© Hootie2710 | Dreamstime.com
If you tend to develop a headache while exercising or start feeling a headache after you exercise, it’s likely that you’re suffering from the exertion headache phenomenon. You’re more likely to experience an exertion headache if you also suffer from migraine symptoms, which can also stem from vigorous exercise.
Exertion headache symptoms can be similar to migraine symptoms. For example, you may experience throbbing pain in your head, increased sensitivity to light, nausea, and vomiting. An exertion headache can last from as little as five minutes to as long as one or two days.
Exertion Headache Causes
An exertion headache after running is common; other sports that particularly increase your exertion headache risk include weightlifting and tennis. It may be that the excessive perspiration that goes with these and other strenuous sports—and the potential for dehydration—can come into play; a dehydration headache, after all, can feel similar to an exertion headache.
Other factors that make an exertion headache more likely include a poor diet, hunger and the low blood sugar that can result from it, heat and humidity, and exercising at high altitudes where there is less oxygen in the air you breathe.
As to what’s going on inside your brain during an exertion headache, the precise mechanisms that underlie headaches aren’t fully understood. However, it is thought that vigorous physical activity may dilate blood vessels to the extent they pull on the nerve fibers that surround them, resulting in the transmission of pain messages to the brain.
Exertion Headache Treatment
If you experience your first exertion headache very abruptly, contact your doctor for advice. If you have other brain aneurysm symptoms or a family history of brain aneurysms, your doctor may order imaging tests such as a CT scan or magnetic resonance imaging to check that all is well.
If there is no underlying reason for your exertion headaches, try taking a nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen (Advil, Motrin) or naproxen (Aleve, Naprosyn) 30 minutes before exercise sessions. Your doctor also may prescribe another NSAID called indomethacin (Indocin), which also is used for ice pick headache treatment.
Indomethacin must be taken sparingly, particularly if you have heart disease, since long-term use is associated with a greater risk for heart attack and stroke. It also has been linked to eye problems, so if you take it, you should have regular eye exams. Furthermore, your gastrointestinal health may be affected by taking indomethacin, so if your doctor prescribes it, he or she may recommend that you also take an antacid such as omeprazole (Prilosec).
Preventing Exertion Headaches
There are no hard-and-fast rules for preventing exertion headaches, but there are some tips you can follow alongside the practice of taking a painkilling drug before you exercise.
First, you definitely should not stop working out just because of your tendency to develop exertion headaches, since physical activity is important for helping to preserve your cardiovascular health and bone density, and also may help protect you against depression. But do take the time to warm up slowly before you exercise, as opposed to launching straight into vigorous activity. You can warm up by taking a few minutes to do some stretches, and by marching or jogging on the spot while circling your arms at the shoulders. It is also important to cool down after exercising—you can do this with stretches, and with step-touching from side-to-side as your heart rate begins to slacken.
Headaches can bring with them various symptoms for different lengths of times. See these related University Health News articles on headache pain:
When you do begin your workout proper, don’t make too sudden a transition from your warming-up session to strenuous exercise moves. Instead, ease in gradually. If you enjoy lifting weights but have noticed that you frequently suffer from exertion headaches while engaged in weightlifting, try lifting lighter weights. Recent research suggests that combining lower weights with more reps may be just as effective for muscle-building as lifting heavier weights with fewer reps.
Be sure that you’re drinking sufficient fluids while exercising, since dehydration has been implicated in exertion headaches, and you’ll be losing more fluids than usual through perspiration. You have likely heard the advice to drink eight 8-ounce glasses of water each day; this amount should keep you on track with the Institute of Medicine’s recommendations for fluid intake. However, think in terms of fluids, not just water. Your eight glasses can include fruit juices, tea, and coffee (though keep in mind that the last two have a diuretic effect that causes you to lose fluids overall).
Also, keep in mind that if you’re exercising hard, you’ll sweat more and might in fact need more fluids to help prevent exertion headaches than the recommended eight glasses—particularly if you’re exercising outdoors in hot and humid weather.
Originally published in 2016 and regularly updated.