Headaches During Exercise: Causes and Fixes

A lot of people think exercising is a headache, but for some people, it actually causes headaches. What causes exercise headaches and how can you stop them? 

For most people, getting a mild headache during exercise is no big deal. It may be the body's way of signaling it's running low on food or water. It might caused by altitude, excess heat, lack of sleep or plain old tension. Some people, however, get severe headaches during exercise or other vigorous activities, including sex. That's why this kind of exercise headache is also called exertional headaches. Some people get exertional headaches from coughing, sneezing, and even straining with bowel movements, but more often they're related to activities like running or weight lifting.

They start shortly after the person begins exercising or finishes a workout and last from five minutes to forty-eight hours. The headache may start out mild then build for several hours after a workout, but The National Headache Foundation says exertional headaches typically become severe quickly after the start of strenuous activities. They are bilateral (pain occurs on both sides of the head) and they throb though they're not usually associated with nausea, light sensitivity or vomiting. 

Exertional headaches are divided into two categories:

1. Primary exertional headaches. We don't know exactly what causes primary exertional headaches, but they don't indicate a serious health problem. They may be caused by blood vessels in the brain dilating in order to bring more circulation to the head and neck during exercise.

They're similar to migraines--very unpleasant, painful and even temporarily disabling, but not dangerous.  Some people get this kind of headache only once, but most have them repeatedly. People who get primary exertional headaches are at higher risk for having migraines.

Primary exercise headaches usually respond to standard headache remedies: Tylenol, aspirin or anti-inflammatory medications like ibuprofen. If they happen too often, a doctor may prescribe Indomethicin (an anti-inflammatory medicine) or Propanalol (blood pressure medicine) to take before exercise.

2. Secondary exertional headaches signal an underlying problem. These may include:

  • Bleeding in the area between the brain and the thin membranes that cover the brain (subarachnoid hemorrhage)
  • Abnormalities in a blood vessel leading to or within the brain
  • Cancerous or noncancerous tumors
  • Obstruction of cerebrospinal fluid flow
  • Reduced blood flow in the arteries feeding the heart
  • Sinus infection

How do you know which type you have? If you experience severe headaches with exercise or exertion (especially if they come on strong and fast, last more than a few hours and/or you're over 40 or have any significant health problems), you should see your doctor. He might prescribe diagnostic tests like MRI or CT scan to rule out serious problems. If no structural or vascular problems are present, you likely have primary exertional headaches.

Does this mean you can't exercise? Not at all. Exercise is essential for everyone. You may be able to prevent exercise headaches by making sure you're well hydrated, properly nourished and well-rested before you work out. Ask your doctor if you should take medication to block the onset of exercise headaches.


National Headache Foundation

Exertional Headaches


Mayo Clinic

Exercise Headaches