: Anywhere from five minutes to 48 hours.
4. Nausea or vomiting: In more severe cases, you might feel sick or even throw up.
5. Sensitivity to light and sound: Just like with migraines, bright lights or loud noises can be bothersome.

Everyone’s experience with headaches is different. If you experience headaches after exercise, or if you start getting headaches at other times of the day, it’s a good idea to speak with your doctor.  

Are exertion headaches dangerous?

Most of the time exertion headaches aren’t dangerous. They’re more of a nuisance and usually resolve on their own, or by changing the way you exercise or go about your daily life. However, it is important to talk to your doctor about your symptoms. 

Some headaches can be caused by an underlying health condition – such as an issue with the blood vessels in your brain. These are called secondary headaches, and can potentially pose a risk to your health.

If you’re experiencing regular headaches, they’re getting more severe, or are happening at random, this could be a sign that you have another medical condition which needs to be treated. You should check in with your doctor to rule out a more serious condition.  

How are exertion headaches diagnosed?

Diagnosing exertion headaches can be difficult, as they only occur after exercise. Getting a proper diagnosis is key to managing headaches effectively, as the right steps to take can differ depending on the type.

A headache diary can be invaluable in tracking your headaches and helping you express your concerns to your GP. Keeping track of when and where your headaches happen can make it much easier to identify the cause.

How can you prevent exertion headaches?

Preventing exertion headaches is mostly about understanding and listening to your body. Usually, these headaches aren’t caused just by exercise, but by exercising too hard or without proper preparation.

Here are a few steps that might help keep those exercise-induced headaches at bay. Before trying these tips, you should discuss your symptoms with your doctor first: 

• Warm up properly: Before jumping into intense physical activity, start with a gentle warm-up – this can help your body get ready for more strenuous exercise. 
• Stay hydrated: Keep yourself well-hydrated, before and during exercise (dehydration can be a big contributing factor to headaches).
• Manage intensity: Gradually increase the intensity of your workouts rather than pushing too hard, or too fast. 
• Cool down: After exercising, take time to cool down – this helps your body ease back to its resting state. 
• Monitor your environment: If you’re exercising outside, be mindful of the weather – extreme heat or cold can bring on headaches. 
• Exercise regularly: Keeping a consistent exercise routine can also help, as sporadic bursts of activity might increase the risk of headaches.

Treatment for exertion headaches

Since the exact cause of exertion headaches is not known, people who experience headaches from working out should follow up with their GP.

Over-the-counter pain relief medications like ibuprofen, paracetamol, or aspirin can be effective in treating regular headaches. If you have been diagnosed with migraines your doctor might prescribe migraine relief medication.