Cough headaches

Description

Cough headaches are a type of headache triggered by coughing and other types of effort. This can include sneezing, blowing your nose, laughing, crying, singing, bending over or having a bowel movement.

Cough headaches are quite rare. There are two types: primary cough headaches and secondary cough headaches. Primary cough headaches are usually harmless, they are just caused by coughing and improve rapidly without treatment. Primary cough headache is diagnosed only when the provider has ruled out other possible causes of the cough.

Secondary cough headache can be triggered by a cough, but is caused by problems in the brain or structures near the brain and the spine. Secondary cough headaches are more serious and may require treatment with surgery.

Any person who has a cough headache for the first time, you should see your health care provider. The doctor can determine if a cough, or something else that caused the pain.

Symptoms

The symptoms of cough headaches:

  • Start suddenly, and only after you cough or other types of effort
  • Usually last a few seconds to a few minutes — some can last up to two hours
  • Cause a sharp, stabbing pain, division, or "bursting" pain
  • It usually affects both sides of your head and can be worse in the back of your head
  • May be followed by a dull pain for hours

Secondary cough headaches are often presented with only a cough, a headache, but you may also experience:

  • Longer duration of headaches
  • Dizziness
  • Instability
  • Fainting
  • Ringing in the ears or loss of hearing
  • Blurred vision or double vision
  • Tremor

A cough headache just happens to be right after cough. Another headache is not a cough headache if you already had a headache when you cough, or if you have a headache condition, such as migraine. For example, people with migraines may find that your headaches get worse when you cough. This is normal, and not a cough headache.

When to see a doctor

Talk to your doctor or health care provider if you experience sudden headaches after coughing — especially if the headaches are new, frequent or severe, or if you have any other worrying signs or symptoms, such as imbalance or blurred or double vision.

Causes

Primary cough headaches

The primary cause of the cough headaches is unknown.

Secondary cough headaches

Secondary cough headaches may be caused by:

  • A defect in the shape of the skull.
  • A defect in the part of the brain that controls balance (cerebellum). This can happen when a part of the brain is forced through the opening in the base of the skull (foramen magnum), where only the spinal cord should be. Some of these types of defects are called Chiari malformation.
  • A weakness in one of the blood vessels in the brain (cerebral aneurysm).
  • A tumor in the brain.
  • A spontaneous cerebrospinal fluid leak.

Sometimes, the thing that is first diagnosed as a cough headache can be caused by a cerebrospinal fluid (CSF) leak. Coughing or straining may trigger headache pain, but the underlying cause is the cerebrospinal fluid (CSF) leak. This is one of the reasons why it is important to see your doctor for a new cough headache.

Risk factors

Risk factors for cough headaches vary widely depending on the type and cause of the headache.

Prevention

After speaking with your provider, here are some tips to prevent actions that trigger the cough headaches — as coughing, sneezing, or straining while using the toilet. This can help reduce the number of headaches from the experience. Some preventive measures may include:

  • The treatment of conditions that could cause coughing, such as bronchitis or other lung infections
  • Avoid medications that cause cough as a side effect
  • Getting an annual flu vaccine
  • The use of laxatives to prevent constipation
  • Minimize the lifting of heavy objects or bending for long periods

While these measures can help prevent the cough sore head, any head pain associated with coughing or straining should always be checked by your doctor.

Cough headaches

Diagnosis

Your doctor may recommend a brain-imaging tests, such as magnetic resonance imaging or computed tomography scan to rule out other possible causes of your headaches.

  • Magnetic resonance imaging (MRI). During a Magnetic resonance imaging (MRI), a magnetic field and radio waves are used to create cross-sectional images of the structures inside your head, to determine potential problems that may be causing cough headache.
  • Computed tomography (CT scan). These scans use a computer to create cross-sectional images of the brain and of the head by the combination of X-ray images of the unit that rotates around your body.
  • Lumbar puncture (spinal tap). Rarely, a lumbar puncture (lumbar puncture) may be recommended. During a lumbar puncture, the provider removes some of the fluid that surrounds the brain and the spinal cord.

Treatment

The treatment varies depending on whether you have primary or secondary cough headaches.

Primary cough headache

If you have a history of primary cough headaches, your doctor may recommend that you take daily medication to help prevent or reduce pain.

These preventive medications may include:

  • Indomethacin (Indocin), a nonsteroidal anti-inflammatory
  • Propranolol (Inderal LA), a drug that relaxes blood vessels and lowers blood pressure
  • Acetazolamide, a diuretic that reduces the amount of fluid in the spinal cord, which can reduce the pressure within the skull

Other drugs used for the treatment of primary cough headache include methysergide, naproxen sodium (Aleve), high blood pressure, migraines, intravenous dihydroergotamine (D. H. E. 45) and phenelzine (Nardil).

Secondary cough headache

If you have secondary cough headaches, surgery is often needed to correct the underlying problem. Preventive medicines usually do not help people who have secondary cough headaches. However, they respond to the medication does not necessarily mean that you have a primary cough headache.

Preparing for your appointment

It is likely to start by seeing your family doctor or a general practitioner. However, in some cases, when you call to schedule an appointment, you may be referred immediately to a neurologist.

Because appointments can be brief, and because there is often a lot of ground to cover, it is a good idea to be well-prepared for your appointment. Here's some information to help you prepare for your appointment and know what to expect from your doctor.

What you can do

  • Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
  • Write down key personal information, including past illnesses and operations, the major stresses or recent life changes, recent accidents, the details about what happened when the cough headache started, and any medical problems that run in your family.
  • Make a list of all the medicines, vitamins, and supplements you are taking.
  • Have a family member or friend along, if possible. Sometimes it can be difficult to remember all the information provided to you during an appointment. Someone who accompanies you may remember something that you missed or forgot.
  • Write questions to ask their provider.

Your time with your doctor is limited, so preparing a list of questions will help you to make the most of your time together. Cough headaches, some basic questions to ask include:

  • What is the most likely cause of my headaches?
  • There are other possible causes?
  • What kinds of tests do I need?
  • When these headaches go away?
  • What treatments are available?
  • Are there any alternatives to the primary approach you're suggesting?
  • I have these other health conditions. How can I best manage these conditions?
  • You should see a specialist?
  • Is there a generic alternative to the medicine you're prescribing me?
  • Are there brochures or other printed material that I can take my house? What sites do you recommend?

What to expect from your doctor

Your doctor or provider is likely to ask a series of questions. Be ready to answer them may reserve time to go over any points you want to spend more time on. Your provider may ask:

  • When did you first start experiencing cough, headaches?
  • Has your cough headaches has been continuous or occasional?
  • Has had a similar problem in the past?
  • Have you had any other types of headache? If so, what are they like?
  • Has someone in their immediate family to experience migraines, headaches, or cough?
  • What, if anything, seems to improve your headaches?
  • What, if anything, makes your headaches worse?
Symptoms and treatment of Cough headaches