Exercise Headaches

Exercise headaches are headaches that occur during intense exercise.

They usually occur in activities such as running, tennis, swimming and weightlifting.

They are classified into two main groups: primary exercise headaches which are not harmful and usually stop when one stops exercising or doing the activity that caused the headache and secondary exercise seizures that are serious and originate from problems within the brain like bleeding or tumors.

Secondary headaches can also occur due to problems otside the brain that affect other organs like coronary heart disease. These headaches usually require immediate medical attention unlike the primary ones.

The common symptoms of exercise headaches include: throbbing pain that affects both sides of the head and usually occurs during strenuous exercise.

The symptoms that are seen in secondary exercise headaches but not in primary exercise headaches include:

• Vomiting
• Loss of consciousness
• Double vision
• Sometimes rigidity of the neck

Primary exercise headaches usually last from five minutes to 48 hours while secondary exercise headaches can last from one day to several days, even weeks.

The exact cause of primary exercise headaches is not known. However, doctors believe it is caused by dilation of blood vessels in the head that occurs due to strenuous exercise.

Secondary exercise headaches are usually caused by problems that affect other parts of the body such as:

• Bleeding within the brain
• Abnormalities of vessels supplying the brain
• Malignant or benign (non-cancerous) tumors
• Disorders in the flow of cerebralspinal fluid (CSF)
• Infections of the sinuses
• Some structural abnormalities of the head, neck and spine

Diagnosis of exercise headaches done by performing image tests.

These include:

• Magnetic resonance imaging (MRI) in which a magnetic field is used to create cross-sectional images of the brain
• computerized tomography (CT) angiography where blood vessels leading to or in the brain are visualised
• CT scan which uses X-rays to generate cross-sectional images of the brain

In some cases in which headaches appear suddenly and no abnormal changes are seen in the structure of the brain, a lumbar can be performed.

Several medications can be used to treat exercise headaches:

• Indomethacine, an anti-inflammatory drug and Propranolol, a drug that reduces blood pressure.
• Propranolol can be used to as a prophylaxis.
• Naproxen, phenelzine and ergonovine can also be effective.

Taking these medications 1-2 hours before exercising can prove to be very effective in the prevention of exercise headaches.

Exercise headaches can be prevented by:

• Avoiding exercising in hot and humid conditions
• Avoiding strenuous exercises that trigger these headaches
• Warming up before exercising.

The risks of exercise headaches include:

• Exercising in hot and humid weather
• Exercising at high attitude
• Having a family history of exercise headaches