Experiencing head pain on the left side when coughing can be a concerning symptom. While frequently a benign occurrence, this specific type of pain may sometimes indicate underlying health issues. Understanding the various possibilities is important for anyone experiencing this symptom.
Benign Causes of Cough-Induced Head Pain
A common reason for head pain, often on one side, when coughing is a sudden increase in intracranial pressure. When you cough forcefully, pressure inside your chest and abdomen temporarily rises, transmitting pressure to the head. This rapid surge can cause sharp, short-lived pain, sometimes felt intensely on one side or in the front and sides.
Muscle strain in the neck or head can contribute. Forceful or repetitive coughing engages neck muscles, such as the sternocleidomastoids and scalenes, to expel air. This exertion can lead to fatigue, stiffness, or spasms, resulting in pain localized to the left side of the head or neck.
Tension headaches, often causing a dull, aching pain around the head, can be exacerbated by coughing. Coughing can intensify existing headache pain or trigger a new one, sometimes on one side. Sinus pressure, especially from sinusitis, can also cause head pain that worsens with coughing due to increased pressure within the sinus cavities. This pain may be felt on the left side if affected sinuses are predominantly on that side.
Dehydration can lead to headaches, which may be aggravated by coughing. When the body lacks fluids, brain tissue can temporarily shrink, pulling away from the skull and putting pressure on surrounding nerves, resulting in pain. This headache can be felt anywhere, including the left side, and the jarring motion of a cough can make discomfort more noticeable.
Potentially Serious Underlying Conditions
While often benign, head pain from coughing can signal serious underlying conditions. One type is a primary cough headache, characterized by pain triggered only by coughing, sneezing, or other straining activities. These headaches cause sharp, stabbing pain, lasting seconds to minutes, and can affect one or both sides of the head.
Secondary cough headaches are symptoms of an underlying structural issue. A common cause is Chiari malformation type I, where brain tissue, specifically the cerebellum, extends into the spinal canal due to a smaller or misshapen skull. This can obstruct cerebrospinal fluid flow, and pressure changes from coughing can exacerbate symptoms, often causing pain in the back of the head that may be felt on one side, along with other neurological symptoms.
Brain tumors, though rare, can cause headaches worsened by coughing or straining. The tumor can increase pressure inside the skull by its size, surrounding swelling, or by blocking cerebrospinal fluid flow. This pain may be felt on one side, depending on the tumor’s location. Cerebral aneurysms, weak, bulging blood vessels in the brain, can also cause head pain, and increased pressure from coughing could aggravate them. Other intracranial lesions, or cerebrospinal fluid leaks or blockages, can also lead to secondary cough headaches.
When Medical Attention is Necessary
Prompt medical evaluation is warranted for head pain when coughing under certain circumstances. Seek medical attention if the pain is severe or has a sudden, “thunderclap” onset. Pain that is new, frequent, or progressively worsening also indicates a need for professional assessment.
Accompanying neurological symptoms are concerning. These include weakness, numbness, vision changes (such as blurriness or double vision), difficulty speaking, or problems with balance and coordination. Other red flags include fever, a stiff neck, unexplained weight loss, or a new cough headache appearing after age 50. Any headache that wakes you from sleep should be discussed with a healthcare provider.
Diagnosis and Treatment Approaches
Diagnosing head pain when coughing involves a comprehensive approach by a healthcare provider. The process begins with a detailed medical history, where the doctor asks about the headache’s nature, duration, frequency, and any associated symptoms. A physical and neurological examination follows to assess reflexes, balance, vision, and other neurological functions.
Imaging tests are often necessary to rule out underlying structural issues. A Magnetic Resonance Imaging (MRI) scan of the brain is often preferred as it provides detailed images of brain tissue, nerves, and blood vessels without radiation. A Computed Tomography (CT) scan may also be used, particularly in acute situations, to visualize the brain and skull. Sometimes, a lumbar puncture (spinal tap) may be performed to analyze cerebrospinal fluid or relieve pressure.
Treatment depends on the identified cause. For benign cough headaches, management may involve over-the-counter pain relievers or addressing the underlying cough. If a primary cough headache is frequent and disruptive, preventive medications like indomethacin, which can reduce pressure around the brain, may be prescribed. For secondary cough headaches caused by structural problems, specific medical or surgical interventions are often required. For instance, Chiari malformation may require surgery to create more space for the brain.