Cough is one of the most common reasons we visit our doctor. It can be your run-of-the-mill type that comes every now and then and comes with a runny nose. Other times, it may be a symptom of a more serious condition affecting your lungs, heart, or other organs. One sign worth noting is whether there is a headache besides the cough. Is this normal? Or should you be concerned?

Cough Headaches

Overall strain to your body, such as coughing or sneezing, often triggers headaches. You might strain yourself even without noticing: when you blow your nose, laugh, cry, sing, bend over, lift heavy objects, and even during bowel movement. Cough headaches can be primary or secondary. Though they may share some similarities, they differ in the root cause, severity of symptoms, and treatment.

Primary Cough Headache

Although the exact cause of a primary cough headache is not yet well known, one theory involves increased pressure. When you cough, pressure increases in your lungs and abdomen to expel air. This rise in pressure can also affect the brain, leading to a headache. This type of headache may manifest as a sharp, stabbing pain immediately after coughing or straining. It usually lasts for about 1 second to 30 minutes. Pain is moderate to severe in intensity, and it usually affects both sides of the head. There is no accompanying nausea, vomiting, or sensitivity to light and sound. Overall though, these headaches are harmless and do not result from conditions in the head or brain.

Secondary Cough Headache

While a secondary cough headache may also be triggered by coughing or straining, these are usually due to structural problems in the brain. The most common cause is a Chiari Malformation Type I, wherein there is a defect in the part of the brain responsible for balance. Other causes include brain tumors, a leak of the cerebrospinal fluid (specialized fluid that cushions, nourishes, and cleans the brain and spinal cord), brain aneurysm, or a hematoma.

Because of these serious conditions, patients frequently feel headaches when coughing, laughing, and other forms of straining. These usually last longer than a minute and can be felt in the back of the head. Pain severity is moderate to severe and is described as bursting, explosive, or pressing. The affected person may also experience dizziness, unsteadiness, and numbness of the face and upper limbs. In short, there is more cause for alarm with secondary cough headaches.

Diagnosis

Depending on your symptoms, your doctor may request a CT scan or an MRI (computed tomography or magnetic resonance imaging) to aid in diagnosis. If there are no significant findings, this is most likely a primary cough headache. However, suppose there are findings of a brain tumor, build-up or leak of cerebrospinal fluid, or aneurysm. In that case, this is most likely a secondary cough headache. Additionally, your doctor may request a lumbar puncture (a needle prick on your lower back) to assess the pressure and volume and measure substances present in the cerebrospinal fluid.

Treatment

Effective treatment addresses the root cause of the headache. Primary cough headaches usually resolve on their own after about 30 minutes. Because of this, you usually will not need any medication. However, since cough headaches can be disruptive to your daily life, preventive treatment may be necessary. In contrast, secondary cough headaches might require surgery to address the underlying cause.

Calling Your Doctor

Your doctor will probably have many questions for you about your headache. Try your best to remember important details about your condition, which could greatly help your doctor. Here are some they might ask:

• When did you first experience the cough headache?
• Have they been continuous or occasional?
• Did you experience this in the past?
• Have you had other kinds of headaches? What were they like?
• Has anyone else in your family experienced these headaches?
• Have you noticed anything that improves your headache?
• What do you think makes your headache worse?

These will provide helpful cues in your doctor’s diagnosis and the treatment that will follow. If this time of pandemic has taught us anything, it is to be extra vigilant when it comes to our health. Consult your doctor immediately if you experience sudden headaches after coughing. It is also worth mentioning if your headaches occur frequently and are severely painful. Other warning signs include changes in your balance or vision. It is always best to play safe than be sorry later on.

Cough Headaches at a Glance

Here is a table summarizing all you need to know about cough headaches. Hopefully, it will give you a keener insight into your cough experience and help your doctor diagnose and treat it.

While we can see some similarities between the two, primary and secondary cough headaches clearly differ in terms of the severity of their symptoms, cause, and treatment. Always be vigilant and pay attention to what your body is telling you. Recognizing your symptoms is the key to early and appropriate intervention. This knowledge will hopefully save you time and headaches (pun intended) in the future.

Click here if you want to learn more about cough headaches and what to expect when consulting your doctor.

Mikaela Millan

Mikaela is a dentistry clinician at the University of the Philippines.