YANMD: What's with this kind of headache?

July 8, 2023 5:27 PM

I get headaches easily from heat or exertion. They come with brain-fog. I'm pretty sure they're not migraines because they're a drag but not incapacitating and they go away with ibuprofen.

I got one today from helping someone lug a desk up a staircase. I sometimes get them from being outside and walking and sweating. It can be pretty minor levels of exertion.

Possibly refining details: I don't think it's dehydration. I drink a reasonable amount of water and these don't go away even slightly if I drink water. They hurt in my left temple and sometimes down the left side of my neck. It's hard to tell what's the pain and what's the "referred pain."

I think if this were anything serious, I'd have known it by now--it's been years and years like this. But I just sort of wonder what's with getting headaches so easily and what's with the brain fog and if I can not get them quite so easily. Does any of this sound familiar, subjectively, non-my-doctorally, to you?

posted by less-of-course to Health & Fitness (12 answers total)

I think some people get migraines that are just aura, and some get mainly nausea. Whatever it is, here's a suggestion:

Instead of just drinking water, try dosing yourself with electrolyte tablets. I've also found that Gerosteiner water sometimes helps (it's got a lot of magnesium). Also: pace yourself.

But mainly the electrolytes. If you're in a situation where that's not an option, V8 (the drink with lots of vegetables as ingredients) seems to have a lot of electrolytes.
posted by amtho at 5:31 PM on July 8, 2023 [7 favorites]

I'd also concider electrolytes.

Possibly a tension headache, especially if your shoulders and neck are tense while doing the activities. For that, a heatpad on my shoulders and neck tends to feel good and help me relax and the headache will go away.
posted by AlexiaSky at 5:59 PM on July 8, 2023 [1 favorite]

You would not believe how many different kinds of headaches there are. I speak as a person who has had a headache for going on 30 years now. One type is "exertional headaches," which people get from exerting themselves. Here is the Cleveland Clinic's page on exertional headaches. Exertion is not one of my many, many triggers, so I don't know much about this from personal experience, but headache doctors do; there are neurologists who specialize in treating headaches. Treatment for headaches is always a combination of lifestyle modification (like avoiding food and other triggers if you can, once you've identified them), preventive medication that can be taken every day or injected weekly or monthly, and rescue meds, that get you out of a flare-up. It sounds like ibuprofen is working really well for you as a rescue med, which is awesome, but you might benefit from looking a bit more into what kinds of other interventions people with exertional headaches find helpful.
posted by Well I never at 6:14 PM on July 8, 2023 [9 favorites]

There are atypical migraines that only produce aura and no pain, among other types. This could still be a migraine. If you were prone to vomiting as a child that is a symptom of being a migraineur. In small children they are usually painless, but cause the kid to throw up and then want to sleep.

Two things you could try are taking magnesium - which could help with your electrolytes, or take a triptan (migraine medicine available by prescription). Either might take the headache away.

Have you tried sticking your head under a cold water tap? It might be vascular and the cold water or ice packs might help.
posted by Jane the Brown at 6:17 PM on July 8, 2023 [1 favorite]

left temple and sometimes down the left side of my neck I'd mention it to my doc fairly soon, in case there's a vascular or other issue.
posted by theora55 at 6:34 PM on July 8, 2023 [4 favorites]

I didn’t know until my late twenties that I have chronic migraines because I thought you had to have visual auras and nausea. Migraines come in a huge range of symptoms and intensities. Brain fog is a very common symptom, exercise in bright light as well.

If ibuprofen works, then yay. Also switch to gentler exercise and wear sunglasses more. If you insist on doing noonday sprints, you could explore preventives with a neurologist to reduce the intensity.
posted by dorothyisunderwood at 6:35 PM on July 8, 2023 [2 favorites]

Headaches, brain fog, and problems after exertion are hallmarks of long COVID. Did this precede 2020 for you? If so, I'd also consider looking into ME/CFS and POTS.
posted by equipoise at 8:47 PM on July 8, 2023

Response by poster: (To the best of my knowledge, I've never had COVID and it does precede 2020. One thing I feel stupid now about not mentioning is that I think a contemporaneous thing is starting to sleep on my side, which probably affects my neck and head. I have sleep apnea and sleep better on my side.)
posted by less-of-course at 9:02 PM on July 8, 2023

Have you tried drinking a lot of water before exertion? For me, a dehydration related headache just gets more and more intense even when I’m drinking lots of electrolytes and water afterward, until I fall asleep for a couple hours at least. But if I’m smart, I make myself drink a bunch beforehand and it staves off the headache, or it shows up but recedes once I’m resting in the shade and topping up my liquids with a small beverage. It’s like the headache signals to my GI system that it is closed to absorbing water now, thanks, and I have to keep it primed ahead of time. Very annoying, but I’m grateful to have figured this out about myself when I do remember to do it.
posted by Mizu at 9:26 PM on July 8, 2023 [1 favorite]

I get something possibly kind of like this and electrolytes seem to help. My current favorite electrolyte supplementation is this.
posted by grobstein at 9:46 PM on July 8, 2023 [1 favorite]

I don't like it. Why is it causing confusion? I really don't like it; in fact, I hate it.

I think you should see a doctor.

Maybe it's a big nothing every time and then one random afternoon you're helping your friend push her antique VW out of a rainpuddle and suddenly whatever's causing the mild headaches causes some additional and more troublesome problem. At that point, you will wish you'd mentioned it to a sawbones.

Whereas if you bring it up to your doctor now and they order forty stupidexpensive tests and it turns out you have zero anatomical problems whatsoever and it's not a secondary exercise headache caused by a potentially lethal vascular peculiarity but a primary headache just like everybody else's benign exercise headaches, then you are simply out a couple thousand in exchange for beautiful, blissful peace of mind. You will be able to help friends move large furniture in exchange for pizza and ibuprofen forevermore, free from fear for your quality of life.

https://www.mayoclinic.org/diseases-conditions/exercise-headaches/symptoms-causes/syc-20372276
posted by Don Pepino at 1:00 PM on July 9, 2023

My partner had exertion headaches for a number of years and got rise of like 95% of them by going to a physical therapist who helped to identify that her shoulders and neck are way too tight, and taught her some techniques to relax them AND by wearing a athletic bite guard when she is exercising.
posted by youthenrage at 6:53 PM on July 9, 2023