exercised induced headaches/are you affected?

21st century. Loving it. Exercise has finally become trendy. For some of us it is a hobby, for others a profession, day in and day out. But, whatever the reason behind your drive for a healthy lifestyle is, you could be a sufferer.

Exercise induced headaches present after a prolonged and strenuous exercise.



Here's a summarised presentation

Headache is pain felt in any part of the head, factor scalp and the interior of the head. (MM) More than 10 million people in the UK get headaches regularly, which makes them one of the most common health complaints (NHS).

  • The brain itself is not sensitive to pain because it lacks pain receptors. However, other areas of the head and neck do have pain receptors and can thus cause pain.

The main types of Headaches:

Tension Type Headache (TTH): also known as “everyday headache”, are described as a constant ache on both sides of the head and people describe it as a tight band around the head.

Duration: usually lasts 30 mins to several hours, in some cases even days.

Possible Causes: stress, dehydration and poor posture.

Cluster Headache (CH): rarer than TTH, occur in clusters for 1 or 2 months around the same time of the year. Excruciating, sharp pain, most commonly around one eye. They can cause redness, watering and/or blocked and runny nose. It is estimated to affect 1 in 500-1000 people, they are more common in men and they tend to develop in people over the age of 20.

Duration: recurrent “bouts” over several weeks (typically 4-12 weeks) followed by a headache free period (remission) that often lasts for months or even years.

Possible causes: not yet completely clear. They have been linked to the hypothalamus (part of the brain responsible for certain metabolic processes).

They could be genetic.

People who smoke are at a higher risk. (NHS)

Migraines: Episodic Primary* Headache Disorder. Pain is often unilateral, described as throbbing and it is aggravated by exertion. Can be accompanied with nausea and sensitivity to odours, light and sound. People who suffer from migraines usually find relief in a quiet, dark room.

Duration: 4-72 hours and symptoms range from mild to severe.

Triggers: Red wine, stress, certain foods (e.g red meat), excessive afferent stimuli (flashing lights, strong odours) and hormonal factors

Head trauma, neck pain and temporomadibular joint (TMJ)-jaw dysfunction sometimes can trigger or aggravate a migraine.

*Exercise Induced Headaches are divided into two categories:

  1. Primary Exercise Headaches (PEH): usually benign (harmless) and aren't connected to any underlying pathologies. Usually can be prevented by medication

  1. Secondary Exercise Headaches (SEH): they are more serious and they are associated with underlying problems within the brain such as: Bleeding or Tumours and outside the brain such as: coronary artery disease.

It is important to identify the symptoms quickly, since secondary Ex. Headaches may require emergency medical attention.

How Do We Identify

Primary: described as throbbing, occur after strenuous exercise and in most cases they affect both sides of the head. PEH last between 5 mins to 48 hours, while SEH last at least a day and sometimes linger for several days or even longer.

Secondary: have the same symptoms as PEH as well as: Vomiting, Double Vision, Neck Rigidity and Loss of Consciousness.


PEH: exact cause is unknown. One theory supports that strenuous exercise dilates blood vessels inside the skull (Inflammation=pain)


-Bleeding in the space between the brain and the membranes that cover the brain, called: Subarachnoid Haemorrhage

-Abnormalities in a blood vessel leading to or within the brain

-Cancerous or Non-Cancerous Tumours

-Obstruction of Cerebrospinal Fluid (CSF=clear fluid found in spine and brain: acts as a buffer for the brain’s cortex, providing basic mechanical and immunological protection to the brain inside the skull).

-Sinus Infection

-Structural abnormalities in the head, neck or spine.

Risk Factors for Exercise Induced Headaches:

Exercise in hot weather

Exercise in high altitude

Have a personal or Family history of migraines

“The hallmark of treatment for exercise-induced migraines tends to be proper warm-up before exercise, minimization of environmental risks, proper sleep hygiene, and good nutrition and hydration; however, in many cases, the pharmacologic solutions that are applied to other types of headaches may also be necessary “ (Nadelson C.)


  1. Corbelli I., D’Amore C., Caproni S. et al. “Migraine with Aura in the locker room: three case reports” (2012). J Headache Pain: 13: 91-93

  2. Miller S., Matharu M.S. “Migraine is underdiagnosed and undertreated”. (2014). Practitioner: 258 (1774): 19-24, 2-3

  3. Nadelson C. “Sport and exercise-induced migraines”. (2006). Curr Sports Med Rep: 5(1): 29-33




Further reading

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