Primary exertional headache occurs during or after physical activity. It is most commonly triggered by: weight lifting, swimming, running, rowing, playing tennis (sometimes only one specific type of exertion). It usually first appears in young adults.
Symptoms and course primary exercise-induced headache
The primary exertional headache is throbbing, bilateral, located in the forehead or occipital region. It can last from 5 minutes to 48 hours. The onset of pain is favoured by high ambient temperature and high altitude. Spontaneous remissions (spontaneous temporary cessation of symptoms) are common, and the periods when the pain recurs can range from a few days to several years If the exercise headache occurs for the first time in one's life, it requires additional investigations because it can be a symptom of: subarachnoid haemorrhage, carotid artery dissection, ischaemic heart disease and other diseases (so-called symptomatic exercise headache).
When to go to the doctor and treat primary exercise-induced headache
Indomethacin and propranolol are used in therapy. In some patients it may be necessary to additionally use gastric mucosal suppressants. After 6-8 weeks of treatment, a trial of drug discontinuation is carried out.
Treatment primary exercise-induced headache
- gradually increasing the intensity of physical activity, especially in high ambient temperatures or at high altitude
- carrying out regular physical activity
- maintaining a normal body mass index (BMI)
