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Exertional Headache, Sports Medicine

Nathan Cardoos, MD, CAQSM Reviewed 04/2019
 


BASICS

  • There are two types of exertional, or exercise-associated, headaches seen in athletes: (i) primary exercise headache (PEH) and (ii) “weight lifter’s headache,” a form of primary cough headache.

  • ...

DIAGNOSIS

HISTORY

  • All of the defining features below come from a small number of case series and expert opinion 1,3,6.

  • PEH:

    • Characterized as bilateral, throbbing, pulsatile

    • Brought on by and occurs only d...

TREATMENT

MEDICATION

  • Given the self-limiting nature and short duration of symptoms from weight lifter’s headache, avoidance of the provoking activity is the preferred treatment.

  • Nonsteroidal anti-inflam...

ONGOING CARE

PATIENT EDUCATION

  • Patients should be advised to avoid exercising in the heat and to stay hydrated.

  • Patients with a history of exertional headache should avoid the type of physical exertion ...

REFERENCES

1
Halker RB, Vargas BB. Primary exertional headache: updates in the literature. Curr Pain Headache Rep.  2013;17(6):337.
2
Cutrer FM, DeLange J. Cough, exercise, and sex headaches. Neurol...

ADDITIONAL READING

Sandoe CH, Kingston W. Exercise headache: a review. Curr Neurol Neurosci Rep.  2018;18(6):28. 

CLINICAL PEARLS

  • PEH occurs during or soon after intense physical activity and can be prevented by avoiding intense exertion. It is typically characterized as bilateral, throbbing, and pulsatile. It la...

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