When I cough my head hurts on the left side can be a common complain of the people around you? How do you tackle with such complaints? What can be the causes of such complaints? Are these benign or serious?
Cough is a protective reflex that performs its normal physiological function of removing excess secretions and debris from the airways. The cough reflex consists of three components: the afferent sensory limb, the central processing center, and the efferent limb.
Contents discussed in the article:
Types of headaches
- Primary cough headache:
These types of headaches are usually harmless and limited in episodes and have been seen to improve on its own. This is caused due to pressure in the abdomen, sudden pressure in the abdomen caused due to coughing, also leading to pressure in head causing cough headache.
These types of headaches can be triggered by other factors other than cough like laughing, sneezing, bowel movements, heavy exertion like straining the abdomen.
No specific cause of primary headaches has been seen to be present.
Risk factors of primary cough headache:
Age: Age more than 40 years are usually seen to be affected.
Sex: Men are seen to be more prone than women
Symptoms involved in primary headache:
Characteristic of pain is usually sharp and stabbing, or splitting pain.
Location of pain is usually felt on the frontal area.
The pain can be bilateral.
After an episode of sharp pain, a dull pain can be followed, lasting for hours.
Usually lasts for seconds to minutes and can rarely last till hours (2hours).
This type of headache has not been seen to be associated with runny nose, watery eyes, sensitivity to physical factors like light and sound are not present as well.
- Secondary headaches:
Secondary headaches are due to an underlying condition. These conditions are very diverse and versatile and the most common of them is Chiari type I malformation. Other conditions include: posterior fossa lesions like tumors, hydrocephalus (obstructive), internal leak of CSF resulting in sudden decrease in CSF (cerebrospinal fluid), weak blood vessels, subdural hematoma (collection of blood outside brain). Some other conditions like laughing, weightlifting, or change in posture of body in synergism with above mentioned conditions can also cause secondary cough headaches.
Causes of secondary headaches can be attributed to:
Defective head or skull shape
Defect in the cerebellar part of the brain, which controls the balance. In this defect this part of the brain is forced through the opening at the base of the skull called as Foramen magnum. At the level of foramen magnum only spinal cord is supposed to exist.
Chiari malformation is a condition in which brain tissue dilates into the spinal canal. This happens when part of the skull is malformed or smaller than normal and pushes down on the brain. Chiari malformations are rare, but with increasing use of imaging techniques, the frequency of diagnosis increases
It starts suddenly after coughing and rapidly increases and you may have to lay down till the pain ceases. If any such symptoms are encounter you might feel a need to go to a doctor so that the root cause can be diagnosed.
Characteristics of pain:
Explosive, bursting, pressuring pain, stabbing, lancing, dull pain.
Headaches that last longer than a minute
Numbness felt in arms and legs
Locations of headache are variable depending on the cause
Pain can be moderate to severe
Pain is usually felt on the back of the head
Risk factors include age younger than 40 years.
Diagnosis can be made on history and physical examinations along with some imaging, all this together can be of great help. Duration and type of headache can lead to the either type of the cough and thus the related mechanisms. Like a headache which lasts for seconds and nearly around the whole head can be categorized as primary cough headache. On the other hand, a headache lasting for several hours to days can be classified as secondary.
CT imaging or MRI can really help in ruling out the primary cause and definitive diagnosis of secondary cause or vice versa. These imaging modalities can help in determining the shape of skull, brain or other parts.
People can treat primary cough headaches at home. Identifying and treating the cause of a cough can help relieve or eliminate headaches. Over-the-counter (OTC) painkillers like ibuprofen can help relieve headache pain.
If a cold or flu causes a cough, cold or flu medications can help relieve the cough and the associated headaches. Cleaning the sinuses also helps reduce pressure in the head. The home remedies you can try if you have a cold or the flu include:
Take over-the-counter cough medicine
Drink warm drinks like honey, lemon and water
Drink plenty of water
Get a flu shot every year if someone is at risk of getting the flu
After coughing, wash your hands with soap and water
Drinking hot drinks such as honey and lemon will calm your throat and make you comfortable if you have a cold or the flu.
Primary cough headache: When the secondary cause is ruled out, the doctor may prescribe medication to reduce the inflammation associated with the primary cough headache. The drug of choice is indomethacin and is believed to relieve pressure around the brain and skull.
If you cannot treat the cause of your cough at home, you should see a doctor. Your doctor may prescribe medication to treat a cough caused by an underlying illness such as a cold or bronchitis. Doctors can prescribe antiviral drugs to people who have the flu.
Doctors may also prescribe other medications to treat primary cough headaches like: Anti-inflammatory drugs such as indomethacin, beta blockers, acetazolamide, which removes excess water and salt from the body ergotamine for migraine. These drugs help reduce inflammation and coughing, as well as relieve pressure and water buildup in the skull.
Your doctor may prescribe medication to treat other primary cough headache disorders that are not indicated. These include acetazolamide, propranolol, methysergide, naproxen, ergonovine and more.
In rare cases, a doctor may remove spinal fluid by a method called spinal puncture/tap to relieve pressure that can cause headaches.
Secondary Cough Headache: Treatment depends primarily on the cause:
Chiari formation: Medications such as indomethacin can relieve your pain. Your doctor may suggest surgery to reshape and relieve pressure of the area caused by the structure.
Cerebral aneurysm: There may be a procedure to seal the aneurysm or flow and drain blood from the aneurysm. Brain tumors: Treatment usually consists of surgery, radiation therapy, and chemotherapy.
This is why it is so important for a doctor to determine the cause of a cough headache before starting treatment, as these treatments include:
Get rid of brain tumors, restoration of normal CSF flow, relieving skull pressure due to excess water, patch holes that cause cerebrospinal fluid to leak etc.
You can reduce the number of headaches you experience by preventing coughing headache-causing behaviors such as coughing, sneezing, and toilet strain. Some precautions include:
Treatment of lung infections such as bronchitis
Avoid drugs that cause coughing as a side effect
Get a flu shot every year
Use stool softeners to avoid constipation
Minimize heavy lifting and bending over long periods of time
When to see a doctor
The main cough headache is benign and may heal spontaneously over time. If you have severe or long-term symptoms, you can see a doctor.
Patients should see a doctor if they experience any of the following:
Fainting, dizziness, or imbalance with headache.
Extreme pain or sudden severe headache
Headache lasting more than 2 hours
Frequent headaches due to cough
Symptoms such as fever, chills, and unexplained weight loss
A headache whose intensity changes when the posture or position is changed from lying down to standing.
Doctors can determine whether a cough headache is primary or secondary through a physical examination and the necessary tests.
Once your doctor has identified the nature and cause of your headache, develop a treatment plan.
In rare cases, a cough can cause a headache. This is often due to extra pressure in the abdomen, which can increase head pressure.
Primary cough headaches are caused only by coughing or other activities such as sneezing or tension. Primary cough headaches are benign and may heal spontaneously.
Secondary cough headaches are more severe and are caused by the following brain disorders: Tumor or skull defect.
People can relieve the headache of a primary cough by reducing or eliminating the cough. Over-the-counter coughs and painkillers are just as helpful as drinking plenty of fluids and resting.
If you have a secondary cough headache, you need treatment for the underlying cause.
If you are not sure if you have a primary or secondary cough headache, or if you are experiencing severe or long-term symptoms, you can see a doctor for diagnosis and treatment.