Are your headaches brought on by physical activity, or after coughing or sneezing? If so, you could be suffering from primary exertional headache. The expert headache physicians at the Diamond Headache Clinic are skilled in diagnosing and treating this condition. A comprehensive examination is necessary to rule out other conditions and help us arrive at an accurate diagnosis. Once we have the right diagnosis, we can offer the right treatment for your pain.
What Are the Symptoms of Exertional Headache?
Exertional headache is often referred to as “primary” because it is not caused by another condition or disorder. It is brought on during or after fits of coughing or sneezing, sexual activity or intense physical exercise, such as running, lifting weights or playing basketball. Approximately 10% of the population experiences exertional headache, but it is seen more among men than women. The condition is more likely to occur in hot weather and at high altitudes, and when caffeine or alcohol has been consumed prior to exercise. Symptoms may include:
- Sudden onset of pulsating pain
- Pain that lasts from 5 minutes to 48 hours
- Headache accompanied by nausea, vomiting and sensitivity to sound and/or light
- Often self-limiting; usually stops occurring in 3 – 6 months
How Is Exertional Headache Diagnosed?
A thorough exam, including patient and family history, is required. This type of headache is found in individuals with a family history of migraine. Seeing a headache doctor is vital if you experience headache brought on by exercise in order to exclude more dangerous conditions. Imaging studies are performed to rule out subarachnoid hemorrhage and arterial dissection. Lumbar puncture helps to rule out issues related to the cerebrospinal fluid and/or cerebrospinal fluid pressure.
What Are the Exertional Headache Treatment Options?
In cases where the headache is mild or builds slowly, you can help prevent exertional headache by doing warm-up exercises before periods of intense activity or by designing an exercise regimen that builds slowly in intensity and duration over several months. Naproxen taken before exercise may prevent exertional headache, but use this sparingly to avoid medication overuse headache.
When given in doses similar to those for migraine prevention, beta blockers have been effective in preventing exertional headache. The medication indomethacin has also been effective in some cases. Because exertional headache is self-limiting, the use of these medications and the need for treatment should be reevaluated after six months.