The headaches caused by the virus differ from your “typical” headaches in that they may be more painful and longer in duration, and they may not respond to over-the-counter (OTC) treatments such as aspirin, according to a review of literature published in November 2021 by the journal Current Pain and Headache Reports. “COVID-19 headaches vary substantially, from pressure-type pain to severe, throbbing pain with some migraine-like features,” notes Teshamae Monteith, MD, an associate professor of clinical neurology at the University of Miami Miller School of Medicine and chief of the Headache Division at the school. With the virus, “headaches generally last days to weeks but, for some people, it may be a feature of long COVID and persist for more than three months,” Dr. Monteith says. Here are five frequently asked questions about COVID-19 headaches and their answers:
What Is a COVID-19 Headache?
COVID-19 headaches on their own can’t be used to diagnose an infection. Still, if you’re experiencing more intense headaches than usual or having them at different times of day — with no obvious stressors or triggers — it’s possible you have the virus, the Centers for Disease Control and Prevention (CDC) says. Women and younger people may be at higher risk for headaches from COVID-19, according to the November 2021 review in Current Pain and Headache Reports. Most people who develop headaches related to the virus have what’s known as tension-type headaches. Symptoms of tension headaches include:
Moderate or severe pain on both sides of the headA pressing feeling in the forehead, on the sides of the head, or around the eyesSymptoms that don’t respond well to OTC medications
However, some people who have headaches due to COVID-19 experience migraine-like symptoms, even if they’ve never had migraine before, the National Headache Foundation (NHF) says. Migraine may cause:
Pain, typically on one side of the headA throbbing or pulsing sensationSensitivity to light, sound, smell, or touchNausea and vomiting
Very rarely, people with COVID-19 will have “thunderclap headaches,” which can cause severe pain within seconds of onset, according to Hartford Healthcare. If you experience this type of headache, you should seek emergency care. Thunderclap headaches can sometimes be caused by life-threatening conditions.
How Do I Know if I Have a COVID-19 Headache?
Having a headache by itself doesn’t mean you have COVID-19, according to Monteith. However, for most people who develop headaches caused by the virus, it usually is the first symptom to appear. If you’re not prone to headaches generally and suddenly start experiencing them, it’s probably a good idea to get tested, particularly if you have other symptoms of the virus, Monteith says. Most people with COVID-19 headaches also tend to have:
FeverSore throatLoss of taste and smellMuscle aches
For most people, headaches resolve along with other symptoms of the virus, typically in about seven days, the CDC says. However, if headaches arise as part of long COVID you may have them for several months after recovery, the agency notes.
Why Does COVID-19 Cause a Headache?
It’s still unclear why COVID-19 causes some people to have headaches, according to Monteith. It’s possible that headaches stem from widespread, systemic inflammation brought on by the virus, particularly if it affects the brain or nervous system, she says. In addition, the virus may trigger the trigeminovascular system, a group of nerve and blood vessel cells that may play a role in many headache disorders, including migraine, she adds.
What’s the Best Way to Treat a COVID-19 Headache?
If you’ve had headaches before testing positive for the virus, you may know your specific triggers — or what brings on your symptoms. For many, headache triggers include stress, lack of sleep, drinking alcohol, and certain smells, among others, according to the NHF. You can try OTC medications, such as aspirin and acetaminophen (Tylenol), though they may not help with COVID-19 headaches, Monteith says. Still, other commonly used remedies can help, including rest, massaging your temples, and cold compresses applied to the forehead, the NHF says. If you’re experiencing headaches due to long COVID, you’ll need to talk to your doctor to develop a workable, long-term treatment plan.
When Should I See a Doctor for My COVID-19 Headache?
Headaches that develop several days after the onset of other COVID-19 symptoms could be a sign of a potentially life-threatening condition called cerebral venous thrombosis, per Johns Hopkins Medicine, which are essentially blood clots that disrupt blood flow to the brain, according to a review published in the May–June 2021 issue of the journal Diabetes & Metabolic Syndrome: Clinical Research & Reviews. Seek emergency medical care if you develop:
A severe headache that doesn’t respond to pain medication, or continues to worsen, particularly when you lie down or bend overBlurred vision, nausea and vomiting, speech problems, muscle weakness, drowsiness, or seizures along with a headacheA rash that looks like a small bruiseShortness of breath, chest pain, abdominal pain, or swelling in the legs
“You should see a doctor if a headache doesn’t respond to standard treatments,” Monteith says. Other red flags indicating a possible need for medical care include, “confusion or disorientation, stiff neck, vision changes, weakness, loss of speech, and problems with balance,” she adds.
