Head pain upon coughing, often localized to the temples, is a common experience. These “cough headaches” can range from benign, temporary annoyances to indicators of more serious underlying health conditions. Understanding the various reasons why a cough might trigger such pain is important for recognizing when medical evaluation is necessary.
Understanding Primary Cough Headaches
Primary cough headaches are a headache brought on by coughing, sneezing, laughing, or other straining activities. These headaches are not caused by an underlying structural problem in the brain. They are relatively uncommon and considered harmless.
The pain begins suddenly with the cough or strain and lasts from a few seconds to a few minutes, though some can persist for up to two hours. The pain is described as sharp, stabbing, or bursting, and can be felt on both sides of the head, including the temples. While the exact cause is not fully understood, it is thought that the sudden increase in pressure within the chest and abdomen during coughing leads to a temporary rise in pressure inside the skull, triggering the pain. They are more common in individuals over 40.
Exploring Secondary Causes
When temple pain is triggered by coughing, it can indicate a more serious underlying medical condition, known as a secondary cough headache. These conditions involve structural issues within or around the brain and spinal cord. It is important to distinguish these from primary cough headaches due to their potential for significant health implications.
Chiari malformation is one condition, where brain tissue extends into the spinal canal through the skull’s base. This structural anomaly can lead to pressure changes during coughing, as the brain tissue is displaced, causing pain. Brain tumors can also cause pain worsened by coughing because a growing tumor can increase intracranial pressure or press on surrounding brain tissue. Headaches associated with brain tumors may be worse in the morning and can feel like tension headaches, sometimes exacerbated by straining.
Aneurysms, weakened areas in a blood vessel, can also be a cause. While a cough alone is unlikely to cause an aneurysm, forceful coughing can temporarily increase intracranial pressure, potentially straining an existing weakened blood vessel. Sinusitis, an inflammation of the sinus cavities, can also lead to head and temple pain that worsens with coughing due to increased pressure. Cerebrospinal fluid (CSF) leaks, where the fluid cushioning the brain and spinal cord escapes, can cause headaches often worse when standing and exacerbated by coughing due to fluid pressure changes.
When to Seek Medical Advice
If you experience headaches when coughing, especially if new or concerning, seeking medical evaluation is important. A sudden, severe headache triggered by coughing warrants prompt attention. This is particularly true if the headaches are new, frequent, or worsening over time.
Other symptoms that should prompt a medical consultation include headaches accompanied by neurological changes such as vision problems like blurred or double vision, dizziness, unsteadiness, or numbness. If the headache wakes you from sleep, or if it is different from any headaches you have experienced before, these are also reasons to consult a healthcare provider. If the cough itself is persistent, lasts longer than three weeks, or is accompanied by fever, shortness of breath, or coughing up blood, medical advice should be sought.