What to Know About Exertion Headaches

Medically Reviewed By Susan W. Lee, DO

Exertion headaches are head pain that occurs due to physical activity. They may be more likely to develop after prolonged activity. Exertion headaches often go away on their own, and treatment can also improve symptoms. Exertion headaches are also called primary exercise headaches or benign exertional headaches.

Though exertion headaches can be painful, treatment can prevent headaches and alleviate pain for many people.

This article explains exertion headaches, their symptoms, causes, and treatment. It also discusses when to contact a doctor for headaches after physical activity.

What are the symptoms of exertion headaches?

Someone closes their eyes and breathes out forcefully while sweating.
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An exertion headache often causes aching, throbbing, or pulsating pain on one or both sides of the head. They typically last 5 minutes to 48 hours and may start during or after physical activity.

Exertion headaches generally cause head pain without other symptoms. This can help doctors distinguish exertion headaches from similar headache disorders, such as a migraine episode triggered by physical activity.

Though there are rarely other symptoms, some people experience:

What causes exertion headaches?

Researchers are working to confirm the cause of headaches after exercise. Theories about the causes of exertion headaches include:

  • dysregulation Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source of the blood vessels in the head
  • narrowed veins in the head, known as stenosis
  • rapid shifts in blood pressure

Exertion headaches usually begin after prolonged exercise or vigorous movements, such as weightlifting, sexual activity, coughing, and sneezing.

Secondary exertion headaches

Exertion headaches sometime occur as a secondary effect of another health condition. These are known as secondary exertion headaches.

Conditions that cause secondary exertion headaches include:

  • migraine Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source
  • blood vessel or circulation conditions, such as an abnormal fistula — an abnormal connection between an artery and vein
  • tumors

What are the risk factors for exertion headaches?

Factors that may increase the risk of a primary exertion headache include:

  • being under the age of 50
  • being assigned male at birth
  • having a history of migraine
  • being in hot weather or at a high altitude

When should I see a doctor?

Contact a doctor if you experience long-lasting, severe, or recurring headaches after exercise.

A headache after physical activity or strain can sometimes be a sign of a more serious condition. Contact a doctor right away if you experience other symptoms alongside severe, recurring, or long-lasting headaches.

Read more about when to see a doctor or call 911 for a headache.

How are exertion headaches diagnosed?

A doctor may ask about your symptoms and personal and family medical histories and perform a physical exam. Also, consider keeping a symptom and activity diary. This can provide your doctor with details such as when your symptoms began, their duration, and possible triggers.

Tests that can help doctors rule out other conditions include:

  • blood tests
  • imaging scans of the head or neck, such as MRI or CT scans
  • ECG, which tracks the heart’s rhythm and electrical activity
  • lumbar puncture or spinal tap

How do you treat and prevent exertion headaches?

Exertion headaches often improve on their own. Still, to prevent headaches or alleviate symptoms, consider:

  • over-the-counter (OTC) pain relief medications, such as acetaminophen (Anacin, Tylenol) or aspirin (Ascriptin, Bayer)
  • prescription medications to prevent exertion headaches, such as:
    • indomethacin (Indocin, Tivorbex)
    • beta-blockers
    • migraine medications known as ergotamines and triptans
  • adjusting your physical activity habits, including:
    • staying hydrated with water or sports drinks
    • starting gradually and slowly increasing the duration or intensity of your physical activity levels over time
    • spending more time warming up and cooling down
    • avoiding activity during hot or humid weather or at high altitudes

What is the outlook of exertion headaches?

The outlook of exertion headaches can vary. Many exertion headaches go away on their own. For some people, recurring headaches recur over long periods. Still, treatment can improve symptoms and prevent headaches. 

Other frequently asked questions

Susan W. Lee, DO, has reviewed the answers to the following frequently asked questions.

Are exertion headaches dangerous?

Exertion headaches themselves are not dangerous. They can, though, affect your physical activity levels and quality of life.

Sometimes, exertion headaches are a secondary effect of a serious underlying condition. Consult a doctor if you regularly experience a headache after exercise or have other symptoms.

Why do I get a headache after working out?

There is often no apparent reason for a headache to develop after workouts. Sometimes, fistulas, migraine, and tumors can cause headaches after physical activity.

Summary

Exertion headaches refer to head pain caused by physical activity or strain. They may be more likely after prolonged physical activity.

Exertion headaches are not dangerous. However, underlying conditions such as blood vessel problems and migraine can cause them.

Medication and adjusting your physical activity can help prevent and alleviate exertion headaches.

Talk with a doctor for exertion headache symptoms or other symptoms of head pain that are persistent, recurring, or severe.

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Medical Reviewer: Susan W. Lee, DO
Last Review Date: 2024 May 8
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