Headaches are just one of many COVID-19 symptoms that can persist long after initial infection, but they can interfere substantially with daily life. “I now get headaches behind my eyes every single day since I had COVID five weeks ago,” one sufferer shared on social media. “It’s super fun when 90% of my job is reading and staring at screens.” 

Why do COVID headaches linger? Why do some people get them, but not others? In a recent interview, experts explain what we know so far about these painful, debilitating episodes.*

Pain levels and types of headaches can vary

Thomas Russo, M.D., chief of infectious disease and professor at New York’s University at Buffalo, says headaches are a “very common symptom” of COVID-19, especially the Omicron variant.

Amesh A. Adalja, M.D., an infectious disease expert at the Johns Hopkins Center for Health Security, says COVID headaches typically last, at most, a couple of days. He says each person’s experience tends to vary depending on several factors, such as:

• Their general susceptibility to headaches,
• The severity of their COVID-19 infection, and
• Any pain medications they’re currently taking.

In people whose headaches linger weeks and months after infection, Adalja says the pain level can vary between individuals. Migraines are common after most post-viral illnesses in people already susceptible to them. 

For people not inclined to having migraines, Michigan State University’s Amit Sachdev, M.D. says post-COVID headaches more closely resemble tension or sinus headaches.

If you suffer with post-COVID headaches, you’re not alone

It’s uncertain just how common post-COVID headaches are. While some experts say that COVID-related headaches seem to be more prevalent during the infection than afterward, a recent study involving 200 patients showed that headaches were the second most common lingering or recurring symptom after fatigue. 

According to Sachdev, anyone is susceptible to post-COVID headaches. There’s no established risk group, he says, though overall, “Many patients with Long COVID symptoms tend to be younger and female, but these are trends—not rules.”

Why it only happens to certain people

Experts say they don’t know why post-COVID headaches happen in some people and not others, but they have several theories:

• Lingering stress on the body from the acute viral illness 
• Overlooked sleep deprivation and/or dehydration
• Rebound headaches from overuse of pain medications like acetaminophen/Tylenol

For headaches lingering for weeks or months after infection, the writers of a research review in The Journal of Headache and Pain have a couple of thoughts.

• People genetically susceptible to migraines or headaches may be having their trigeminovascular system (the major pain-signaling pathway in the brain) stimulated.
• It may also be due to a persistent overactive immune response to COVID-19, since “[h]eadaches are largely the result of the inflammatory cascade being triggered by the virus,” says Adalja.

Not necessarily Long COVID

Post-COVID headaches may also be coincidental. Per the CDC’s definition, post-COVID symptoms or complications must last longer than four weeks from onset of the initial illness to be considered part of the syndrome that is Long COVID.

Persistent pain “is not only caused by COVID, and it is not the most classic sign of Long COVID,” says Sachdev. “Persisting headaches, where none existed before, should prompt an investigation.”

*Miller, K. (2022, August 22). Here’s What Experts Know About Post-COVID Headaches So Far. Self. https://www.self.com/story/post-covid-headaches