Exercise has demonstrated efficacy in treating several pain conditions and improving self-esteem. Researchers recently investigated what role exercise plays in migraine prevention and found that although exercise can trigger migraine attacks, regular exercise may have prophylactic effects on migraine frequency.
, published by The Journal of Headache and Pain,
reviewed primary literature on the PubMed website
involving associations between physical exercise and migraine from epidemiological, therapeutic, and pathophysiological perspectives. In total, 44 articles were included in the study.
“Exercise can be used for management of several chronic pain conditions. Interestingly, this includes conditions comorbid with migraine such as depression, anxiety, and sleep disturbances,” the authors explained. “On the other hand, some migraineurs report exercise as a triggering factor for their attacks. This might be a reason why the interictal behavior of migraine patients frequently includes reduced physical activity.”
The review revealed that several large population-based studies have demonstrated that low physical activity levels are associated with a higher prevalence and frequency of migraine. However, they authors noted, the number of showing demonstrating exercise as a migraine trigger is limited.
Several studies reported a significant reduction in pain intensity as well as beneficial effects on frequency and duration of migraine attacks, indicating positive therapeutic outcomes for adolescent and adult patients with migraine.
The researchers also explained possible mechanisms for how exercise may trigger migraine attacks, including the acute release of neuropeptides such as calcitonin gene-related peptide or alternation of hypocretin or lactate metabolism. Additionally, for migraine prevention through exercise, the review recalled that beta-endorphin, endocannabinoid, and brain-derived neurotrophic factor levers in plasma after exercise may be effective.
Based on the findings of the review, the authors made exercise recommendations, including aerobic exercise training, which has been seen to have positive therapeutic outcomes for adolescent and adult migraine patients by reducing the frequency and intensity of headaches, body weight, and psychiatric comorbidities, as well as improving their quality of life.
“The program in total should remain in a tolerable level preventing exercise-related pain and disability, with a suggested frequency of 2 to 3 times per week,” explained the authors. “Patients must continue with this despite initial lack of improvement because it is found that people with migraine can develop a ‘tolerance’ to the pain-inducing effects of moderate exercise.”
The authors concluded that public health services should financially support interdisciplinary intervention programs and educational campaigns since exercise programs have demonstrated efficacy, minimal side effects, and cost savings for managing migraine. They also suggested that headache experts and general practitioners incorporate such exercise programs in their therapeutic plan for migraine patients.
Amin F, Aristeidou S, Baraldi C, et al. The association between migraine and physical exercise [published online September 10, 2018]. J Headache Pain
. doi: https://doi.org/10.1186/s10194-018-0902-y.