The association between migraine and physical exercise

Abstract

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.

The Role of Positive Health Behaviors in the Relationship Between Early Life Stress and Migraine

“…Despite the pharmacological interventions available to prescribing treatment providers, 15 there exists a need for adjunctive non‐pharmacological treatment for migraine 16 . Points of inquiry have included self‐management approaches, 17 and it has been suggested that regular exercise may exert prophylactic effects 16 .…”

“…Despite the pharmacological interventions available to prescribing treatment providers, 15 there exists a need for adjunctive non‐pharmacological treatment for migraine 16 . Points of inquiry have included self‐management approaches, 17 and it has been suggested that regular exercise may exert prophylactic effects 16 . There is general interest in the headache field in developing a better understanding of which types of modifiable positive health behaviors, such as physical activity and fruit and vegetable consumption, can be drawn upon in reducing the individual migraine burden.…”

Health Behaviors and Social Determinants of Migraine in a Canadian Population‐Based Sample of Adults Aged 45‐85 Years: Findings From the CLSA

“…Understanding the role of social determinants of migraine in aging samples is needed in order to better characterize risk and disease course among those with co-morbid medical conditions and multiple medications, which may affect treatment. [21][22][23] There is support for exercise regimes as a treatment option for migraine, 24 however, our understanding of the mechanisms in which aerobic exercise may exert positive effects, and corresponding therapeutic considerations (eg, dose) for such activities is not yet understood, hindering the use of exercise as a treatment option. 18 Non-pharmacological treatment of migraine is a rapidly expanding field, with special attention being given to a variety of lifestyle factors which may ameliorate risk, including exercise.…”

“…17 Among older migraineurs, medication options are reduced and non-pharmacological options may be of particular interest to prescribing health care practitioners and patients alike. 25 Gaining an understanding of the potential therapeutic benefit of physical activity in migraineurs is warranted given its affordability and ability to be administered on a large scale, 24 making it a potentially equitable treatment option. 19 Traditional recommendations for the treatment of chronic pain have excluded physical activity, however, a recent overview of Cochrane Reviews 20 demonstrated that while the quality of the evidence for physical activity/exercise as an intervention is low, there were positive effects and further study with increased methodological rigour is needed.…”

“…Additionally, animal research on the effects of early life stress on migraine demonstrated that voluntary exercise is linked to improved healthrelated outcomes for stress-exposed rodents. [21][22][23] There is support for exercise regimes as a treatment option for migraine, 24 however, our understanding of the mechanisms in which aerobic exercise may exert positive effects, and corresponding therapeutic considerations (eg, dose) for such activities is not yet understood, hindering the use of exercise as a treatment option. 25 Gaining an understanding of the potential therapeutic benefit of physical activity in migraineurs is warranted given its affordability and ability to be administered on a large scale, 24 making it a potentially equitable treatment option.…”