Exertional Headache, Migraine and the Neck

‘Benign’ (or harmless) Exertional Headache is defined as headache caused by exertion such as coughing, sneezing, bending, heavy lifting, running (how is this different to headache triggered by exercise?) or when straining at stool.

It is important that if your headache history is less than 3 months and is triggered or aggravated by these activities that you consult you doctor.

These activities create similar effects on the body as do the Valsalva manoeuvers.

Recent research1 found a wide range of symptoms in Exertional Headache, some with migrainous symptoms, and the authors suggested that the ‘triptans’ might be useful. As usual there is a lot of discussion as to the actual mechanism of Exertional Headache and indeed Exercise Induced Headache, but the causes remain unknown – why?

The Valsalva manoeuver is used (and has been for years) to identify problems or injury in the nerves of the cervical spine. Upon the exertion of pressure, pain may be felt, and may indicate increased pressure on the C2-3 intervertebral disc or other part of a cervicogenic (neck) disorder.

Clearly increased headache or headache or migraine triggered by exertion or exercise is likely to be caused by a neck disorder.

Cheers

Dean

(Chen S-P, Fuh J-L, Lu S-R, Wang S-J. Exertional headache – a survey of 1963 adolescents. Cephalalgia 2008; 29:401-407

Johnson RH, Smith AC, Spalding JM (February 1969). “Blood pressure response to standing and to Valsalva’s manoeuvre: independence of the two mechanisms in neurological diseases including cervical cord lesions”. Clin Sci 36 (1): 77–86)

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