What are the primary and secondary types of cough headaches. How are cough headaches diagnosed and treated. What are the key differences between primary and secondary cough headaches.

Understanding Cough Headaches: An Overview

Cough headaches are a unique type of head pain triggered by coughing and other forms of straining. These headaches can be initiated by various activities, including sneezing, laughing, crying, singing, bending over, or even having a bowel movement. While relatively uncommon, cough headaches can be categorized into two distinct types: primary and secondary cough headaches.

Primary vs. Secondary Cough Headaches

Primary cough headaches are generally considered harmless and are caused solely by the act of coughing. They typically resolve quickly without requiring treatment. On the other hand, secondary cough headaches are more complex, as they are caused by underlying problems with the brain or surrounding structures. Understanding the differences between these two types is crucial for proper diagnosis and treatment.

Causes of Cough Headaches: Unraveling the Mystery

The causes of cough headaches can vary depending on whether they are primary or secondary in nature. Let’s explore the potential factors behind each type:

Primary Cough Headaches

While doctors understand that the strain from coughing, sneezing, or laughing causes primary cough headaches, the exact mechanism behind the pain remains unclear. These headaches are more common in individuals over 40 and tend to affect men more frequently than women.

Secondary Cough Headaches

Secondary cough headaches are associated with underlying conditions or abnormalities. Some common causes include:

• Chiari type 1 malformation: A defect in skull shape that forces the lower, rear part of the brain (cerebellum) into the spinal canal
• Other skull shape defects
• Cerebral aneurysm: A weak blood vessel that balloons out, putting pressure on surrounding brain tissue
• Cerebrospinal fluid abnormalities: Leaks or blockages that build pressure around the brain
• Brain tumors

It’s important to note that secondary cough headaches account for nearly half of all cough headaches, emphasizing the need for proper medical evaluation.

Recognizing Cough Headache Symptoms: What to Look For

The symptoms of cough headaches can vary depending on whether they are primary or secondary. Understanding these differences can help in identifying the type of headache and seeking appropriate medical attention.

Primary Cough Headache Symptoms

Primary cough headaches typically present with the following characteristics:

• Duration: Usually lasts a few seconds to minutes, rarely up to 2 hours
• Pain type: Sharp, stabbing pain
• Location: Often affects both sides of the head
• Onset: Starts suddenly, immediately after coughing, sneezing, or straining
• Absence of other symptoms: Does not cause nausea, watery eyes, runny nose, or sensitivity to light and sound

Secondary Cough Headache Symptoms

Secondary cough headaches may exhibit more varied and severe symptoms:

• Duration: Can last for hours or even weeks
• Pain location: May be focused on the lower, back part of the skull if caused by a Chiari malformation
• Additional symptoms: May include dizziness, facial numbness, blurry vision, balance problems, and fainting (particularly in cases of Chiari malformation)
• Age of onset: More common before the age of 40

Diagnosing Cough Headaches: The Importance of Medical Evaluation

Proper diagnosis of cough headaches is crucial for determining the appropriate course of treatment. Healthcare providers employ various methods to identify the type and cause of cough headaches:

Medical History and Symptom Assessment

Doctors will inquire about your symptoms, including the nature of the headaches, their duration, and associated factors. The characteristics of the pain can provide important clues:

• A stabbing pain on both sides of the head that dissipates within seconds may indicate a primary cough headache
• A dull ache on one side of the head lasting for several days might suggest a secondary cough headache

Imaging Studies

To rule out secondary causes, doctors may order specialized imaging tests:

• Computerized tomography (CT) scan
• Magnetic resonance imaging (MRI)

These imaging techniques can reveal abnormalities in the shape of the skull, brain, or other head structures that could be responsible for cough-induced headaches.

Only after secondary causes have been ruled out can a diagnosis of primary cough headache be confirmed.

Treatment Options for Cough Headaches: Tailored Approaches

The treatment of cough headaches depends on whether they are primary or secondary in nature. Let’s explore the various approaches for each type:

Primary Cough Headache Treatment

Once secondary causes have been ruled out, treatment for primary cough headaches may include:

• Medication: Indomethacin is the drug of choice, believed to relieve pressure around the brain and skull
• Off-label medications: Doctors may prescribe drugs typically used for other conditions, such as acetazolamide, propranolol, methysergide, naproxen, or ergonovine
• Spinal tap: In rare cases, a procedure to remove some spinal fluid may be performed to alleviate pressure

Secondary Cough Headache Treatment

Treatment for secondary cough headaches is tailored to the underlying cause:

• Chiari malformation: Medication like indomethacin for pain relief; surgery may be recommended to alter the skull shape and relieve pressure
• Cerebral aneurysm: Procedures to seal off the aneurysm or use a flow diverter to deprive it of blood
• Brain tumors: Treatment typically involves a combination of surgery, radiation therapy, and chemotherapy

The importance of accurate diagnosis cannot be overstated, as it directly impacts the choice of treatment approach.

Prevention Strategies for Cough Headaches: Minimizing Triggers

While not all cough headaches can be prevented, there are several strategies that may help reduce their frequency and severity:

Lifestyle Modifications

• Avoid activities that trigger cough headaches when possible
• Stay hydrated to help thin mucus and reduce coughing
• Use a humidifier to moisten the air and soothe irritated airways
• Practice good posture to reduce strain on the head and neck

Managing Underlying Conditions

Addressing health issues that may contribute to coughing can help prevent cough headaches:

• Treat allergies or sinus problems that cause postnasal drip
• Manage acid reflux, which can trigger coughing
• Quit smoking or avoid secondhand smoke
• Seek treatment for chronic respiratory conditions like asthma or COPD

Medication Adjustments

In some cases, your doctor may recommend changes to your medication regimen:

• Review medications that may cause coughing as a side effect
• Consider preventive medications for chronic cough headaches

When to Seek Medical Attention: Red Flags for Cough Headaches

While many cough headaches are benign, certain symptoms warrant immediate medical evaluation. Be alert for the following red flags:

Severe or Persistent Symptoms

• Headaches that persist for hours or days
• Intensifying pain or changes in headache patterns
• Headaches that interfere with daily activities or sleep

Neurological Symptoms

Seek immediate medical attention if you experience:

• Vision changes or double vision
• Weakness or numbness in any part of the body
• Difficulty with balance or coordination
• Changes in consciousness or confusion

Additional Concerning Symptoms

• Fever accompanying the headache
• Stiff neck or sensitivity to light
• Headaches triggered by mild physical activity
• New onset of cough headaches, especially if you’re under 40

Remember, early detection and treatment of secondary cough headaches can be crucial in preventing potential complications.

Living with Cough Headaches: Coping Strategies and Support

Dealing with cough headaches can be challenging, but there are several ways to manage symptoms and improve quality of life:

Pain Management Techniques

• Apply cold or hot compresses to the head
• Practice relaxation techniques like deep breathing or meditation
• Consider gentle neck and shoulder stretches to relieve tension
• Use over-the-counter pain relievers as recommended by your doctor

Lifestyle Adjustments

Making certain changes to your daily routine can help minimize the impact of cough headaches:

• Identify and avoid personal triggers when possible
• Maintain a consistent sleep schedule
• Stay physically active, but avoid exercises that exacerbate symptoms
• Practice stress management techniques

Support Systems

Don’t underestimate the importance of emotional support:

• Communicate with family and friends about your condition
• Consider joining a support group for individuals with chronic headaches
• Seek professional counseling if cough headaches are significantly impacting your mental health

Working with Healthcare Providers

Maintain open communication with your medical team:

• Keep a headache diary to track triggers and symptoms
• Attend regular follow-up appointments
• Discuss any new symptoms or concerns promptly
• Be proactive in exploring treatment options and adjustments

By implementing these strategies and working closely with healthcare providers, many individuals with cough headaches can effectively manage their symptoms and maintain a good quality of life.

Possible Causes & What To Do

Written by Paul Frysh

Medically Reviewed by Jennifer Robinson, MD on August 22, 2021

• Causes of Cough Headache
• Cough Headache Symptoms
• Diagnosis
• Treatment

Ever notice that if you cough a little too hard, your head hurts for a bit? That’s a cough headache. It can also happen when you laugh, sing, sneeze, poop, bend over, blow your nose, or otherwise strain yourself. It’s often harmless and goes away quite quickly on its own, but it’s a good idea to tell your doctor because there could be a more serious cause.

There are two types of cough headache. Each has a different cause:

Primary cough headache: Doctors know that the strain from a cough, sneeze, or laugh causes the headache. But they aren’t sure why it hurts.

Secondary cough headache: There’s an illness or condition to blame. The most common one is a defect called Chiari type 1 in which the shape of your skull forces the lower, rear part of your brain (it’s called the cerebellum) down and into your spinal canal. Other causes include:

• Other defects in the shape of the skull
• A weak blood vessel that balloons out to push on tissue around the brain (cerebral aneurysm)
• A leak or blockage of cerebrospinal fluid that builds pressure around the brain
• A brain tumor

Secondary cough headaches make up nearly half of these types of headaches. That’s why it’s important to talk to your doctor about your symptoms.

A primary cough headache:

• Typically lasts a few seconds or minutes (rarely up to 2 hours)
• Causes sharp, stabbing pain
• Usually causes pain on both sides of your head.
• Starts suddenly, just after you cough, sneeze, or otherwise strain
• Doesn’t cause nausea, watery eyes, runny nose, or sensitivity to light and sound, the way some headaches do

This type of headache is more common after 40 and affects men more than women.

A secondary cough headache:

• Will have symptoms that vary, depending on the cause
• Typically has more — and more serious — symptoms
• May last for hours or weeks instead of just seconds
• Will hurt at the lower, back part of the skull if cause by a Chiari formation
• May cause dizziness, facial numbness, blurry vision, balance problems, and fainting if it comes from a Chiari formation

Secondary cough headaches are more common before you turn 40.

The doctor will ask about your symptoms. They’ll want to know what your headaches feel like and how long they last. A stabbing pain on both sides of your head that goes away in a few seconds could mean a primary headache. A dull ache on one side of the head that lasts for several days might suggest a secondary type.

They may also take special pictures of your brain and skull with a computerized tomography (CT) scan or magnetic resonance imaging (MRI) machine. These can show problems in the shape of your skull, brain, or other parts of your head that could cause head pain when you cough. Only after your doctor rules out secondary causes can you be sure that your cough headaches are the more harmless primary type.

Primary cough headache: Once they’ve ruled out secondary causes, your doctor may prescribe medication to ease inflammation linked to primary cough headache pain. The drug of choice is indomethacin. Doctors don’t know exactly why it works, but it may relieve pressure around your brain and skull.

Your doctor might prescribe medications made to treat other illness off-label for a primary cough headache. These include acetazolamide, propranolol, methysergide, naproxen, ergonovine, and others.

In rare cases, your doctor might do a procedure called a spinal tap to remove some spinal fluid and ease the pressure that could be causing your headache.

Secondary cough headache: Treatment depends in large part on the cause:

• Chiari formation: Medication like indomethacin can ease your pain. Your doctor might suggest surgery to change the shape and relieve pressure.
• Cerebral aneurysm: You might have a procedure to seal off the aneurysm, or a flow diverter to deprive it of blood.
• Brain tumors: Treatment is usually surgery, radiation, and chemotherapy.

That’s why it’s so important for your doctor to figure out the cause of your cough headache before starting treatment.

Top Picks

Cough headaches | Sparrow

Overview

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

Cough headaches are fairly uncommon. There are two types: primary cough headaches and secondary cough headaches. Primary cough headaches are usually harmless, are caused only by coughing and get better quickly without treatment. A primary cough headache is diagnosed only when a provider has ruled out possible causes other than coughing.

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

Anyone who has a cough headache for the first time should see their health care provider. The provider can determine whether a cough or something else caused the pain.

Symptoms

Symptoms of cough headaches:

• Begin suddenly with and just after coughing or other types of straining
• Typically last a few seconds to a few minutes — some can last up to two hours
• Cause sharp, stabbing, splitting or “bursting” pain
• Usually affect both sides of your head and may be worse in the back of your head
• May be followed by a dull, aching pain for hours

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

• Longer lasting headaches
• Dizziness
• Unsteadiness
• Fainting
• Ringing in the ears or hearing loss
• Blurred vision or double vision
• Tremor

A cough headache only happens right after coughing. Other headache pain is not a cough headache if you already had a headache when you coughed, or if you have a headache condition such as migraine. For example, people with migraine might find that their headaches get worse when they cough. This is normal, and not a cough headache.

When to see a doctor

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

Causes

Primary cough headaches

The cause of primary cough headaches is unknown.

Symptoms

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 part of the brain is forced through the opening at the base of the skull (foramen magnum), where only the spinal cord should be. Some of these types of defects are called Chiari malformations.
• A weakness in one of the blood vessels in the brain (cerebral aneurysm).
• A brain tumor.
• A spontaneous cerebrospinal fluid leak.

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

Risk factors

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

Prevention

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

• Treating conditions that would cause coughing, such as bronchitis or other lung infections
• Avoiding medications that cause coughing as a side effect
• Getting an annual flu shot
• Using stool softeners to avoid constipation
• Minimizing heavy lifting or bending for long periods

While these steps may help prevent a cough headache, any headache related to coughing or straining should always be checked by your provider.

Diagnosis

Your doctor may recommend brain-imaging tests, such as MRI or CT scans, to rule out other possible causes for your headaches.

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

Treatment

Treatment differs, 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 the pain.

These preventive medications may include:

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

Other medications used to treat primary cough headache include methysergide, naproxen sodium (Aleve), methylergonovine, intravenous dihydroergotamine (D.H.E. 45) and phenelzine (Nardil).

Secondary cough headache

If you have secondary cough headaches, surgery is often needed to fix the underlying problem. Preventive medications usually don’t help people who have secondary cough headaches. However, responding to medication doesn’t necessarily mean that you have a primary cough headache.

Preparing for an appointment

You’re likely to start by seeing your family doctor or a general practitioner. However, in some cases when you call to set up an appointment, you may be referred immediately to a neurologist.

Because appointments can be brief, and because there’s often a lot of ground to cover, it’s a good idea to be well prepared for your appointment. Here’s some information to help you get ready 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, major stresses or recent life changes, recent accidents, details about what happened when the cough headache started, and any medical problems that run in your family.
• Make a list of all medications, vitamins and supplements that you’re taking.
• Take a family member or friend along, if possible. Sometimes it can be difficult to remember all of the information provided to you during an appointment. Someone who accompanies you may remember something that you missed or forgot.
• Write down questions to ask your provider.

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

• What’s the most likely cause of my headaches?
• Are there any other possible causes?
• What kinds of tests do I need?
• When will these headaches go away?
• What treatments are available?
• Are there any alternatives to the primary approach that you’re suggesting?
• I have these other health conditions. How can I best manage these conditions together?
• Should I see a specialist?
• Is there a generic alternative to the medicine you’re prescribing me?
• Are there any brochures or other printed material that I can take home with me? What websites do you recommend?

What to expect from your doctor

Your doctor or provider is likely to ask you a number of questions. Being 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 begin experiencing cough headaches?
• Have your cough headaches been continuous or occasional?
• Have you had a similar problem in the past?
• Have you had other kinds of headache? If so, what were they like?
• Has anyone in your immediate family experienced migraines or cough headaches?
• What, if anything, seems to improve your headaches?
• What, if anything, makes your headaches worse?

why there is a headache in the back of the head, temples or frontal part during coughing

Published: April 17

Updated: May 16

Reading time: 4 minutes

Cough is a frequent companion of respiratory infections and allergies. Often, coughing attacks cause a person severe discomfort and are accompanied by a headache. Most often, this symptom is harmless and goes away on its own after recovery. However, if the pain is sharp, intense and does not disappear for several days, you need to understand the causes of its occurrence.

Why does my head hurt when I cough?

Headache, or cephalalgia, which occurs only when coughing, is usually not associated with any disease. It accompanies coughing attacks and goes away on its own along with other symptoms. The mechanism of its occurrence is simple. The brain and spinal cord are surrounded by cerebrospinal fluid (CSF). At the moment of coughing, due to strong tension, its fluctuations occur, intracranial pressure increases and sensitive nerve endings are compressed.

There are other causes of cephalalgia on the background of cough attacks:

• increased blood pressure – a short-term rise is caused by muscle tension, especially against the background of a painful dry cough, while between attacks the pressure in the vessels quickly normalizes;
• decrease in the level of oxygen supplied to the brain – an inflammatory process in the respiratory tract against the background of SARS is accompanied by the development of edema, difficulty breathing through the nose, so the patient has a severe headache, especially when coughing;
• intoxication of the body – during influenza and other viral infections, a large amount of toxins accumulate in the body, which irritate the nerve endings and provoke cephalalgia.

There is also a secondary headache. It occurs due to coughing, but the main reason lies in serious problems with the brain or other structures located nearby. These include:

• Arnold-Chiari syndrome – a congenital pathology in which the cerebellum compresses the spinal canal and interferes with the free circulation of cerebrospinal fluid;
• brain tumors and cysts ;
• sinusitis – when inflammation in the paranasal sinuses, the head starts to hurt when coughing and bending forward.

You can guess the cause of cephalalgia by its localization.

When coughing, headache in the frontal part

The main cause of headache in the forehead when coughing is inflammation of the frontal sinuses , or frontal sinusitis . This condition often develops as a complication of SARS. In addition to headache, with frontal fever, weakness, nasal congestion and mucopurulent discharge appear. But not only coughing provokes increased pain. The forehead hurts when the body is tilted forward and when the fingers are pressed into the area above the eyebrows.

Another cause of cephalalgia when coughing in adults is increased intracranial pressure . Pain sensations increase gradually, become bursting and are localized in the forehead. If measures are not taken in time, then the pain spreads throughout the head, it becomes painful for a person to move his eyes, nausea and vomiting are possible.

When coughing, headache in the temples

Headache in the temples when coughing is typical for influenza and other SARS . The second reason why whiskey hurts is increased intracranial or arterial pressure . At the moment of coughing, tension arises, which provokes a rise in pressure.

Back of the head hurts when coughing

The main cause of headache in the back of the head when coughing is cervical osteochondrosis . In a healthy person, the intervertebral discs are resilient and elastic, so they do a good job of shock absorber function. If the cartilage becomes thinner and deformed, then the vertebrae gradually change their position. If measures are not taken in time, the pain gradually spreads to other parts of the head to the back of the head.

Cervical osteochondrosis pain is aggravated by coughing. This is due to compression of the nerve endings due to a sharply increasing tension. In addition to the headache in the back of the head, there is a feeling of congestion and tinnitus.

Cough headache – what to do?

The most effective way to get rid of cephalalgia against the background of coughing attacks is to find and eliminate the cause of unpleasant symptoms. To do this, you need to consult a doctor. With severe pain, you can drink an anesthetic from the group of non-steroidal anti-inflammatory drugs.

Depending on the results of the examination, the specialist may prescribe:

• antivirals to fight the flu and colds;
• antibiotics if bacterial infection is confirmed;
• preparations for correcting blood pressure levels;
• medicines for symptoms of SARS and intoxication, for example, antipyretics at a temperature;
• cough medicines.

To combat painful attacks of both dry and wet cough with sputum, a specialist may recommend the use of Rengalin. It consists of three components that help reduce the activity of the cough center, moderate expansion of the bronchi to remove sputum and eliminate swelling and inflammation. The drug can be taken by adults and children from 3 years of age. It is available in the form of lozenges and oral solution. Before use, you should consult with your doctor.

Similar articles

December 22

Cough inhalation

01 October

Allergic cough

02 Dec

Cough at night

Rengalin is the most prescribed antitussive drug. According to the 2019 RxTest™ Prescribing Audityear. Database “Market research system “Pharmxplorer”, conducted by Proxima Research LLC.

Rengalin No. 1 on the Russian market of cough medicines. Monthly monitoring of the pharmaceutical market DSM Group, November 2022

Why does my head hurt when I cough?

Irritation and itching in the respiratory tract, accompanied by cephalgia, is uncommon. When coughing, the head hurts only during a strong attack. Unpleasant sensations last no more than 5-10 minutes. They occur as a result of the fact that coughing provokes an increase in pressure. By its nature, this symptom is similar to pain caused by physical exertion. In most cases, patients have bilateral intense cephalgia. Medical statistics show that men suffer from this problem 4 times more often than women. Often the symptom is associated with nicotine addiction. In some cases, this kind of cephalgia can become chronic. This may indicate the beginning of the development of an intracranial tumor.

The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact a specialist.

Sore throat accompanied by cephalalgia occurs predominantly in men over 40 years of age. The main causes of pain in the head when coughing are:

• Heavy lifting;
• Arnold-Chiari syndrome;
• Excessive exercise;
• Violent sneezing;
• High pressure in cerebral vessels;
• Smoking;
• Bronchial asthma;
• Allergic reaction.

In most cases, if a person has a headache when they cough, no intensive medical treatment is required. The only exceptions are tumor formations. To establish how serious the cause of cephalgia is, it is necessary to undergo a study with a specialized specialist.

Diagnosis of headaches when coughing

To rule out possible pathologies in cephalalgia, you should consult a general practitioner for an examination as soon as possible. Before visiting a specialist, it is recommended to go through an online self-diagnosis on our website. Its results will help the patient to navigate what to look for when visiting a doctor. Diagnosis of headaches when coughing is necessary in order to exclude the presence of dangerous diseases, for example, the development of intracranial formation. If a patient has a headache when coughing, he is prescribed the following tests:

Which doctor should I contact?

If you have a headache when you cough, you should see a doctor in the following specialty:

Our specialists

Suvan-ool Marina Anatolyevna

Therapist
Gastroenterologist
Pulmonologist

83%

Satisfied with the result of treatment

m.
Therapist

98%

Satisfied with the result of treatment
Gastroenterologist
Nutritionist

98%

Satisfied with the result of treatment

m.0002 Cardiologist
Therapist

98%

Satisfied with the result of treatment

m. 0002 Satisfied with the result of treatment

m. Street 1905 Goda

Olga Alexandrovna Torozova

Therapist
Gastroenterologist

98%

satisfied with the result of treatment

m. Some diseases are difficult to diagnose as they say “by eye”.