Primary Exertion Headaches

[Sly Saint]

wondering if this might be related to PEM?

The cause is as yet unknown although there are some hypotheses.

Diagnostic criteria include two or more headaches that are brought on by, and occurring during or after, strenuous physical activity and that last more than 48 hours.

Presentation
Exertional headaches generally present unilaterally with moderate-to-severe pain that is pulsating in nature.1 In one retrospective analysis, approximately one-third of patients reported neck pain as the initial symptom at headache onset.5 This symptom was more commonly associated with exercise headaches than with typical migraines, especially in men.

Although the diagnosis of primary exercise headache remains distinct from that of migraine, these two conditions often share similar characteristics, such as nausea, vomiting, scotomas, and photophobia.1,6 If a patient experiences an aura, an additional diagnosis of migraine with aura should be considered. The element unique to exercise headache is its onset during or shortly after completing exercise. Several studies analyzing exercise headaches found that they occurred most commonly after weightlifting, distance running, or other aerobic activity, possibly because of increases in intracranial pressure during these activities.5-8 Other triggers include insufficient warm-up, extreme heat or cold, dehydration, hypoglycemia, and fatigue or extreme exercise.6,8

https://www.uspharmacist.com/article/exerciseinduced-headaches-prevention-management-and-treatment

this is obviously aimed at healthy people who exercise and suggests 'building up tolerance'.
(hmm where have I heard that before.)

 

[Peter T]

Interesting. It is not something I had heard of.

Headaches and migraine type headaches are a feature of my ME/PEM and of my food intolerances though in both instances they are delayed, however when I my ME was milder and I was more likely to push through I could also get headaches that kicked in during activity. These could happen during physical exertion though they were more likely when I was still working to kick in on my drive home.

I also remember one occasion having taken my godson and his girl friend out for the day really struggling to drive home through the headache and ending up throwing up as I got out of the car. However, then I was generally doing too much and it was before I was aware of my food intolerances, so it was harder to know what was due to what.

 

[Midnattsol]

As a kid exercise was a trigger for my migraines that could last up to three days. I have wondered sometimes if it was the first signs of my ME, but I outgrew it and headaches are not a common PEM symptom for me (I can get pulsating pain around the eyes at times I've overexerted myself, but it is nowhere near what it used to be and is not always followed by other PEM symptoms).