Headache When Standing Up – Why It Happens?

If you have ever had a headache, you are in a widespread company. According to WebMD, headaches are the most common cause for pain among Americans today. (1)

In fact, if you have a headache right now, you share your pain with approximately 19 other people – Harvard Medical School reports.(2)

That’s right – every day, one out of every 20 people will suffer from a headache!

Of course, none of this is really helpful when you are in the midst of battling yet another headache.

When your headaches occur when you stand up quickly or bending over, you may also begin to worry if there is an underlying cause, which sure doesn’t help your pain go away any faster!

In this article, learn about the major reasons why pounding headache can occur when you stand up, the warning signs to look for, how diagnosis occurs and what to expect from treatment.


Major Types of Headaches

WebMD states that more than 150 different types of headaches have been chronicled by medical researchers to date.(1)

That is a lot of headache types to sort through!

But for our purposes here, all 150 can be distilled own into four major categories of headaches:


Tension headaches

As many as 90 percent of all headache sufferers are having what is called a “tension headache.”

If your headaches occur less than half the days in the average month, you have what is called “episodic” tension headaches. If your headaches occur more frequently than that or last for more than one day at a time, you have “chronic” tension headaches.


Migraine headaches

Migraine headaches are probably the best-known type of headaches. Up to 17 percent of people may suffer from migraines. More than half of all migraine headaches occur only on one side of the head. Often migraine headaches start very early in life – even as young as five years old.

Migraines are very debilitating. The pain can cause vomiting, nausea, dizziness and vision issues. They are unmistakable in the severity of their symptoms.


Cluster headaches

Cluster headaches are a lesser known category that only happen to about one percent of people and involve the hypothalamus in the brain. They can last for hours or days at a time.

Often the onset is quite sudden and the end is equally sudden, and they happen most frequently at night, and at the same time each night.

Victims describe a “knife-like” pain, often behind one eye along with allergy symptoms like a runny nose and feelings of restlessness, states the Daily Mail.(3)


Sinus headaches

Best known as one symptom of sinusitis, or respiratory infection, these potent headaches are primarily felt across the front of the face near the nose and between the eyes where the sinuses are located.

When the sinuses get inflamed or stuffed up, this puts pressure on the sinus cavities, leading to a sinus headache.


Why Headache Happens When Standing Up?

There are a number of potential causes for why you experience headaches only when you stand up.

Some of the simplest possible causes relate to tension, dehydration or low blood sugar.


The coat hanger headache

One more complex cause that is still being studied is the strangely named “coat hanger” headache.

According to Migraine Again, its name is derived from where a headache actually starts and how it progresses.(4) A coat hanger headache typically begins in the shoulders, shoots up the neck and into the head in a sort of “coat hanger” motion.

The coat hanger headache can arise for a number of reasons, but the two best-known causes are as follows:

» Postural hypotension. Postural hypotension could be translated to mean “bad posture exacerbated by insufficient dietary salt and high blood pressure medication.” It can also be a natural part of the aging process for certain people.

» POTS syndrome. POTS stands for postural-orthostatic tachycardia syndrome, a serious medical condition that raises the heart rate, resulting in dizziness, fainting, headaches and other symptoms.

According to New Health Advisor, additional possible causes for headaches, that occur suddenly when you stand up, include these:(5)

» Intracranial hypotension. Sometimes called pseudotumor cerebri, symptoms of intracranial hypotension can mimic the presence of a brain tumor due to abnormalities in how cerebral fluid is absorbed. Improper absorption leads to a rise in intracranial pressure when you stand up, resulting in a headache.

» Blood pressure issues. Issues with low or high blood pressure are two of the best-known causes of headaches when you stand up. Sometimes nausea, dizziness or vomiting are also present. Here, extreme heat, anemia, a prior diagnosis of diabetes, pregnancy, Parkinson’s disease, heart conditions and some medications can all interfere with blood pressure and cause headaches when you stand up.

» Exertion headaches. When you have been involved in a vigorous physical activity and then you suddenly stand up, this can trigger a headache. There are two types: primary and secondary. The former is linked to how exercise changes your body’s needs for hydration and fuel. The latter is linked to more serious issues in the brain.

Finally, there is one rare possible cause of headaches that occur when you stand up:

» Spinal fluid leak. As the New York Times details, occasionally a patient may develop a spinal fluid leak, which can trigger spontaneous headaches when standing up during or after exertion.(6)



As you might expect, the full set of symptoms that occurs alongside your standing headache can differ depending on the possible underlying cause.

However, the more you can study each headache episode, noting what happened just prior (what you ate or drank, what you were doing, etc) how long the pounding headache lasted and other symptoms that were present, the easier it will be to notice any patterns that may recur from headache to headache.

The most common co-occurring symptoms that can happen when you have a headache when standing up include these:

» Dizziness.
» Nausea.
» Vomiting.
» Fatigue.
» Blurred vision.
» Impairment with walking, moving or speaking.
» Fever.
» Stiffness or weakness.
» Fainting.
» Sensitivity to light, scent or sound.
» Loss of appetite.
» Cold or flu symptoms (runny or stuffy nose, chills, coughing/sneezing, et al).
» Chest, neck or shoulder pain.



Because of the diversity of possible underlying causes, diagnosing the reason why you are suffering from pounding headaches that occur when you stand up or bending over always begins with the doctor taking a full personal and family medical history.

Next, the doctor will perform a physical exam and discuss your specific symptoms with you. Here is where your headache journal notes can come in very handy!

From here, according to Healthline, the doctor may order any or all of the following tests:(7)

CBC (complete blood count) and blood chemistry. This basic, yet comprehensive blood test will look for evidence of possible underlying causes, including anemia (iron deficiency), proteins that may indicate certain diseases and other abnormalities.

Electrocardiogram (EKG). This test measures the regularity of your heart rhythm.

Echocardiogram. This test measures your heart and valves function.

Tilt table test. This test is done to try to induce fainting and pinpoint what is going on in the body.

Exercise stress test. This test is done to measure your heart stress during exertion.

Sinus X-rays. This test is done to look for issues with the sinus passages.

CT or MRI scans. These tests are done to look for evidence of prior trauma in the brain, head or neck regions.

From here, a diagnosis can typically be made, along with recommendations for treatment.



According to John Hopkins Medicine Health Library, treatment will depend on the diagnosis.(8)

Each of the following treatments may be used as needed:

Changes in hydration and dietary habits to control blood sugar levels
Use of blood pressure medications
Avoiding possible triggers (alcohol, nicotine, fasting, sleep deprivation, et al)
Stress management
Surgery (for diagnoses such as sinus issues or a spinal fluid leak)


If you or a loved one have been suffering from headaches that occur when standing up and walking, you may feel justifiably anxious and eager to find out the diagnosis and start treatment right away.

Here are the steps you need to take to start feeling better fast:

» Keep a headache journal and note down every detail of each headache episode.
» Do this for at least a week or two (or longer if your headaches are less frequent).
» Make an appointment with your doctor and bring your headache journal.
» Have your physical exam and any tests.
» Proceed with the treatment your doctor recommends.