What Causes Headaches When Bending Over?

Several different types of headaches can cause pain when you bend over. Most are not cause for alarm, but some require medical attention.

This article will describe what causes a headache when bending over, risk factors, when to see a healthcare provider, and treatment options. 

headache bending over

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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 of intracranial 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.

Sinus Headache

A sinus headache develops from increased pressure within the sinuses (the four pairs of hollow spaces) of the head and face. It usually starts from inflammation caused by a cold or allergies. Increased ICP can aggravate already inflamed sinuses and produce a headache.

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.

Dehydration Headache

A dehydration headache results 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.

Cough Headache

A cough headache is a sudden headache that occurs after coughing, sneezing, laughing, straining, or bending over. It's caused by the increased pressure that develops within the head and body from the force of these movements.

Positional Headache When Bending Over

Orthostatic, or positional, headaches are caused by upright posture and are usually relieved by lying down. These types of headaches can get worse when bending over. Positional headaches can result from a CSF leak, cervicogenic headache (pain transfers from the neck to the head), or postural orthostatic tachycardia (rapid heart rate) syndrome.

CSF Leak

A CSF leak occurs 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, and meningitis. These symptoms tend to increase with increased ICP, which can occur from certain positions like bending over.

Cervicogenic Headaches

A cervicogenic headache is 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's cervical spine due to muscle tightness. 

Cervicogenic headaches result from muscle irritation in the neck controlled by the C1, C2, and C3 spinal nerve roots. Bending over can worsen cervicogenic headaches by increasing strain on the neck muscles.

Postural Orthostatic Tachycardia Syndrome (POTS)

Postural orthostatic tachycardia syndrome (POTS) is a condition characterized by a significant increase in heart rate (tachycardia) when assuming 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.

When to See a Healthcare Provider

General headaches from bending over will subside when the underlying cause, 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. 

Diagnosis

To help make a diagnosis, your healthcare provider will ask you about your medical history, including:

  • Your headache symptoms
  • How long do your headaches last 
  • When your headaches started 
  • How often your headaches occur 
  • If certain conditions trigger your headaches 
  • Other medical conditions you may have 

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.

Treatments

A general headache that worsens when bending over can be managed and prevented through lifestyle changes. These include:

  • Staying adequately hydrated
  • Managing stress
  • Getting enough sleep at night
  • Limiting exposure to bright screens from phones, tablets, televisions, and computers
  • Treating colds and allergies 
  • Avoiding migraine triggers like loud noises and bright lights
  • Taking pain-relieving medications like nonsteroidal anti-inflammatory drugs (NSAIDs, including Advil or Motrin ibuprofen or Aleve naproxen sodium) or medication prescribed for migraines

Treatments for Positional Headaches

Treatment for positional headaches will depend on the underlying cause. Options include:

  • Physical therapy, exercise, and lifestyle changes, such as improving your posture and managing stress to help decrease cervicogenic headaches
  • Cardiovascular medication to improve cardiac functioning and reduce symptoms of POTS
  • Other lifestyle changes to decrease POTS symptoms like compression garments, increased fluid intake, exercise, and avoidance of caffeine, alcohol, and heat exposure
  • An epidural blood patch, in which a sample of your blood is injected into the CSF in your spine to circulate and form a clot to seal a CSF leak and decrease symptoms
  • Surgery to close a CSF leak

Risk Factors for Positional Headaches

Certain factors increase the risk of developing positional headaches. These include:

  • Poor posture 
  • Straining too hard during exercising or coughing
  • Brain tumors
  • Trauma to the head or face

Positional headaches from POTS have unique risk factors that 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.

A general headache that worsens when bending over can often 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 Word From Verywell

An occasional headache here or there is generally not a cause for concern. You should see your healthcare provider, however, if you have been experiencing ongoing headaches several times per week or month to determine the underlying cause. 

Frequently Asked Questions

  • What part of the head is affected by a COVID-19 headache?

    A COVID-19 headache typically presents across both sides of the head rather than localized to one side.

  • What does a brain tumor headache feel like?

    A headache from a brain tumor often causes a constant, dull headache localized to a specific head area and is sometimes accompanied by nausea, vomiting, and seizures.

10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Kristen Gasnick, PT, DPT
Kristen Gasnick, PT, DPT, is a medical writer and a physical therapist at Holy Name Medical Center in New Jersey.