Cough headaches are a type of headache that occurs when coughing, sneezing, or straining. These headaches are usually brief and typically resolve on their own once the underlying cause is addressed. They are usually not a cause for concern but may be a sign of an underlying medical condition in some cases.

Cough headaches are often described as sudden, sharp pain that occurs on both sides of the head and can last anywhere from a few seconds to a few minutes. The pain is often felt in the back of the head and may be accompanied by other symptoms such as nausea, dizziness, or neck pain.

The exact cause of cough headaches is not known, but they are believed to be related to changes in pressure within the skull that occurs during coughing, sneezing, or straining. Cough headaches may be more common in people who have a history of migraines, and may be associated with conditions such as Chiari malformation or other structural abnormalities of the brain.

Treatment for cough headaches may involve addressing the underlying cause, such as treating a sinus infection or allergy that may be causing the cough. In some cases, medication may be prescribed to help manage the pain and other symptoms associated with cough headaches.

While cough headaches are generally not a cause for concern, it is important to seek medical attention if experiencing frequent or severe headaches, or if other symptoms such as fever or neck stiffness are present. This can help identify any underlying conditions that may require treatment, and help prevent more serious complications from occurring.

Primary cough headaches

The cause of primary 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 cerebellum, the part of the brain that controls balance. This can occur when a portion of the brain is forced through the opening at the base of the skull (foramen magnum), where only the spinal cord is supposed to 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.

Preventing the actions that trigger your cough headaches — whether that's coughing, sneezing or straining on the toilet — may help reduce the number of headaches you experience. Some preventive measures may include:

• Treating lung infections, such as bronchitis
• 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

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, Tivorbex), an anti-inflammatory drug
• Propranolol (Inderal, Innopran XL, others), 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 naproxen (Naprelan, Naprosyn, others), ergonovine (Methergine), intravenous dihydroergotamine (D.H.E. 45) and phenelzine (Nardil).

Rarely, a spinal tap (lumbar puncture) may be recommended. With this procedure, the doctor removes some of the fluid that surrounds your brain and spinal cord. It's not clearly understood why this helps cough headaches, but the procedure may reduce the pressure inside your skull that may be causing the headaches.

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.