Table of ContentsView AllTable of ContentsCommon CausesPositional HeadachesDiagnosisWhen to See a Healthcare ProviderHeadache PreventionFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Common Causes
Positional Headaches
Diagnosis
When to See a Healthcare Provider
Headache Prevention
Frequently Asked Questions
Headacheswhen bending over can have many causes, such as sinus pressure, coughing, ordehydration. Bending over may also worsenmigrainesor positional headaches—which intensify with upright posture and tend to improve when lying down.
Most headaches when bending over are not cause for alarm, but some require medical attention. Positional headaches, in particular, can be a sign of more serious underlying causes, such as a leak ofcerebrospinal fluid(CSF) that cushions the brain, a heart issue, or abrain tumor.
This article will describe both common and rare causes of a headache when bending over, risk factors, when to see a healthcare provider, and treatment options.
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Common Causes of Headache When Bending Over
Blood and cerebrospinal fluid (CSF) circulate throughout your brain and spinal cord, providing a certain amount ofintracranial pressure(ICP), or pressure within the head, to support and protect the brain and its blood supply. ICP changes with different positions due to gravity’s effect on fluid distribution throughout the body.
When standing upright, ICP naturally decreases due to gravity pulling fluid away from the head. However, when the head is tilted back, inverted, or bent over, ICP increases. This increase in ICP can worsen symptoms of headaches due to the increased pressure within the head.
Some common causes of headache that worsen when bending over include the following.
Sinus Headache
Treatments may include over-the-counter pain relievers for headache pain anddecongestantsorantihistaminesto help reduce swelling and congestion. Home remedies like a steamy shower can also help relieve some of the sinus pressure to offer relief.
What Causes a Sinus Headache Without Congestion
Dehydration Headache
Adehydration headacheresults from a lack of fluids within the body, which causes head pain due to inadequate fluid balance. Increased ICP causes a force of pressure within the head, further constricting blood vessels and worsening a dehydration headache. Dehydration can come from vomiting, having diarrhea, or not drinking enough water.
Treatment involves rehydrating with plenty of fluids. Broth and sports drinks with electrolytes can be helpful.
Cough Headache
A cough headache may resolve on its own or may be treated with over-the-counter or prescriptionnonsteroidal anti-inflammatory pain medications (NSAIDs). See your healthcare provider for an evaluation since it could be that a cough is triggering another type of headache or there may be a more serious underlying condition.
Migraine Headache
A migraine is a neurological condition that can cause a severe throbbing headache, sensitivity to light and sound, nausea, and vomiting. Increased ICP that occurs from bending over will compound the intensity of head pain with migraines.
Migraine treatment often involves a combination of medication and prevention strategies, such as identifying and avoiding triggers (such as foods or activities). OTC NSAIDs, such asAdvil (ibuprofen)orAleve (naproxen), may be helpful for mild to moderate migraines.
Severe or persistent migraines may be treated withtriptans, such as Imitrex (sumatriptan) orMaxalt (rizatriptan), or a combination triptan/NSAIDs, such as Treximet (sumatriptan/naproxen).
CSF Leak
A CSF leak can occur when there is a tear in the outermost layer surrounding the brain (dura mater) or a fracture to one of the bones in the skull. If there is a tear in the dura mater or a skull fracture, CSF can leak out from the brain through the nose and ears.
In addition to drainage from the nose and ears, a CSF leak can also cause headaches, ringing in the ears (tinnitus), vision problems, andmeningitis. These symptoms tend to increase with increased ICP, which can occur from certain positions like bending over.
CSF leaks may also occur after a recent brain surgery orlumbar punctureand result in headaches.
Treatments for a CSF leak may include:
Cervicogenic Headaches
Acervicogenic headacheis typically located on one side of the head and neck. “Cervicogenic” means originating from the neck. These headaches often present with decreased range of motion of the neck, or cervical spine, due to muscle tightness.
Physical therapy, exercise, and lifestyle changes, such as improving your posture and managing stress, can help decrease cervicogenic headaches.
Postural Orthostatic Tachycardia Syndrome (POTS)
Postural orthostatic tachycardia syndrome(POTS) is a condition that causes a significant increase in heart rate (tachycardia) when you transition to an upright position, either from lying down to sitting up or from sitting or bending to standing up. This change in heart rate can also cause headaches,heart palpitations, fatigue, nausea, and fainting.
Treatment for POTS typically includes heart medication to improve heart functioning and reduce symptoms of POTS, as well as lifestyle changes to decrease symptoms, such as:
Brain Tumors
There may be other neurological symptoms such as seizures, difficulty speaking, hearing or vision changes, or personality changes.
Treatment may include surgery to remove the tumor,radiation, and/orchemotherapy.
To help make a diagnosis, your healthcare provider will ask you about your medical history, including:
Your healthcare provider will perform a physical examination to assess your neck’s movement and range of motion to screen for a possible neurological condition. They may also recommend diagnostic testing to help determine the underlying cause of your headaches. These tests may include:
If POTS is suspected, your healthcare provider will perform a tilt test. During this test, you will be secured to a flat table that changes positions horizontally and vertically. Your heart rate and blood pressure will be monitored as the table changes positions.
Common causes of headaches from bending over will subside when the underlying issue, such as a sinus infection or dehydration, is alleviated. They typically do not require further treatment.
More severe and longer-lasting headaches, such as migraines or positional headaches, often require more treatment. If you have been experiencing ongoing headaches several times a week or month, especially if your headaches have gotten worse over time, schedule an appointment with your healthcare provider to determine the underlying cause and appropriate treatment.
A Word From Verywell
—SMITA PATEL, DO, MEDICAL EXPERT BOARD
Most common headaches that worsen when bending over can be managed and prevented through lifestyle changes. These include:
Summary
A headache when bending over can result from sinus infections, dehydration, coughing, or migraines. Positional headaches that result from a CFL leak can also lead to headaches when bending over.
Most headaches that worsen when bending over can be managed with lifestyle changes like reducing stress, staying hydrated, getting enough sleep, and avoiding triggers like loud noises and bright lights. Medications, physical therapy, epidural blood patching, or surgery may be needed for more involved positional headaches.
A COVID-19 headache typically presents across both sides of the head rather than localized to one side.
15 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Lawley JS, Petersen LG, Howden EJ, et al.Effect of gravity and microgravity on intracranial pressure.J Physiol. 2017;595(6):2115-2127. doi:10.1113/JP273557American Migraine Foundation.Sinus headaches.Little P, Stuart B, Mullee M, et al.Effectiveness of steam inhalation and nasal irrigation for chronic or recurrent sinus symptoms in primary care: a pragmatic randomized controlled trial.CMAJ. 2016;188(13):940–949. doi:10.1503/cmaj.160362Arca KN, Halker Singh RB.Dehydration and headache.Curr Pain Headache Rep. 2021;25(8):56. doi:10.1007/s11916-021-00966-zBahra A.Other primary headaches-thunderclap-, cough-, exertional-, and sexual headache.J Neurol. 2020;267(5):1554-1566. doi:10.1007/s00415-020-09728-0Cordenier A, De Hertogh W, De Keyser J, Versijpt J.Headache associated with cough: a review.J Headache Pain. 2013;14(1):42. doi:10.1186/1129-2377-14-42Burstein R, Noseda R, Borsook D.Migraine: multiple processes, complex pathophysiology.J Neurosci. 2015;35(17):6619-6629. doi:10.1523/JNEUROSCI.0373-15.2015UpToDate.Treatment of migraine in adults.Do TP, Remmers A, Schytz HW, et al.Red and orange flags for secondary headaches in clinical practice: SNNOOP10 list.Neurology. 2019;92(3):134-144. doi:10.1212/WNL.0000000000006697Johns Hopkins Medicine.Cerebrospinal fluid (CSF) leak.Verma S, Tripathi M, Chandra PS.Cervicogenic headache: current perspectives.Neurol India. 2021;69(Supplement):S194-S198. doi:10.4103/0028-3886.315992Bryarly M, Phillips LT, Fu Q, Vernino S, Levine BD.Postural orthostatic tachycardia syndrome: JACC focus seminar.J Am Coll Cardiol. 2019;73(10):1207-1228. doi:10.1016/j.jacc.2018.11.059Tabatabai RR, Swadron SP.Headache in the emergency department: avoiding misdiagnosis of dangerous secondary causes.Emerg Med Clin North Am. 2016;34(4):695-716. doi:10.1016/j.emc.2016.06.003American Association of Neurological Surgeons.Brain tumors.Patel DM, Weinberg BD, Hoch MJ.CT myelography: clinical indications and imaging findings.Radiographics.2020;40(2):470-484. doi:10.1148/rg.2020190135
15 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Lawley JS, Petersen LG, Howden EJ, et al.Effect of gravity and microgravity on intracranial pressure.J Physiol. 2017;595(6):2115-2127. doi:10.1113/JP273557American Migraine Foundation.Sinus headaches.Little P, Stuart B, Mullee M, et al.Effectiveness of steam inhalation and nasal irrigation for chronic or recurrent sinus symptoms in primary care: a pragmatic randomized controlled trial.CMAJ. 2016;188(13):940–949. doi:10.1503/cmaj.160362Arca KN, Halker Singh RB.Dehydration and headache.Curr Pain Headache Rep. 2021;25(8):56. doi:10.1007/s11916-021-00966-zBahra A.Other primary headaches-thunderclap-, cough-, exertional-, and sexual headache.J Neurol. 2020;267(5):1554-1566. doi:10.1007/s00415-020-09728-0Cordenier A, De Hertogh W, De Keyser J, Versijpt J.Headache associated with cough: a review.J Headache Pain. 2013;14(1):42. doi:10.1186/1129-2377-14-42Burstein R, Noseda R, Borsook D.Migraine: multiple processes, complex pathophysiology.J Neurosci. 2015;35(17):6619-6629. doi:10.1523/JNEUROSCI.0373-15.2015UpToDate.Treatment of migraine in adults.Do TP, Remmers A, Schytz HW, et al.Red and orange flags for secondary headaches in clinical practice: SNNOOP10 list.Neurology. 2019;92(3):134-144. doi:10.1212/WNL.0000000000006697Johns Hopkins Medicine.Cerebrospinal fluid (CSF) leak.Verma S, Tripathi M, Chandra PS.Cervicogenic headache: current perspectives.Neurol India. 2021;69(Supplement):S194-S198. doi:10.4103/0028-3886.315992Bryarly M, Phillips LT, Fu Q, Vernino S, Levine BD.Postural orthostatic tachycardia syndrome: JACC focus seminar.J Am Coll Cardiol. 2019;73(10):1207-1228. doi:10.1016/j.jacc.2018.11.059Tabatabai RR, Swadron SP.Headache in the emergency department: avoiding misdiagnosis of dangerous secondary causes.Emerg Med Clin North Am. 2016;34(4):695-716. doi:10.1016/j.emc.2016.06.003American Association of Neurological Surgeons.Brain tumors.Patel DM, Weinberg BD, Hoch MJ.CT myelography: clinical indications and imaging findings.Radiographics.2020;40(2):470-484. doi:10.1148/rg.2020190135
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Lawley JS, Petersen LG, Howden EJ, et al.Effect of gravity and microgravity on intracranial pressure.J Physiol. 2017;595(6):2115-2127. doi:10.1113/JP273557American Migraine Foundation.Sinus headaches.Little P, Stuart B, Mullee M, et al.Effectiveness of steam inhalation and nasal irrigation for chronic or recurrent sinus symptoms in primary care: a pragmatic randomized controlled trial.CMAJ. 2016;188(13):940–949. doi:10.1503/cmaj.160362Arca KN, Halker Singh RB.Dehydration and headache.Curr Pain Headache Rep. 2021;25(8):56. doi:10.1007/s11916-021-00966-zBahra A.Other primary headaches-thunderclap-, cough-, exertional-, and sexual headache.J Neurol. 2020;267(5):1554-1566. doi:10.1007/s00415-020-09728-0Cordenier A, De Hertogh W, De Keyser J, Versijpt J.Headache associated with cough: a review.J Headache Pain. 2013;14(1):42. doi:10.1186/1129-2377-14-42Burstein R, Noseda R, Borsook D.Migraine: multiple processes, complex pathophysiology.J Neurosci. 2015;35(17):6619-6629. doi:10.1523/JNEUROSCI.0373-15.2015UpToDate.Treatment of migraine in adults.Do TP, Remmers A, Schytz HW, et al.Red and orange flags for secondary headaches in clinical practice: SNNOOP10 list.Neurology. 2019;92(3):134-144. doi:10.1212/WNL.0000000000006697Johns Hopkins Medicine.Cerebrospinal fluid (CSF) leak.Verma S, Tripathi M, Chandra PS.Cervicogenic headache: current perspectives.Neurol India. 2021;69(Supplement):S194-S198. doi:10.4103/0028-3886.315992Bryarly M, Phillips LT, Fu Q, Vernino S, Levine BD.Postural orthostatic tachycardia syndrome: JACC focus seminar.J Am Coll Cardiol. 2019;73(10):1207-1228. doi:10.1016/j.jacc.2018.11.059Tabatabai RR, Swadron SP.Headache in the emergency department: avoiding misdiagnosis of dangerous secondary causes.Emerg Med Clin North Am. 2016;34(4):695-716. doi:10.1016/j.emc.2016.06.003American Association of Neurological Surgeons.Brain tumors.Patel DM, Weinberg BD, Hoch MJ.CT myelography: clinical indications and imaging findings.Radiographics.2020;40(2):470-484. doi:10.1148/rg.2020190135
Lawley JS, Petersen LG, Howden EJ, et al.Effect of gravity and microgravity on intracranial pressure.J Physiol. 2017;595(6):2115-2127. doi:10.1113/JP273557
American Migraine Foundation.Sinus headaches.
Little P, Stuart B, Mullee M, et al.Effectiveness of steam inhalation and nasal irrigation for chronic or recurrent sinus symptoms in primary care: a pragmatic randomized controlled trial.CMAJ. 2016;188(13):940–949. doi:10.1503/cmaj.160362
Arca KN, Halker Singh RB.Dehydration and headache.Curr Pain Headache Rep. 2021;25(8):56. doi:10.1007/s11916-021-00966-z
Bahra A.Other primary headaches-thunderclap-, cough-, exertional-, and sexual headache.J Neurol. 2020;267(5):1554-1566. doi:10.1007/s00415-020-09728-0
Cordenier A, De Hertogh W, De Keyser J, Versijpt J.Headache associated with cough: a review.J Headache Pain. 2013;14(1):42. doi:10.1186/1129-2377-14-42
Burstein R, Noseda R, Borsook D.Migraine: multiple processes, complex pathophysiology.J Neurosci. 2015;35(17):6619-6629. doi:10.1523/JNEUROSCI.0373-15.2015
UpToDate.Treatment of migraine in adults.
Do TP, Remmers A, Schytz HW, et al.Red and orange flags for secondary headaches in clinical practice: SNNOOP10 list.Neurology. 2019;92(3):134-144. doi:10.1212/WNL.0000000000006697
Johns Hopkins Medicine.Cerebrospinal fluid (CSF) leak.
Verma S, Tripathi M, Chandra PS.Cervicogenic headache: current perspectives.Neurol India. 2021;69(Supplement):S194-S198. doi:10.4103/0028-3886.315992
Bryarly M, Phillips LT, Fu Q, Vernino S, Levine BD.Postural orthostatic tachycardia syndrome: JACC focus seminar.J Am Coll Cardiol. 2019;73(10):1207-1228. doi:10.1016/j.jacc.2018.11.059
Tabatabai RR, Swadron SP.Headache in the emergency department: avoiding misdiagnosis of dangerous secondary causes.Emerg Med Clin North Am. 2016;34(4):695-716. doi:10.1016/j.emc.2016.06.003
American Association of Neurological Surgeons.Brain tumors.
Patel DM, Weinberg BD, Hoch MJ.CT myelography: clinical indications and imaging findings.Radiographics.2020;40(2):470-484. doi:10.1148/rg.2020190135
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