Why does my head hurt after exercise

Tension headache

Tension headache: Most common headache disorder with dull, pressing (not pulsating) pain in the entire head. Depending on the frequency of occurrence, a distinction is made between episodic and chronic tension headaches. The chronic form in particular can become a problem due to the impairment of the quality of life and the frequent abuse of pain medication. The disease often begins in young adulthood; women are more often affected than men.

Leading complaints

  • Constant dull headache, mostly in the entire head ("like a vice") or emphasizing the back of the head
  • Duration ½ hour to a week. Duration and severity vary from infrequent, brief, mild headaches to constant daily headaches.
  • No increase in physical activity
  • Everyday activities are “more arduous” than normal, but otherwise not impaired
  • At most, slight fear of noise or light, or slight nausea without vomiting
  • No further complaints or failures (such as visual disturbances).

When to the doctor

In the next two weeks, if the headache recurs frequently or a previously successful self-treatment is no longer effective.

In the next few days, if the headache does not go away even after several days despite self-treatment

Even today, when a severe headache occurs for the first time, the headache is very strong or does not respond to "anything" (anymore)

Immediately if the headache is accompanied by a high fever and a stiff neck, impaired consciousness or failures such as speech disorders.

The illness

The tension headache is the most common type of headache - everyone is familiar with this dull, pressing pain that actually doesn't hurt that much, but wears you down if you persist for a long time.

The tension headache becomes a problem when it occurs more frequently. Around 20–40% of the population, in Germany over 25 million, suffer from episodic tension headaches (a total of more than ten observed attacks, but headaches on less than 180 days per year), around 2–3% even from chronic tension headaches that exceed occur on at least 15 days per month for more than six months.

The cause of more frequent tension headaches is still unclear. Due to the familial accumulation, a hereditary predisposition seems likely. As far as we know today, changes in the processing of pain in the brain play a role, which subsequently leads to a lowering of the pain threshold. Whether the often observed tension in the neck muscles, one-sided physical strain (e.g. when working on the computer), stress or other psychological factors are the cause or whether the changed pain perception is the basis on which these factors then trigger the headache, is unclear.

The headache is to be delimited as Concomitant symptom an incipient cold, otitis media or toothache, but also as a result of a brain tumor or meningitis. These have an identifiable cause, and the real problem is usually not the headache, but the underlying illness.

The doctor does that

Further examinations are only required if the symptoms do not really fit into the pattern of the typical tension headache or the doctor finds abnormalities during the physical examination, most often imaging procedures such as CT or magnetic resonance imaging to rule out tumors or bleeding.

Medication is a double-edged sword for tension headaches:

  • On the one hand, untreated headache is associated with learning experiences in which the pain is engraved in the memory. This pain memory favors the development of a chronic headache.
  • On the other hand, even "banal" painkillers, if taken frequently, have serious side effects

For occasional headaches, adults can safely use 500–1000 mg acetylsalicylic acid (e.g. Aspirin®), 500–1000 mg paracetamol (e.g. ben-u-ron®), 400 mg ibuprofen (e.g. Dolo-Puren ®) or 500–1000 mg naproxen (e.g. Proxen®) if non-drug self-help measures are unsuccessful. For children and adolescents under 16 years of age, the dose is reduced according to the information on the package insert. Acetylsalicylic acid must not be given to children and adolescents, however, as it can trigger the dangerous Reye's syndrome with brain and liver damage if a virus infection occurs at the same time. Paracetamol is most likely to be recommended for pregnant women if it is not possible to dispense with medication.

For acute tension headaches, several international medical societies recommend 1,000 mg acetylsalicylic acid (e.g. Aspirin® or ASS Ratiopharm®), 12.5–25 mg diclofenac (e.g. Diclofenac Ratiopharm® Schmerztabletten), 400 mg ibuprofen as the first choice (e.g. Ibubeta® or Dolo-Puren®) or the fixed combination of 500 mg paracetamol and 65 mg caffeine. The combination of 250–265 mg acetylsalicylic acid, 200–265 mg paracetamol and 50–65 mg caffeine (e.g. Neuralgin® pain tablets or Thomapyrin® Intensiv) has proven to be the most effective; the single dose here is 2 tablets. Taking 1,000 mg of paracetamol alone is a second choice.

There is a risk of taking pain medication (analgesics) for several weeks or even continuously Analgesic headache. With these dull, oppressive or pulsating headaches, only one thing helps: consistently omitting all painkillers.

If tension headaches occur frequently, pain relievers are therefore not considered. Here a combination of lifestyle changes and preventive medication is most likely to be successful. Are used v. a. various antidepressants (such as amitriptyline, e.g. Saroten®). These preventive drugs are taken on a daily basis whether there is a headache or not. If necessary, several medications have to be tried, whereby their effectiveness can only be estimated after about six weeks.

Your pharmacy recommends

A hot shower or a full bath have proven effective as a means of quick self-help. Take 10–20 minutes for the full bath and try to relax in the 36–38 ° C warm water. Bath additives made from spruce needles and rosemary promote blood circulation, valerian and hops soothe, arnica and hay flowers relieve pain. Then treat yourself to z. B. with a lemon balm tea some rest.

Rest and sleep also often help and can be combined well with heat or cold applications: For pain that emphasizes the back of the head and a "tense" feeling in the neck, heat is more suitable, otherwise cold applications on the forehead are more promising.

At the same time, you should ask yourself what is causing the headache and try to eliminate the cause - a new mattress or a new work chair combined with regular relaxation exercises often relieve muscle tension and thus the headache problem. If the headache occurs in the evening and it has been some time since the last visit to the ophthalmologist, (new) glasses may also be required, because "strained" vision can be expressed not only by poor vision, but also by headaches. If the headache is triggered by stress, it is worth learning a relaxation technique if it occurs frequently.

In addition, if you have frequent headaches, you should get enough sleep and a regular daily routine as well as regular endurance sports (every 2nd or 3rd day). Even if these measures can be annoying - they increase z. B. the effectiveness of preventive drugs is essential.

Complementary medicine

Herbal medicine.

The natural pharmacy offers effective and well-tolerated aids for mild to moderate tension headaches. A proven remedy is peppermint oil, a few drops of which are gently massaged into the forehead and temples (e.g. Euminz® solution, China-Oil® distillate, Inspirol® medicinal plant oil solution). Its pain-relieving effect has been scientifically proven. In addition, the relaxing effect of the massage helps to improve the symptoms. In children, too, tension headaches can be alleviated with the help of peppermint oil (e.g. wild herb oil special K®). Important: In any case, keep your eyes out of any contact with the oil and wash your hands thoroughly after rubbing in.

Willow bark extracts appear to be pain relievers in some cases. Drugs and ready-to-use drugs with a fixed proportion of the main active ingredient salicin are better than tea. In addition, willow bark preparations have the advantage of being well tolerated by the stomach. The recommended daily dose is 180–240 mg total salicin (e.g. Assalix® coated tablets, Assplant® coated tablets, Lintia® capsules).

Autogenic training.

Autogenic training is recommended for both the prevention and treatment of milder forms of acute tension headache. The forehead cooling exercise is the crucial part of the exercise program and aims at comprehensive relaxation. Autogenic training should be carried out regularly and is taught by doctors, psychologists and community colleges. Autogenic training is mostly learned in a group. It is also possible to do it alone at any time.


Massages against muscle tension in the head and neck area are easy to perform yourself. To do this, massage your temples with your index and middle fingers using light pressure and circular movements. Important: massage for at least five minutes. The ball of the hand can also be used instead of the fingertips.

Acupuncture and acupressure.

According to a large German study, acupuncture can both effectively relieve acute tension headaches and reduce the number of chronic headache days. However, acupuncture according to the rules of traditional Chinese medicine has shown itself to be only slightly more effective than sham acupuncture with arbitrary acupuncture points. The same acupuncture points are also accessible through acupressure, a scientific proof of effectiveness is still pending. If you want to treat yourself, have a qualified therapist instruct you beforehand.


Homeopathy provides Gelsemium D4 and D6.

Further information

  • www.dmkg.de - website of the German Migraine and Headache Society e. V., Rostock: Offers a. Therapy recommendations and current research results.
  • H. Göbel: Successful against headaches and migraines. Springer, 2004. In the meantime, the 4th edition of the tried and tested guide of the chief physician of the Kiel Pain Clinic.


Dr. med. Nicole Menche, Dr. med. Arne Schäffler in: Gesundheit heute, edited by Dr. med. Arne Schäffler. Trias, Stuttgart, 3rd edition (2014). Revision and update: Dr. med. Sonja Kempinski | last changed on at 16:05

Important note: This article has been written according to scientific standards and has been checked by medical professionals. The information communicated in this article can in no way replace professional advice in your pharmacy. The content cannot and must not be used to make independent diagnoses or to start therapy.