This article reviews some of the causes, treatments, and prevention methods for exercise-induced headaches.
Causes
Exercise-induced headaches occur after strenuous physical activity such as running, weight lifting, cycling, or swimming. This type of headache can occur as increased circulation around the head and scalp causes blood vessels to vasodilate (enlarge) to increase blood flow.
The two categories of exercise headaches are:
Primary exercise headaches: These occur during or immediately following physical exertion. They usually resolve on their own and are generally not connected to a more significant physical issue. These headaches can often be managed or prevented with over-the-counter (OTC) medications. Secondary exercise headaches: These stem from an underlying health condition, such as heart disease, and are much less frequent. Older age and severity of the headache after strenuous activities may warrant a discussion with your healthcare provider to rule out a more severe condition.
Exertional Headache
Exertional headaches are headaches that arise with physical activity. These usually develop soon after performing physical activity or activities that require “bearing down,” such as:
RunningWeight liftingCoughing or sneezingSexual intercourseStraining with bowel movements
Dehydration
Physical exercise without adequate water intake to replace lost fluids can lead to dehydration.
Dehydration by itself can cause headaches. However, it may also exacerbate other underlying medical conditions and primary headache disorders that are dependent on hydration and fluid balance.
Low Blood Sugar
Your muscles use fuel in the form of sugar to supply energy for physical exertion. Intense physical activity may drop your blood sugar during a strenuous workout.
People who are not diabetic may be able to prevent exercise headaches due to low blood sugar, or hypoglycemia, by eating carbohydrates before working out.
Prevention
Strategies to prevent exercise-induced headaches include:
Staying hydratedWarming up before exerciseEating a small meal before working out to prevent hypoglycemia
Talk to your healthcare provider about medications that may help prevent headaches during exercise, including:
Nonsteroidal anti-inflammatory drugs (NSAIDs), which, when taken about 45 minutes before exercise, may prevent primary exercise headache in some cases Beta-blockers, which have been reported to prevent exercise-induced headaches and may be an option for people who cannot take NSAIDs
Primary exercise headaches are more common in hot weather and high altitudes, so consider these factors before working out.
Although exercise can cause a headache for some people, many experts say that getting regular exercise can reduce the frequency and intensity of headaches and migraines.
Treatment
If you get a headache following exercise, you should see your healthcare provider for a physical to ensure you don’t have an underlying medical condition. Diagnostic tests that can rule out underlying health conditions that may be causing your headache include magnetic resonance imaging (MRI) or lumbar puncture (spinal tap).
It’s also important to talk to your provider about medications to help manage your headaches. Most exercise-induced headaches are harmless. They typically respond well to OTC medications used for other types of headaches, such as Tylenol (acetaminophen) and NSAIDs.
Summary
Exercise-induced headaches occur after physical activity due to increased circulation in the head that increases blood flow. A primary exercise headache is characterized by pulsating pain on both sides of the head. Primary exercise headaches can be caused by many factors such as exertion, dehydration, and low blood sugar.
A Word From Verywell
Exercise-induced headaches can be frustrating, especially if you regularly exercise. Fortunately there are ways to prevent them, like staying hydrated, warming up before exercise, and eating a small meal before working out. There are also treatment options available. Talk to your healthcare provider about medications that may help manage or prevent headaches after exercise.
Better cognitive functionRegulation of circadian rhythmEnergy balanceIncreased metabolismImproved stress responseMaintenance of mobilityOverall physiological health
Feeling tired and needing more restDepressionDeveloping mood swings or irritabilityInsomniaPainful muscle sorenessBecoming injured from overusing musclesLack of motivationGetting sickWeight lossAnxiousness
Onset after age 50Following a head injuryThose requiring bed restHaving new onset of headache symptomsHaving “the worst headache of your life"Headaches that get worse or increase with coughingHeadaches that change your personality or cognition levelHeadaches accompanied with a pink eye or pain at the templesHeadaches in a cancer patient or someone with an immune deficiencyA sudden headache upon waking
If you have a headache accompanied by any of the following symptoms, call your healthcare provider or 911:
FeverStiff neckConfusionLoss of consciousness or memoryHallucinationsSlurred speech, weakness, numbness, or seizures
