Exertional headaches are caused by pressure on nerves in the brain due to dilated blood vessels during physical exertion. Treatment includes medication, lifestyle adjustments, and medical imaging to rule out underlying conditions. If headaches persist, further testing may be necessary.
An exertional headache is a headache directly related to physical exertion such as straining to lift something heavy, exercising, or working hard outdoors. Upon completion of the activity, the patient may experience pain in the head for several seconds to minutes before it resolves. Exercise headaches are treatable, and patients should see a neurologist if they begin to develop an unusual number of headaches or headaches at odd times. It helps keep a record of when headaches occur and what the patient was doing just before the onset, as it can be used in diagnostic evaluations.
When people exercise, and especially when they strain the muscles in the torso, blood vessels tend to expand as the body adjusts to provide people with energy. The cause of exertional headaches is thought to be pressure on nerves in the brain caused by dilated blood vessels, although there may be other factors that contribute to the development of such headaches.
Patients with suspected exertional headaches will be evaluated with the use of medical imaging to check for problems such as tumors, venous malformations, cysts, and other problems that could be contributing to the headaches development. If the brain scans look clean and the patient can clearly document that the headache is related to physical activity, a neurologist can diagnose the exertional headache and discuss options for management and treatment with the patient.
Medications, especially anti-inflammatory drugs, can be helpful in treating stress headache. Your doctor may recommend several medications before a treatment regimen that works is developed. Patients should take note of any side effects experienced. Lifestyle adjustments such as changing an exercise routine, getting coaching to learn how to exercise with less exertion, and wearing supportive clothing while exercising may also be recommended. These small changes to the patient’s habits and routine can help the patient avoid developing exertional headaches in the future.
If a patient’s exercise headache problem is not responding to treatment, further testing may be required. Sometimes the physical changes to the brain don’t show up immediately and can show up on later scans, or a patient has another medical problem that wasn’t discovered during the initial diagnostic evaluation. Generally, headaches are not normal and are a cause for concern, which makes it important to find out why people are experiencing headaches and address the cause.
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