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Headache the day after riding

Old 08-08-18, 10:59 AM
  #1  
Arthur Peabody
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Headache the day after riding

I rode 30 miles Monday morning. I felt well the whole ride and the rest of the day. I woke at 3 AM with a throbbing headache (at the same beat as my pulse) on the right side of my head, running down to my neck. Nothing relieved the pain, no OTC medicine, not ice packs, not hot compresses, not yoga or other stretching exercises. I was unsafe on my feet and it hurt to focus my eyes. I spent all day either in bed or hunched over in a chair, wishing my head didn't hurt. The pain didn't subside until after midnight. I had no fever or high pulse or high blood pressure or low blood oxygenation.

This has been happening on all of my 'long' rides (>10 miles) the past year or so. I go everywhere on my bike; I haven't driven since 2017 March. I'm 64 and have ridden about 300K miles lifetime. It's taken a number of incidents like Monday/Tuesday's to notice the correlation with riding. I don't know how to make sense of it. Neither does my internist.

Does this make sense to anyone?
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Old 08-08-18, 12:37 PM
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It could be so many things from the street lights or room lights to a tumor , you could be drinking too much or too little water , your water could have lead in it ... best to get scanned and maybe see a sports doctor.
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Old 08-08-18, 02:29 PM
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First thought #IAmNotADoctor is cardiac. If, like most REAL men, you are reluctant to go to a cardiologist, maybe invest in a heart rate monitor?

For advice with a higher level of validity: https://www.mayoclinic.org/diseases-...s/syc-20372276
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Old 08-08-18, 07:13 PM
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I get a headache at night after a long hot ride(30 plus miles), but not on every occasion. I noticed that if I drank alcohol after a ride it upped the chances. Like at dinner having a beer. So, I stopped doing that after a long ride. I also started taking GU Energy Gel without caffeine. This seems to have helped also. I suspect for me it has to do with hydration. An Advil will take the edge off, but it never really clears it. It just takes around 12 hours to completely resolve after one starts. Finally, I love Fig Newtons, so I take a few along on a ride also and eat those. Again the Fig Newtons seem to help, but who knows(they say they are bad for you ). I am 65, so in the same age bracket. I also carry two 24 oz. water bottles and make sure I drink both during a long ride. Even if it means drinking half a bottle when I get back to the house. Finally, I drink a large glass of water prior to leaving the house for a ride to kick start hydration.

Last edited by themp; 08-08-18 at 07:16 PM. Reason: add another thought
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Old 08-08-18, 07:24 PM
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I have had the same thing and in my case, I realized it was that I was straining the neck muscles (riding tense or forgetting to look around if I was pushing hard). I noticed it went away as season progressed (riding more naturally and neck muscles “in shape”). Now, wouldn’t you know, I get the same thing now that I’m trying to life weights, but it is from straining my neck the other way (down/out instead of up).
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Old 08-08-18, 07:26 PM
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Good thing it wasn't an aneurysm...
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Old 08-08-18, 08:11 PM
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You need to see a doctor. See if your internist can come up with some appropriate specialist to see. It could just be a migraine, but these aren't symptoms to ask a bunch of bicyclists to diagnose. It could be something serious and/or easily treatable.

Last edited by livedarklions; 08-08-18 at 08:26 PM.
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Old 08-08-18, 10:08 PM
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It happened to me and turned out to be a mild case of heat stroke
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Old 08-08-18, 10:13 PM
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Originally Posted by MarcusT View Post
It happened to me and turned out to be a mild case of heat stroke
Could be just about anything. People get headaches for many known and unknown reasons. Mine are mostly from sinus congestion. Some in my family get terrible ones that involve nausea and never found actual cause.

Last edited by u235; 08-08-18 at 10:16 PM.
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Old 08-09-18, 06:24 AM
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I just looked at the information available on my UpToDate program. Executive summary follows.

1. There are both exercise headaches and cough headaches.
2. Exercise headaches tend to occur with young folks. Cough headaches occur with old coots.
3. No one knows exactly why they occur.
4. The incidence of underlying anatomical pathology (aneurysms, tumors, etc) runs around 15-20%.
5. Best treatment appears to be NSAIDs but no one knows for sure.

If this is the first time you’ve had this type of headache, you should consider seeing a doctor who should consider an imaging study.
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Old 08-09-18, 07:06 AM
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Originally Posted by Arthur P*****y View Post
I had no fever or high pulse or high blood pressure or low blood oxygenation.
You wrote that this have been ongoing for a year. You measured your BP and blood O2 count each time?

Since there is a long tradition of BF speculation on causes for medical conditions, I am going to go with high pulse pressure due to a "leaky" aortic valve.
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Old 08-09-18, 10:22 AM
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aww Sorry you are getting headaches! that is really frusterating. I bet it's nothing serious about your health. Do you get a headache with other physical activity? Does your bike fit to your height? I bet it's the fit of the bike! anecdote to assume the fit: I ride a 1996 Specialized Stump Jumper my ex fiance gave me which was his highschool graduation present. It is too small for me, and it gives me a headache unless i ride it more erect or don't tense my neck muscles. Over 9 years It's been main source of transportation and I adusted myself to prevent headaches. Been restoring and maintenencing it regularly. have been saving and shopping for New bike/used nice bike my size but get in financial predicament continuously. Size totally matters!!!!!
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Old 08-09-18, 07:19 PM
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Originally Posted by MarcusT View Post
It happened to me and turned out to be a mild case of heat stroke
I don't run a temperature. It happened in the winter and when I ride at night

Originally Posted by u235 View Post
Could be just about anything. People get headaches for many known and unknown reasons. Mine are mostly from sinus congestion.
That's rare. I had sinus surgery in '91. A neurologist who looked at my x-rays years later told me that my sinuses looked okay back then. The surgery made no difference.

Originally Posted by u235 View Post
Some in my family get terrible ones that involve nausea and never found actual cause.
Finding no cause is common. Nausea happens with migraine. I had those as a child. Fortunately I grew out of them. I remember how awful they were.

Originally Posted by Dudelsack View Post
If this is the first time youíve had this type of headache, you should consider seeing a doctor who should consider an imaging study.
I've had them for nearly a year. CAT scan turned up nothing. The physicians tell me I'm healthy; they have the data to back it up.

Originally Posted by indyfabz View Post
You wrote that this have been ongoing for a year. You measured your BP and blood O2 count each time?
I bought the tools. When I have nothing better to do, as is the case when pain stops me, I check. I feel my pulse throbbing, but my BP is the same (90/60). I feel feverish but my temperature is normal (97.4, for me). I think I'm not getting enough oxygen so try to hyperventilate, but my spO2 is normal... Condemned to health!

Originally Posted by indyfabz View Post
Since there is a long tradition of BF speculation on causes for medical conditions, I am going to go with high pulse pressure due to a "leaky" aortic valve.
Congratulations for playing deep left field! Aorta okay - had a Doppler a couple of years ago.

Originally Posted by SharonS View Post
I bet it's nothing serious about your health.
I agree, why I'm submitting to the BF panel for my diagnosis.

Originally Posted by SharonS View Post
Do you get a headache with other physical activity?
No.

Originally Posted by SharonS View Post
Does your bike fit to your height?
Yes. I've had it for 20 years, put > 100K on it.

Originally Posted by SharonS View Post
I bet it's the fit of the bike! anecdote to assume the fit: I ride a 1996 Specialized Stump Jumper my ex fiance gave me which was his highschool graduation present. It is too small for me, and it gives me a headache unless i ride it more erect
You can make almost any bike fit with a longer seat post and handlebar post. Most people are adult size at age 18.

I'd think a ride on a badly-fitting bike would ache immediately, not 12 hours later - don't you-all?

Physicians aren't interested in you unless you have something obvious. The last thing I want to do when my head hurts so badly is subject myself to the torture of the urgent care clinic or, worse, the ER. I'd rather die. So I can only go after I've recovered, but then have nothing to report.
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Old 08-09-18, 08:18 PM
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To much time/ excursion while riding in sun/heat , dehydration, or if its too bright on my eyes. So try not to forget shades. Those are all known to give me headaches occasionally. Alcohol compounds there effects, try not to indulge until after the ride, and a little re-hydration in the form of water and maybe some electrolytes that lack processed sugar. I dilute Gatorade or try to have banana with it. The electrolytes in things like banana also keep vitals functioning so a boost before and during a ride cant hurt.

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Old 08-09-18, 11:47 PM
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I've had severe headaches since childhood -- only once or twice a year back then but much more frequently as an adult, sometimes several a month. And I've had them after bike rides -- the first was in the 1980s after a long group bike ride in Baja California. Horrible and nothing worked.

Since then I've had a neck injury so I have more headaches now if I push myself too far. Usually I can manage up to 50 miles. Beyond that I'm risking a day or two of misery with headache, neck pain, etc.

The neurologists I've seen can't even agree on whether it's migraines, cluster headaches or trigeminal neuralgia. I've tried everything available, prescription and non-prescription.

Yours sounds like a migraine or cluster headache -- the light sensitivity, intractability and lack of response to anything else.

Try a beta blocker like metoprolol next time it occurs. Sometimes double the usual dosage, or two or three spread out over a few hours. If you aren't already taking a beta blocker ask your doctor for a prescription to try it. You don't necessarily need to take them daily, although some folks do as a preventive. Beta blockers can work to relieve some severe headaches already in progress.

Be aware that any new-to-you BP meds, beta blockers or calcium channel blockers may cause dizziness and weakness at first. But if you already have a severe headache you'll be mostly resting anyway. Just be careful walking to the bathroom, etc.

Other than something like Imitrex (sumatriptan), metoprolol works better than almost anything else I've tried for migraines and cluster headaches.

Also try the topical pain reliever Stopain roll-on or Stopain Migraine gel. They're a little different. I've been using regular Stopain roll-on for my injured shoulder and neck and it works very well. Part of the effect is due to a transdermal carrier (MSM) used in a few topical analgesics that penetrates the skin to reach surface level nerves, blood vessels, joints and muscles.

Most topical analgesics lack any transdermal carrier (MSM or DMSO) and cannot penetrate effectively, so most of the pain relief is probably due to massage and some placebo effect. I've tried dozens of pain balms over the years since my neck was broken in 2001, and none of them worked. Stopain is the first that worked and did so quickly, within minutes. Ted's Pain Cream also contains MSM but takes longer to be effective, up to a full week of repeated applications. Stopain works very quickly. There's a strong cooling sensation that's pleasant, like a chilled but not frozen gel pack.

The Stopain Migraine gel has other ingredients and doesn't list MSM on the label, but it may not need a transdermal carrier for application to the neck, behind the ears and temple areas where the target nerves are just barely under the skin. The regular Stopain roll-on has worked so well for me and friends I'm going to order the Migraine version.

Stopain Migraine studies:
1. https://clinicaltrials.gov/ct2/show/NCT01687101
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4316718/

Last edited by canklecat; 08-09-18 at 11:51 PM.
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Old 08-09-18, 11:59 PM
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Originally Posted by Arthur P*****y View Post
Physicians aren't interested in you unless you have something obvious. The last thing I want to do when my head hurts so badly is subject myself to the torture of the urgent care clinic or, worse, the ER. I'd rather die. So I can only go after I've recovered, but then have nothing to report.
I know exactly what you mean. I've had headaches so bad I considered suicide. Unless someone has suffered these types of headaches they cannot imagine the pain. It feels like a corkscrew in the eyeball into the brain, being wiggled around. Every second feels like an hour and it goes on for 12-48 hours. It's worse than anything else I've experienced, including my recently broken and dislocated shoulder from being hit by a car. These severe headaches are worse than the six broken vertebrae in my back and neck from being hit in 2001, and that was pretty bad.

And you're right, most health care folks aren't particularly sympathetic. If they can't see it, it doesn't exist. Even one of the neurologists I saw wasn't particularly interested in my description of symptoms.

And nowadays most ERs, urgent care clinics and hospitals assume that anyone who claims to have pain that isn't related to traumatic injury is just a junkie trying to mooch opiate pain pills. The problem is that opiates will not relieve this type of headache.

Fortunately the two times I had to be taken to an ER the doctors knew what the problem was and gave me appropriate medications, including an Imitrex injection which works quickly. They later gave me a prescription for the self-injection kits, before the pill form, sublingual and nasal spray versions were available. When you have that kind of headache you won't hesitate to jab a needle in your own thigh.

There are effective remedies. Find a sympathetic doctor and try the stuff I suggested above. Don't let the pain get so bad that dying seems like a reasonable alternative. Been there, many times over the decades. I'm still here. But I remember all too well how bad it can be.
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Old 08-10-18, 02:30 AM
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Originally Posted by livedarklions View Post
You need to see a doctor. See if your internist can come up with some appropriate specialist to see. It could just be a migraine, but these aren't symptoms to ask a bunch of bicyclists to diagnose. It could be something serious and/or easily treatable.
This. Even though a headache is arguably the most common ailment people have, you just named to many variable to consider any OTC advice. Once you have the result of your stress test, then you can decide from there.
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Old 08-10-18, 03:14 AM
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Originally Posted by Arthur P*****y View Post
This has been happening on all of my 'long' rides (>10 miles) the past year or so. I go everywhere on my bike; I haven't driven since 2017 March. I'm 64 and have ridden about 300K miles lifetime. It's taken a number of incidents like Monday/Tuesday's to notice the correlation with riding. I don't know how to make sense of it. Neither does my internist.

Does this make sense to anyone?
Looks like too much road vibration to the brain than it can cope with. Most of it come through the hands, but other two contact points also can deliver (seat, pedals). I would go to more plush setups (less tire pressure, softer grips and saddle, etc.).

Also do not spend time in HR zone 5, if that's a case. Try those two things. They are simple.

It could be wrong/heavy glasses too. I have no ideas about helmet (never used it).
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Old 08-10-18, 03:55 AM
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1) Go see a Dr when you have the headache. During the headache ... go to the walk-in clinic or see your own Dr if you can.

2) All the answers you gave ... and not a word about how much water you drink when you ride.

3) Can you post a photo of you with your bicycle? On your bicycle and/or standing next to your bicycle?
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Old 08-10-18, 04:00 AM
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I would see a physician immediately without further delay, naturally provide all the history details as this is not a one time isolated health concern.
Again, I would not delay. Prayers for a quick diagnosis and healing.
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Old 08-10-18, 05:31 AM
  #21  
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Originally Posted by canklecat View Post
And you're right, most health care folks aren't particularly sympathetic. If they can't see it, it doesn't exist. Even one of the neurologists I saw wasn't particularly interested in my description of symptoms.
I recently saw a sports medicine ortho doc for a lingering ankle sprain and it was such a good experience. Instead of saying ďjust stay off of itĒ he understood I wanted to continue running without on going issues and sent me to physical therapy to build strength. Itís was nice to have a doctor who understands getting back to your sport is a priority even if youíre not an athlete. Too bad there arenít doctors like that in every speciality.
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Old 08-10-18, 05:40 AM
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So, have you googled exercise-induced headaches? What did you come up with?
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Old 08-10-18, 07:12 AM
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I often get headaches following longer rides. In about 100% of these cases, it’s because I haven’t eaten enough. It takes me some time to catch up on food. You’d think I’d learn.
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Old 08-10-18, 07:51 AM
  #24  
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Originally Posted by Jno View Post
I have had the same thing and in my case, I realized it was that I was straining the neck muscles (riding tense or forgetting to look around if I was pushing hard). I noticed it went away as season progressed (riding more naturally and neck muscles “in shape”). Now, wouldn’t you know, I get the same thing now that I’m trying to life weights, but it is from straining my neck the other way (down/out instead of up).
This is likely it if you're a road cyclist. Since you're keeping your upper body low, but you still need to see in front of you, you're forced to crane your neck back to keep your eyes pointed forward. This way you are probably building tension in your levator scapulae, rectus capitis, and all of the other intrinsic muscles of your posterior neck/back. Rectus capitis minor partly anchors into your *****ges (protective covering of your brain/spinal cord), so it can often produce migraine-like headaches. If you notice any vision issues (lights/swirls/shimmers) prior to the onset of the pain, this may be a clue that it is neck tension.

I would stretch the back of your neck with some chin-tucks (see picture below. Make a double chin and hold it there for 10 sec -- you should feel the stretch at the base of our sull. Do multiple reps.) and "tit-looks" (turn your head a bit to the right and pull it straight down such that you're looking at your nipple. Helps to tuck your chin a bit -- you should feel the stretch radiating into the most medial aspect of your left shoulder blade. Hold for 30 sec. Look to the left and repeat. Do it 3-5 times per side.). These symptoms can also be signs of dehydration or cardiac issues, so if drinking water and stretching doesn't work after a few days, go see a doctor!

Here's a funny picture...

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Old 08-10-18, 08:00 AM
  #25  
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Originally Posted by canklecat View Post
Fortunately the two times I had to be taken to an ER the doctors knew what the problem was and gave me appropriate medications, including an Imitrex injection which works quickly. They later gave me a prescription for the self-injection kits, before the pill form, sublingual and nasal spray versions were available. When you have that kind of headache you won't hesitate to jab a needle in your own thigh.

There are effective remedies. Find a sympathetic doctor and try the stuff I suggested above. Don't let the pain get so bad that dying seems like a reasonable alternative. Been there, many times over the decades. I'm still here. But I remember all too well how bad it can be.
Glad to hear you found something that works for you!

I just want to caution both you and the OP that although these options may alleviate the pain, they are not necessarily remedies. Chronic pain is horrible, so managing it is important, but it is also important to determine and treat the root-cause of the pain. Just because you can't feel it doesn't mean it is fixed. However, it is tough to find a good doctor these days that a) understands that pills aren't cure-alls and b) has the time/humanism to work with you to determine the underlying cause of your invisible pain.
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