Exercise-Induced Headaches

Headaches are a common ailment – nearly 90 percent of men and 95 percent of women have had at least one in their lifetime. For more than 45 million people in the U.S., headaches are a chronic, recurring problem. According to the National Headache Foundation, Americans spend more than 4 billion dollars annually on over-the-counter pain relievers for treatment of headache.

There are three main types of headache. Tension-type headaches are characterized by a steady ache affecting both sides of the head (sometimes over the entire head). These are the most common types of headache, affecting three-fourths of all headache sufferers. Tension-type headaches may occur on an occasional basis or chronically (sometimes as often as every day).

Migraine headaches are vascular headaches that cause throbbing pain – usually on one side of the head. Migraine symptoms may be disabling, causing severe head pain, sensitivity to light and sound and nausea. Migraines are less common than tension-type headaches, but still affect a significant number of Americans (25 to 30 million). Symptoms can last from a few minutes to several days.

Cluster headaches are also a vascular type of headache. They are much rarer than tension-type or migraine headaches – affecting about one percent of Americans. The headaches are characterized by severe pain around an eye. Symptoms tend to last no more than an hour or two and can be accompanied by eye tearing and inflammation and nasal congestion. They are called cluster headaches because the symptoms tend to recur at about the same time over the course of the "cluster."

Exercise-Induced Headache
Headache symptoms can often be controlled with medication and diet. For many patients, a program of regular exercise is also helpful in reducing the severity and frequency of headaches. However, for some people, exercise actually seems to trigger a headache. Some patients experience migraine-like symptoms while others may experience symptoms that are similar to a tension-type headache. These are called exercise-induced, or exertional, headaches.

No one knows why some people get headaches when they exercise. Doctors theorize exercise can cause a sudden increase in blood pressure, causing the blood vessels to swell. A temporary increase in the size of blood vessels in the head may trigger pain symptoms in some people. Excessive heat, bright sun, high altitude, dehydration and prolonged exertion are associated with an increased risk for exercise-induced headaches.

Since physical activity is an important part of a healthy lifestyle, doctors are reluctant to recommend avoidance for those who suffer exercise-induced headaches. Instead, a thorough evaluation should be performed to make sure the headaches don't have an organic cause (such as brain tumor or bleeding). Once other factors have been ruled out, patients may gain relief by pre-treating themselves with medication. In some cases, performing adequate warm-ups and starting out slowly may prevent the headache. Breaking up exercise routines into smaller segments or switching to low-impact exercises (like walking or swimming) may also be helpful. In addition, doctors recommend drinking plenty of water, eating a balanced diet, getting adequate rest and avoiding too much exercise in heat and humidity.

For general headache information:
American Council for Headache Education (ACHE), 19 Mantua Rd., Mt Royal, NJ 08061, http://www.achenet.org
National Headache Foundation, 820 N. Orleans, Suite 217, Chicago, IL 60610, http://www.headaches.org
National Institute of Neurological Disorders and Stroke, http://www.ninds.nih.gov