Know Your Pain

Exertional Headache

If you get a headache during or after exercise, you are not alone. 1 in every 100 people share the same problem. It is called exertional headache and you might even get it during sexual activity.

Generally this headache is characterized by severe throbbing pain, mostly on both sides of the head or sometimes at the back. After an initial spurt it settles down to a mild ache which could continue for several hours.

The activities mostly associated with exertional headache are: weight lifting, running, rowing, tennis, heading the ball in soccer, and sexual intercourse. People who are new at these activities or are resuming them after a long time are more susceptible to this headache.

The reasons for exertional headache are linked to changes in blood pressure and dilating of blood vessels in the brain. Intracranial pressure increases during or after strenuous activities. And dehydration always worsens the problem. Hot weather conditions or high altitudes will often contribute to your headache. Those with a family history of migraine are more likely to experience exertional headache.

Exertional headaches can be divided into two types - primary exertional headaches and secondary exertional headaches. The primary ones are often benign and can be avoided by taking a preventive medicine. They last for anything between 5 minutes to 2 days, and mostly occur in 20-somethings.

Secondary exertional headaches are due to serious internal problems like bleeding in the brain, blood vessel irregularities, tumors, obstruction in flow of cerebrospinal fluid, reduced blood flow through the arteries, or sinus infections. These headaches could last for several days together and mostly occur in 40-somethings. Secondary exertional headaches may be accompanied by double vision, neck rigidity, or vomiting. These are serious and need to be seen by a doctor immediately. He might want to get your MRI done.

However, the majority of exertional headaches are of primary nature and are harmless. Medications can be taken preventively. If you know that certain exercises cause you headache, you can ask your doctor for medication to be used an hour or two before the exercise. If you always get these headaches no matter what the sport is, you will need daily doses of medicine. Indomethacin and Propranolol are routinely prescribed by doctors. The former is anti-inflammatory and the latter is a blood pressure regulator.

Before thinking of those pills, you might want to have a look at your water intake. You are supposed to drink 8 ounces of water 20 minutes before exercise and 8 ounces after exercise. You must also keep drinking a couple of ounces every 10 minutes during exercise. If you are not doing this and complaining of headache, you may have just found out the reason. And do warm up before exercise. It might help too.