You may have heard that long-term exercise programs can help reduce migraine attacks. But it can be hard to start a workout routine when every attempt results in migraine symptoms. “Exercise sometimes gives me a feeling like an ice pick in my ear, then a massive migraine attack,” one MyMigraineTeam member said. “Not all the time, but it happens.”

If you’re trying to do more physical activity but don’t want to trigger migraine symptoms, keep reading. This article will help you better understand the link between migraine attacks and exercise. You’ll also discover how to manage this risk.

The Effect of Movement on Migraine

Migraine and movement have a difficult relationship. While it’s clear that having a regular exercise routine can be beneficial, it’s not always easy to start working out.

The Benefits of Exercise

Vigorous exercise, when practiced consistently, can help reduce migraine attacks. One study found that consistent exercise that raised participants’ heart rates and caused them to sweat reduced the frequency of migraine headaches by 24 percent. Results were especially strong for those who combined vigorous exercise with muscle-strengthening movements.

And while exercise alone can’t eliminate all migraine attacks, many people say it helps. “My neurologist told me to do one hour a day of extensive exercise at least five times a week,” one MyMigraineTeam member said. “I did three to four one-hour sessions a week, and for three months I was migraine-free! I stopped for December and had two migraines, so now I’m back again.”

Researchers think vigorous exercise helps migraine symptoms because of the chemicals it releases in your body. These chemicals, called endorphins and enkephalins, can reduce pain signals. Scientists believe exercise can also ease inflammation in your brain.

Exercise as a Migraine Attack Trigger

Despite the benefits of physical activity, some people are cautious about starting an exercise program because movement has triggered attacks for them in the past. One study found that 38 percent of participants living with migraine experienced attacks triggered by exercise.

Exercise can trigger migraine attacks because intense effort can activate several migraine triggers at once, such as an increase in heart rate and blood pressure, dehydration, skipped meals, heat and humidity, and the release of migraine chemicals such as lactate and CGRP.

Exercise-induced migraine attacks often affect people who haven’t exercised in a while. “I walked four miles this morning and now I’ve got that post-exercise migraine looming,” one member said. “I feel like I’m being penalized for trying to be good to my body.”

To avoid exercise-induced symptoms, it’s important to start slowly when launching a new workout routine. Begin with gentle movement and work your way up to more vigorous exercise. Always warm up before you start exercising.

Is This the Same as an Exertion Headache?

An exertion headache is different from a migraine attack triggered by exercise.

• Exertion headaches — These headaches occur during physical exertion (such as weight-lifting), due to an increase in blood pressure in the skull. They’re not caused by an underlying condition. They are usually bilateral, throbbing or “pounding,” and usually don’t appear with nausea, vomiting, or photophobia.
• Exercise-induced migraine attacks — When people have migraine, a chronic neurological condition, disabling headaches and other symptoms can be triggered by specific stimuli, such as exercise.

If you experience headaches when you exercise, talk to a healthcare provider. They can evaluate the cause and provide personalized treatment options for you. A person can have both migraine and exertional headaches.

Which Workout Triggers Should You Watch for?

If exercise leads to migraine attacks, track what you were doing just before symptoms started. For instance, some MyMigraineTeam members find that bending down triggers an attack, while others only have symptoms if they exercise without warming up first. It’s important to know what specifically may be triggering your attacks so you can avoid having the same issue in the future.

Keep an eye out for these potential triggers, which some people report with exercise.

• Dehydration — Not drinking enough can be a common migraine trigger. You may need to drink more when you’re exercising to make up for what you lose through your sweat.
• Overheating — Getting overheated, especially if you aren’t drinking enough, can lead to a migraine attack while exercising.
• Under-fueling — If you’re exercising, you may need to increase your food intake to account for the calories you burn during a workout. Skipping meals or not eating enough could cause your blood sugar to dip, which can trigger a migraine attack.
• Straining or holding your breath — Strenuous sports, such as weight-lifting, may be more likely to trigger migraine attacks.
• Back or neck pain — Certain exercises may cause pain in the back or neck. Pain in these areas may trigger a migraine attack.

Preventing Exercise-Triggered Migraine Attacks

Always talk to your migraine specialist before starting a new exercise program. They can help provide strategies to reduce the likelihood of an attack. They may also adjust your migraine treatment plan to account for any new activities you’re adding to your routine.

As part of their recommendations, your doctor may suggest:

• Warming up slowly before beginning any exercises
• Pacing yourself by exercising for short periods before building up to longer workouts
• Ensuring you maintain proper hydration by stopping your workout frequently for beverage breaks
• Eating consistent snacks or meals to keep your blood sugar levels consistent
• Checking the temperature to avoid overheating
• Avoiding bright and noisy gyms if these are your triggers

MyMigraineTeam members have offered their tips for exercising with migraine. “I eat clean and walk, bike, or lift weights when I feel I can,” one member said. “I avoid putting my head down or anything that brings blood to my head, and I do cardio only when I feel good. Nothing hard.” Another replied, “Sometimes movements aren’t a good idea, especially if the weather is all wacky.”

Your neurology specialist may refer you to a physical therapist for specific, personalized exercise strategies that fit your lifestyle and preferences. If exercise is part of your overall migraine management plan, they can develop a comprehensive plan to help you work out without triggering new attacks.

When To Call a Doctor

While some post-workout migraine symptoms can be managed at home, there are times when you should call a doctor right away. This includes:

• Sudden, severe, or new head pain that appears out of nowhere
• Headache pain accompanied by trouble talking, confusion, numbness, fever, double vision, a rash, or neck stiffness
• Headaches that develop after hitting your head
• Headaches that worsen during sudden movements, such as coughing
• Headaches accompanied by seizures
• Migraine auras (sensory changes like seeing halos or hearing ringing in your ears) that last more than an hour

See a migraine specialist, neurologist, or headache specialist right away if you have any of these symptoms. They could indicate an emergency that requires immediate medical advice.

Join the Conversation

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