Hi, thanks for asking from HCM. I can understand your concern. Headache for such long duration is most probably Tension or Migraine. It is less likely to be due to some lesion or organic pathology. Now coming to the point that it increases with exertion. Actually most of the headache increases with exertion because it leads to more physical stress, sometimes eye strain, increased body temperature and dehydration. So not much can be concluded from this point. However to treat such long standing headache, you can ask her to follow few tips : Always try to sleep for 8-9 hours in a day : Avoid stress : Use glasses if numbered glasses : Avoid bright light, prolonged workington laptop/computer : She can have coffee or tea to relieve some pain : Daily exercise. Yoga and meditation are very effective in controlling pain of long duration. : Keep well hydrated. Drink 3 litre of water daily. : head massage. : If still no relief, she can take painkiller like Paracetamol or Diclofenac after proper prescription. Hope it will help her. If still no relief, please send me her reports and complete details of her headache, I will try to help her. thanks. Take care