Q. I get headaches whenever I lift weight above my head or strain my shoulder muscles in any way with weight lifting. What do you recommend? – Steven T.
A. Your headaches likely represent exertional headaches. These are typically throbbing and last from five minutes to 24 hours after exertion. Most of the time, these headaches are benign and are not associated with any underlying diseases. However, I usually recommend an MRI of the brain and an MRA (magnetic resonance angiograph) of the blood vessels of the brain to be absolutely sure you don’t have other causes for your headaches. The typical treatment options for benign exertional headaches are NSAIDS or beta-blockers prior to exercise.
Another possibility is thoracic outlet syndrome. This occurs when the muscles in the shoulders con- tract and tighten down on nerves or blood vessels. The most common symptoms are pain and numbness in the arms. Headaches are rare in this syndrome and typically occur in the back of the head. Your physician can diagnose this by putting your arms and shoulders in different positions, and it can often be treated using physical therapy.
Vincent Martin, MD, University of Cincinnati College of Medicine, Cincinnati
