Does Exercise Make Migraines Worse and Tension Type Headaches Better?

Hindiyeh, Nada; Krusz, J.; Cowan, Robert P.

doi:10.1007/s11916-013-0380-5

Cited by 32 publications

(22 citation statements)

References 92 publications

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“…The program in total should remain in a tolerable level preventing exercise-related pain and disability, with a suggested frequency of two to three times per week. 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 [ 109 ].…”

Section: Methodsmentioning

confidence: 99%

The association between migraine and physical exercise

et al. 2018

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BackgroundThere is an unmet need of pharmacological and non-pharmacological treatment options for migraine patients. Exercise can be used in the treatment of several pain conditions, including. However, what exact role exercise plays in migraine prevention is unclear. Here, we review the associations between physical exercise and migraine from an epidemiological, therapeutical and pathophysiological perspective.MethodsThe review was based on a primary literature search on the PubMed using the search terms “migraine and exercise”.ResultsLow levels of physical exercise and high frequency of migraine has been reported in several large population-based studies. In experimental studies exercise has been reported as a trigger factor for migraine as well as migraine prophylaxis. Possible mechanisms for how exercise may trigger migraine attacks, include acute release of neuropeptides such as calcitonin gene-related peptide or alternation of hypocretin or lactate metabolism. Mechanisms for migraine prevention by exercise may include increased beta-endorphin, endocannabinoid and brain-derived neurotrophic factor levers in plasma after exercise.ConclusionIn conclusion, it seems that although exercise can trigger migraine attacks, regular exercise may have prophylactic effect on migraine frequency. This is most likely due to an altered migraine triggering threshold in persons who exercise regularly. However, the frequency and intensity of exercise that is required is still an open question, which should be addressed in future studies to delineate an evidence-based exercise program to prevent migraine in sufferers.

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Section: Methodsmentioning

confidence: 99%

The association between migraine and physical exercise

et al. 2018

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“…It is important to consider that there are two different exercise strategies; (1), aerobic exercises; and (2), local exercises targeting specific musculoskeletal disorders of the cervical spine. This differentiation is clinically relevant since aerobic exercises could be the best option in migraine prophylaxis, whereas specific neck/shoulder strengthening exercises may be a potential better choice for TTH [61]. This assumption is based on the presence of motor output changes of the cervical musculature, e.g., reduced neck muscle strength [62], an increased co-activation of the superficial cervical muscles [63], in patients with TTH.…”

Section: Scientific Evidence Of Exercise Interventions For Headachesmentioning

confidence: 99%

Clinical Reasoning Behind Non-Pharmacological Interventions for the Management of Headaches: A Narrative Literature Review

Fernández‐de‐las‐Peñas

Plaza-Manzano

Arias-Buría

2020

IJERPH

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Headache is the clinical syndrome most commonly observed by neurologists in daily practice. Pharmacological and non-pharmacological treatments are commonly used for the management of headaches; however, the clinical reasoning behind these interventions is not properly applied. We conducted a narrative literature review using as data sources for academic PubMed, MEDLINE, EMBASE, AMED, CINAHL, EBSCO, PEDro, Cochrane Database of Systematic Reviews, Cochrane Collaboration Trials Register, and SCOPUS. This narrative literature review mainly considered systematic reviews, meta-analyses, randomised clinical trials, and expert opinions published after the year 2000 discussing clinical reasoning for application of non-pharmacological interventions in individuals with tension-type, migraine, and cervicogenic headaches. After the data extraction, we organized the literature thematically as follows: (1) mapping of theoretical aspects of non-pharmacological interventions; (2) summarizing most updated literature about effectiveness of non-pharmacological interventions grouped by targeted tissue and headache; (3) identifying research gaps in the existing literature and proposing hypotheses for better understanding of current clinical reasoning. We found that there are many non-pharmacological treatment strategies used for headaches, including beyond the tissue-based impairment treatments (bottom-up) and strategies targeting the central nervous system (top down). Bottom-up strategies include joint-biased, soft-tissue biased, or needling interventions, whereas top-down strategies include exercise and cognitive interventions. Evidence shows that the effectiveness of these interventions depends on the application of proper clinical reasoning, since not all strategies are effective for all headaches. For instance, evidence of non-pharmacological interventions is more controversial for migraines than for tension-type or cervicogenic headaches, since migraine pathogenesis involves activation of sub-cortical structures and the trigemino- vascular system, whereas pathogenesis of tension-type or cervicogenic headaches is most associated to musculoskeletal impairments of the cervical spine. We conclude that current literature suggests that not all non-pharmacological interventions are effective for all headaches, and that multimodal, not isolated, approaches seem to be more effective for patients with headaches. Most published studies have reported small clinical effects in the short term. This narrative literature review provides some hypotheses for discrepancies in the available literature and future research. Clinical reasoning should be applied to better understand the effects of non-pharmacological interventions.

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“…Our review of the medical literature did not identify studies investigating the combined effects of these three domains of RLB. Previous studies have investigated one domain alone, i.e., either sleep [5,18], exercise [6,11], or mealtime [15]. The purpose of the present study is to address this by investigating the connection between the RLB triumvirate and migraine.…”

Section: Introductionmentioning

confidence: 98%

“…Maintenance of biological rhythms is important in maintaining health, i.e., ultradian (e.g., feeding cycles) [2], circadian (e.g., cycles of sleep, digestive secretions, bowel movements) [3], infradian (e.g., menstrual cycles) [3], and diurnal rhythms (circadian rhythms synchronized with day-night cycle) [4]. Lifestyle behaviors of sleep [5], exercise [6][7][8], mealtime pattern [9] and hydration status [10] are known to independently affect migraine occurrence. Individual-customized daily aerobic exercise, daily scheduled stress management and relaxation techniques, and mindfulnessbased stress reduction prevent migraine [5], while inadequate sleep hygiene, non-restorative sleep, skipping meals, and dehydration can trigger migraine [11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

The impact of regular lifestyle behavior in migraine: a prevalence case–referent study

Woldeamanuel

Cowan

2016

J Neurol

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Regular lifestyle behaviors (RLBs) of sleep, exercise, mealtime pattern and hydration status independently affect migraine occurrence. We aimed herein to evaluate the differences in migraine occurrence among participants who do and do not maintain the RLB triumvirate. Cases of chronic migraine (CM) and referents of episodic migraine (EM) ≥ aged 15 years with charts regularly documenting RLB notes were continuously enrolled from a retrospective case-referent cohort study performed on electronic chart review from January 1, 2014 to January 1, 2015 at the Stanford Headache and Facial Pain Program. Association between RLB prevalence and migraine occurrence was studied. 175 CM and 175 EM patients were enrolled (mean age 44.4 years, 22 % males). Migraine was diagnosed according to the ICHD-3 beta criteria, and was confirmed by a Headache Specialist attending the Clinic. The CM cohort (22 %) exhibited less RLB than the EM cohort (69 %), with crude odds ratio of 0.13 (95 % confidence interval or CI 0.08-0.21). The adjusted odds ratio and adjusted relative risk between RLB+, Meds+ (those taking medication) and CM were 0.67 (95 % CI 0.32-1.40) and 0.74 (95 % CI 0.43-1.28), indicating no significant effect modification. Engaging in regular lifestyle behavior helps quell chronic migraine.

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Does Exercise Make Migraines Worse and Tension Type Headaches Better?

Cited by 32 publications

References 92 publications

The association between migraine and physical exercise

The association between migraine and physical exercise

Clinical Reasoning Behind Non-Pharmacological Interventions for the Management of Headaches: A Narrative Literature Review

The impact of regular lifestyle behavior in migraine: a prevalence case–referent study

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