What Does Exercise Have to Do With Migraine?

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April 11, 2022
May 18, 2021
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What Does Exercise Have to Do With Migraine?

Exercise and Migraine

Physical activity and migraine have a complicated relationship.  Exercise definitely helps prevent migraine in a number of ways, but it can also trigger worsening headache symptoms, and even be associated with its own category of headaches.  

Exercise as a form of prevention

Many studies investigating lifestyle and behavioral changes have found regular exercise to be helpful for preventing migraine.  The amount of time recommended is approximately 30-45 minutes, 3 times per week, and doing this regularly can be almost as effective as many of the preventive medications we use for migraine. 

There isn’t a perfect exercise for migraine prevention, and there are many advantages to a number of different kinds of exercise.  The deep breathing practice that you learn with yoga can itself improve the frequency of migraine and can be utilized during a migraine attack to decrease your pain and sensitivities. 

Cardio-type exercises can be great to lower your resting heart rate and decrease your blood pressure.  And exercise has long been known to be an effective stress-reducer. Since stress is such a prominent migraine trigger, anything that can be help decrease stress is worth pursuing. 

How exercise can worsen headaches

There are some circumstances where exercise may actually trigger migraine symptoms.  Early in the onset of a migraine attack, and certainly in the throes of a bad migraine, physical exertion may worsen the headache pain.  In fact, one of the criteria for the diagnosis of migraine is that it’s a headache that “worsens with physical activity”.  This may be something as small as walking up a few steps, or lifting something heavy. 

Similarly, after experiencing a concussion, you may have associated symptoms that resemble migraine.  These include sensitivity to light and sound, throbbing or tight headache pain that is commonly constant, and worsening with physical activity.  As you recover, it may be difficult to tolerate physical exertion, and you may need to work with a physical therapist to begin exposing yourself slowly to exercise in a way that you can tolerate. 

There are also some exertional headache disorders.  Some of these slowly worsen as you continue to exert yourself, some only after you’ve reached a certain heart rate or exertion level.  These should definitely be discussed with your neurologist, as some may actually represent a concerning neurological condition.  Your doctor may consider imaging with an MRI or even an MRA which also looks at the blood vessels of the brain.  If your evaluation is reassuring, your doctor may consider giving a medication to take prior to exercise that will ward off the headache.  

If you'd like to speak with a neurologist specializing in headaches about how you can best prepare yourself and manage your headaches, join Neura Health today.

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Thomas Berk, MD
Thomas Berk is Medical Director at Neura Health and a Clinical Assistant Professor at the Department of Neurology at NYU Grossman School of Medicine
About the Author
Dr. Thomas Berk is Medical Director of Neura Health and a neurologist and headache specialist based in New York City. He has over 12 years of clinical experience, having graduated from the NYU Grossman School of Medicine in 2010. He completed his neurology residency at NYU as well and is a board-certified headache specialist, having completed a headache fellowship at the Jefferson Headache Center. He is an emerging leader of the American Headache Society and has been on the Super Doctors list of rising stars for the past five years.

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