Exercise Headaches: Causes, Risk Factors, Symptoms, Treatment

Exercise Headaches

Exercise headaches, also known as exertional headaches, are headaches that occur during or after physical exertion. They can range from mild to severe and typically happen during strenuous activities such as running, weightlifting, or sexual activity.

If you're encountering Exercise-induced headaches or have risk factors, consulting with a Neurologist is crucial for proper evaluation and management.



Exercise headaches can be caused by various factors, including:

Increased Blood Flow: During strenuous physical activity, blood flow to the brain increases rapidly, leading to a sudden rise in intracranial pressure, which can trigger headaches.

Vascular Issues: Certain individuals may have a predisposition to vascular abnormalities, such as dilated blood vessels or narrowed arteries, which can contribute to exercise-induced headaches.

Dehydration: Inadequate fluid intake before, during, or after exercise can lead to dehydration, affecting blood volume and electrolyte balance, potentially triggering headaches.

Heat Exposure: Exercising in hot and humid conditions can cause heat-related illnesses such as heat exhaustion or heatstroke, which may manifest with headaches among other symptoms.

Exertion-Related Strain: Intense physical exertion can strain neck muscles and structures, leading to tension headaches or exertional headaches.

Underlying Medical Conditions: Secondary exercise headaches may be caused by underlying medical conditions such as brain tumors, bleeding in the brain (subarachnoid hemorrhage), or abnormalities in the blood vessels supplying the brain.

Medication: Certain medications or supplements, such as vasodilators or stimulants, may increase the risk of exercise-induced headaches as a side effect.

Risk Factors

  • Intense Physical Exertion: Engaging in vigorous exercise or strenuous activities.
  • Dehydration: Inadequate fluid intake before, during, or after exercise.
  • Heat and Humidity: Exercising in hot and humid environments, leading to increased body temperature and dehydration.
  • High Altitude: Exercising at high altitudes where oxygen levels are lower, leading to increased strain on the body.
  • Personal History: Previous experience of exercise headaches or migraines may increase susceptibility.
  • Underlying Medical Conditions: Conditions such as high blood pressure, vascular disorders, or structural abnormalities in the brain.
  • Medications: Certain medications or supplements may increase the risk of exercise-induced headaches.
  • Poor Physical Conditioning: Lack of regular exercise or inadequate fitness level.
  • Excessive Caffeine or Alcohol Consumption: Consumption of stimulants or alcohol before exercise can trigger headaches.
  • Environmental Factors: Exposure to pollutants or allergens during outdoor activities.


Symptoms of exercise headaches can vary but typically include:

Throbbing Pain: Headaches often involve a pulsating or throbbing sensation, typically on both sides of the head.

Onset During or After Exercise: Headaches may develop during strenuous physical activity or shortly after exercise has ended.

Duration: Primary exercise headaches can last from a few minutes to several hours after exercise, while secondary exercise headaches may persist for longer periods.

Location: Pain is commonly felt at the back of the head or on both sides, but it can also occur in the front or on one side of the head.

Accompanying Symptoms: Additional symptoms may include nausea, vomiting, sensitivity to light (photophobia), and sensitivity to sound (phonophobia).

Intensity: Headaches can range from mild discomfort to severe pain that interferes with daily activities.

Triggered by Specific Activities: Exercise headaches are often triggered by specific types of physical exertion, such as running, weightlifting, or sexual activity.

Relief with Rest: Rest and relaxation typically alleviate primary exercise headaches, while secondary headaches may require medical intervention for relief.

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The diagnosis of exercise headaches involves a thorough evaluation by a healthcare professional to rule out underlying medical conditions and determine the appropriate course of treatment. Here's an overview of the diagnostic process:

Medical History: The healthcare provider will take a detailed medical history, including a description of the headaches, their frequency, duration, and any associated symptoms.

Physical Examination: A physical examination will be conducted to assess neurological function, blood pressure, and other relevant factors.

Diagnostic Tests: Depending on the suspected cause, additional tests may be ordered. These could include imaging studies such as MRI or CT scans to rule out structural abnormalities in the brain, or angiography to assess blood flow in the blood vessels.

Exercise Testing: In some cases, exercise testing may be performed to induce headaches and assess their characteristics and response to exertion.

Differential Diagnosis: The healthcare provider will consider other potential causes of headaches, such as migraines, tension headaches, or secondary headaches due to underlying medical conditions.

Monitoring and Follow-Up: If no underlying cause is identified, the patient may be monitored over time to track headache patterns and assess response to treatment.


Treatment for exercise headaches depends on their underlying cause and severity. Here are some common approaches:

Pain Relief Medications: Over-the-counter pain relievers like ibuprofen or naproxen sodium may help alleviate mild exercise headaches. For more severe cases, prescription medications may be necessary.

Preventive Medications: If exercise headaches are frequent or severe, your doctor may prescribe preventive medications such as beta-blockers or calcium channel blockers to reduce their occurrence.

Hydration: Ensuring adequate hydration before, during, and after exercise can help prevent dehydration-related headaches.

Gradual Warm-Up and Cool-Down: Gradually warming up before exercise and cooling down afterward can help prevent sudden changes in blood flow that trigger headaches.

Identify and Avoid Triggers: Keeping a headache diary to identify triggers and avoiding them can help prevent exercise headaches.

Proper Technique: Using proper form and technique during exercise, especially activities that involve repetitive head movements, can help reduce strain on the neck and head muscles.

Manage Stress: Stress-reduction techniques such as meditation, deep breathing exercises, or yoga may help prevent tension-related exercise headaches.

Medical Evaluation: If headaches persist despite preventive measures, a thorough medical evaluation may be necessary to rule out underlying conditions or structural abnormalities causing secondary exercise headaches.

Preventive Measures

Exercise headaches, whether primary or secondary, can be managed and prevented with the following measures:

Gradual Warm-Up and Cool-Down: Ease into physical activity with a proper warm-up and finish with a gradual cool-down to prevent sudden changes in blood flow that can trigger headaches.

Stay Hydrated: Maintain adequate hydration by drinking water before, during, and after exercise to prevent dehydration, a common trigger for headaches.

Identify and Avoid Triggers: Be mindful of activities or environmental factors that consistently trigger headaches, and modify your exercise routine accordingly.

Proper Technique and Form: Use correct posture and technique during exercise to minimize strain on the neck and head muscles, reducing the risk of tension headaches.

Manage Stress: Practice stress-reduction techniques such as deep breathing, meditation, or yoga to alleviate tension and prevent stress-related headaches.

Monitor Intensity and Duration: Avoid overexertion by pacing yourself and gradually increasing the intensity and duration of your workouts to prevent exertion-related headaches.

Medication Consultation: If headaches persist despite preventive measures, consult a healthcare professional for guidance on appropriate medications or treatments to manage symptoms effectively.

Do's & Don’t's

When it comes to exercise headaches, knowing the do's and don'ts can make a significant difference in managing and preventing these uncomfortable episodes. By following a few simple guidelines, you can ensure that your workouts are headache-free and enjoyable. 

Do's Don't
Listen to your body and pay attention to warning signs during exercise.  Avoid pushing yourself too hard or overexerting during workouts. 
Stop exercising immediately and rest if you experience unusual sensations or head pain.  Avoid exercises that involve excessive straining or bearing down, such as heavy weightlifting or breath-holding. 
Stay hydrated by drinking plenty of water before, during, and after your workout.

Neglect proper hydration; failure to drink enough water before, during, and after your workout can increase the risk of exercise headaches.

Warm up properly before engaging in intense physical activity to prepare your body for exertion. 

Skip or rush through warm-up exercises; inadequate preparation before intense physical activity may heighten the risk of exercise-induced headaches.

Gradually increase the intensity of your workout to minimize the risk of triggering a headache. 

Sudden, intense changes in workout intensity; avoid abrupt increases, as they may elevate the risk of triggering headaches during exercise.

If you're encountering Exercise-induced headaches or have risk factors, consulting with a Neurologist is crucial for proper evaluation and management.

Frequently Asked Questions
Exercise headaches are characterized by a throbbing pain that occurs during or after physical activity. They typically occur on both sides of the head and can last from a few minutes to several hours.
The exact cause of exercise headaches is still unknown, but there are several factors that may contribute to their occurrence. These include dehydration, improper breathing techniques, strenuous exercise, high altitude, and underlying medical conditions such as migraines or exertional compartment syndrome.
Prevention is key when it comes to managing exercise headaches. Some strategies that may help include staying hydrated before, during, and after your workout; warming up properly before exercising; avoiding sudden changes in intensity; practicing proper breathing techniques; and listening to your body's limits.
While most exercise headaches are harmless and resolve on their own with rest and hydration, there are instances where medical attention is necessary. If your headache is severe or accompanied by other concerning symptoms such as dizziness, confusion, loss of consciousness, or neck stiffness, it is important to consult with a healthcare professional.
In some cases, over-the-counter pain relievers such as ibuprofen or aspirin may provide temporary relief from exercise headaches. However, it's important to consult with a healthcare professional before taking any medication for your specific situation.
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