Other accompanying symptoms

In addition to the strong, throbbing headaches, other symptoms can also occur after sporting activity. For example, those affected often report that they also suffer from severe nausea to vomiting. If these symptoms are very pronounced, the differential diagnosis of migraine must always be considered. Furthermore, fatigue, a general lassitude or sensitivity to noise as well as dizziness can occur after sport. Depending on possible underlying causes, further symptoms are possible, which can be groundbreaking in the diagnosis of the disease.

Diagnosis

In the diagnosis of headaches following physical activity, the clinical picture of the disease is initially groundbreaking. For example, headaches occur only in isolation after exercise and are characterized by a typical pulsating headache that lasts for a few minutes to hours. However, this picture must be distinguished from migraine.

The decisive factor in this distinction may be the isolated occurrence of pain during physical activity, whereas there are significantly more triggers for migraine. Furthermore, in the diagnosis of these headaches, the exclusion of possible serious causes, such as a cerebral haemorrhage, is crucial. In most cases, imaging in the form of a CT or MRI is performed for this purpose.

Ultimately, the diagnosis of primary headache attributed to physical exertion is an exclusionary diagnosis because there is no conclusive test for this disorder. However, it may be helpful to consider treatment with indomethacin. If the response to this treatment is very good, this may be a further indication of the disorder.

Therapy

The treatment of headaches depends first on a possible underlying cause. If such a cause can be found, the focus of the treatment is on the therapy of this cause.While in the case of a simple sinusitis, only a decongestant nasal spray is prescribed, bleeding or space-occupying patients may require more extensive measures. If, however, no underlying cause can be proven, in the sense of primary headaches, the therapy is much more specific with regard to headaches.

It should be noted that this form of headache is relatively rare and therefore there are only limited studies available to treat the condition. Which pain therapy is ultimately used depends first of all on the frequency of the sporting activity and thus the pain attacks. Indomethacin, which is very similar to ibuprofen or ASA, has been shown to be most effective in the treatment of these headaches.

If the person concerned does not do much sport, taking 25-50mg of indomethacin before sport is usually sufficient to prevent headaches from occurring. However, if physical activity is more regular and the pain occurs frequently, the therapy can be changed to a long-term therapy and indomethacin can be taken three times a day at a similar dose. In this case, however, the synchronous intake of stomach protectors should be considered in order to avoid possible side effects of indomethacin. However, it should always be remembered that in addition to drug therapy, certain non-drug measures should always be taken, such as avoiding heavy physical activity and avoiding excessive heat.