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Headache and exercise

What are Exercise Induced Headaches?

Exercise induced headaches are simply that, a headache brought on by or occurring during/after exercises. A primary exercise headache is not caused by any other underlying condition or disorder, commonly causes pain bilaterally and is often difficult to distinguish from migraines triggered by exertion. They are more likely to occur in hot weather or at higher altitudes.

A secondary exercise headache is one that is caused by an underlying condition such as a sinus or ear infection, or sometimes something more sinister such as a tumour, other structural abnormalities or a brain bleed. For this reason it is important to seek medical attention if you suddenly begin to experience headaches related specifically to exercise. 

These headaches are thought to be caused by increased pressure associated with abdominal contractions that occur when you exercise. 

Causes: 

  • Sudden increase in exercise amount/duration
  • Dehydration
  • Heat
  • High Altitude

Signs and Symptoms

Primary exercise headaches:

  • Throbbing pain
  • Occur during or after strenuous exercise
  • Affect both sides of the head in most cases
  • Lasting 5 min to 48 hours

Secondary exercise headaches:

  • The same symptoms as above as well as;
  • Vomiting
  • Loss of consciousness
  • Double vision
  • Neck rigidity
  • Lasting at least a day, may linger for 2-3 days

Treatment

Primary exercise headaches often only last for a finite period time (commonly between three to six months), and so sufferers are advised to avoid excessive exercise or other triggering activities during this time. In place of usual aggravating exercise, patients are encouraged to keep fit and active by going for walks, and participating in light, gentle exercise. 

In some cases, warming up more intently, and building intensity slowly may prevent onset of exercise headaches.

There are people that experience exercise headaches for an extended period of time, in which they will seek alternative treatment for their headaches. It is common that there is a sensitisation of the brainstem in people experiencing repeated headaches, and thus physiotherapy treatment to the upper neck may be successful in reducing headache frequency, intensity and duration.

 

References:

https://americanmigrainefoundation.org/resource-library/understanding-migraineprimary-exertional-headache/

https://www.mayoclinic.org/diseases-conditions/exercise-headaches/symptoms-causes/syc-20372276

https://www.hopkinsmedicine.org/health/conditions-and-diseases/headache/primary-exertion-headache

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