“You Should Exercise More!”

“You Should Exercise More!”

“You should exercise more!”

These were the dreaded words that came out of my headache specialist’s mouth at my last appointment. She told me that aerobic exercise a few times a week (with sweating and all) can reduce migraine pain by an average of 30%. And I have absolutely no reason to disbelieve her. My own experience tells me on no uncertain terms that the more I can get my heart rate up (in non-triggering environments) the better I feel. It’s no mystery why summer vacations spent near a lake, with nightly walks and daily swims feel great. And it’s no mystery why February and March are my worst pain months of the year, because it’s hard to get outside to exercise very much at all. It makes sense! More exercise should equal less pain!

So why did I grimace when I heard these wise, well-intended words?

We know exercise can have good benefits

It might have something to do with books I’ve read that claim to have the answer to banishing all chronic pain that are merely long, drawn out exercise plans, like that foodie blog that promises you the best chocolate fudge brownies ever, but begins with a novel about procuring the ingredients before getting to the darn recipe! Exercise!? Thanks, tips. Glad I wasted a whole trip to the library for your magical cure-all for something I already knew about.

But it’s not that simple to stick to a routine

It might also have something to do with the fact that it’s not very easy, at all, to stick to any kind of regular exercise routine when you’re dealing with frequent migraine attacks. For many of us, the recovery or “postdrome” phase means that for many hours or even days after an attack, we have limited energy and are even more prone than usual to subsequent attacks. And the tricky thing about exercise is that for many of us, it can act as a trigger. So if we have several attacks per week, with long recoveries, where exactly does the exercise fit in? How about that for a paradox? One of the things that can make us feel better in the long run can also make us feel immediately, acutely, much, much worse!

The struggle of prioritizing exercise

Prioritizing exercise is hard enough when we’re well and free of any chronic, disabling conditions. One need look no further than all the unused gym memberships when the lustre of New Year’s Eve resolutions wears off to a dull matte to see how hard it is to schedule serious exercise in around work, family, and a social life. But when work, family, and a social life are all affected, maybe even non-existent, due to pain, it’s hard to say, well, even though I can’t work, or spend time with my family and friends, or even go get my groceries weekly, no matter what, I’m going to make it to the gym.

The exercise paradox

I consider myself incredibly fortunate. After being almost completely out of commission due to migraine over three years ago, I am now able to work almost full time, spend some time with family, and manage some semblance of a social life. And it’s still hard to prioritize exercise when I want to give more of myself to all of those things.

But then there’s that evidence staring me in the face: if I could just find a way to fit in more exercise, I could potentially reduce the pain enough that I WOULD have more time for work, family, or friends.

And so, with the “exercise as preventative and trigger” paradox pushed to the back of my mind, with my tail between my legs, and with my pride fully swallowed, I hereby pledge to start engaging in some kind of aerobic activity for 20 minutes at least twice a week.

(How’s that for commitment? “Some kind of aerobic activity…” I’ll figure it out, okay?)

How do you fit in aerobic exercise despite the many demands of regular life plus migraine? Is it even possible!?

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Migraine.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.


View Comments (36)
  • Maryse
    3 months ago

    Hi Anna and everyone, exercice is for sure essential for us with migraines to get our energy back and calm our nervous system. The big impacts of the migraines on all our systems make us super tired, even depressed and exercice helps to counteract these effects. But not all exercices methods are good for everyone. There are so many choices we have to go towards the exercice activity that will suit us, that will bring us wellness and pleasure to take our mind off! Just like meditation it is possible to find a physical activity that is in harmony with our energy level. My personnal experience of 25 years suffering of migraines made me try many methods until I found one that could satisfy my need for moving my whole body softly but completely, breathing in full consciousness and feeling almost in a meditative state. I am passionate about it. it is now part of a daily routine and helps me greatly to lower the intensity and frequency of my migraines. It is called Gyrotonic. The best exercice method ever. But most importantly, you need to find the one that will be in harmony with your personnality and your needs bringing you joy and happiness. I hope this helps.

  • Emily
    2 years ago

    I know that more exercise–any exercise–would help me. At the moment I seem to be locked into chronic migraine, though, and the Topamax I’m on to try to help manage it makes me fatigued and dizzy. It’s a recipe for sitting on the couch doing nothing. I know this sounds lazy, but the Topamax side effects really wipe me out–I went from an energetic enthusiastic person to a slug nearly overnight. It’s so frustrating.

  • Nonster
    2 years ago

    Heat, even elevated body heat, is a huge trigger for me. I used to exercise regularly and it helped everything about my being. Then I got chronic migraines. How can I get my heart rate up and not raise my body temperature thus inducing a migraine????

  • HelenC
    3 years ago

    I was active duty Army when my migraines started. There was no way to avoid working out every single day and sometimes I thought it was going to kill me, quite literally. Running wasn’t the worst. It was the calisthenics. Up and down off the ground, my head in constant motion, head below the heart. There were times I was afraid my head might actually explode. The pounding would take over to the point that everything would go black. Before we figured out it was not a brain tumor I was absolutely terrified. Even after I knew I was not going to die I would have those episodes and the pain and blackness would be so severe I would revert back to not believing the test results. I would be sure they missed something and I really did have a tumor.
    On a good day exercise is probably good for me but I am still so terrified of it that there is pretty much nothing in the world that could make me get down on the floor and put my head below my heart again.

  • DonnaFA moderator
    3 years ago

    Hi, Helen, and thank you for your service.

    It’s certainly understandable that you have a negative association with exercise, the military PT routine can be inflexible and unforgiving. The good news is, we have articles that discuss lots of great low-impact options that don’t require floor time. Mental Health, Migraine and Exercise discusses several options, the most interesting to me personally, is Tai Chi. The article states that it works with the body similarly to acupuncture! Migraine, Exercise, & 10 Simple Steps To a Healthier Lifestyle talks about ways to make activities-of-daily-living into endorphin-boosting exercise. As always, please be sure to check with your doctor before starting a new routine.

    We’re glad you’re here, Helen. You’re never alone, we’re always here to share information and support. -All Best, Donna (Migraine.com team)

  • cal2
    3 years ago

    I worked out 6 days a week before becoming chronic 9 years ago and was able to do light aerobics when chronic began. I miss it terribly because it really made me feel better physically and emotionally. Before chronic, I had migraines that I could still manage a work out through. Now it takes every ounce of energy most days to do 4 core excercises for spot toning. I would have sworn I’d never be hit with something that drained me of my life of exercise. I worked out through a pregnancy at age 40 and was still a toned happy size 4 when life changed. I know I’d feel better, I’ve paid my gym membership each year and haven’t gone once in 9 years. The energy I had or the days I could function were spent with my child who was 12 when this started. I totally relate to your artIcle.

  • fccuman
    3 years ago

    I get three to four headaches a week, I my new doctor sent me to see a new neurological doctor she took me off all my meds and then told me don’t expect and help with my pain medication but she will not prescribe them, my pain doctors don’t want to either what do I do? I have never abused them because I have always been afraid of losing them. Now I have no way to manage my pain.

  • Leilani Siplon
    3 years ago

    I have been running full-time since May 2013, and I noticed that the frequency of my migraines have gone down. However, the severity is still the same.

  • zippy1987
    3 years ago

    Iam in tears right now. I have had two major sinus surgeries with in the year of 2015. I continue to have pain. I prayed and prayed and did not know what to do. I finally just typed a migraine in my nose, and found this site. This fits all that is happening to me. Except that most of the time the pain comes on at night while i am sleeping. I was in the middle of deciding if i wanted to do allergy shots, something told me no. I have taken all the rugs out, covered my pillow and sheet (for dust), gotten air purifier and salt lamp for bed room. And still in pain. I think i may have found my problem. Please keep me updated on this subject.

  • cal2
    3 years ago

    I had sinus surgery in 1986 thinking it would help my pain. I couldn’t breathe for long through my nose so my deviated septum needed to be fixed. It took years before I kept tract of my pain and it started each month with hormonal changes. I am chronic now and they do feel somewhat like sinus. It’s a common thread for many migraine sufferers. My pain is behind my right eye and my nose feels stuffy which can be common during migraine. I wish you luck and a good diagnosis.

  • Hormones
    3 years ago

    Fall 2015 I had to stop doing Mysore Yoga due to an injury. It was strenuous, major sweat-inducing exercise and I loved it. So giving it up for several months has been so disappointing for me. It’s now May 2016 & I can report that stopping it made no difference in the length or severity of my migraines. Both the length and the severity of my migraines has remained the same. So for me, although I was in terrific shape, the exercise did not seem to have any positive affect on my migraines. I was very surprised by this. Just wanted to share this with you.

  • Anna Eidt author
    3 years ago

    It’s possible that nothing surprises me any more when it come to migraine! I think each individual’s treatment plan truly needs to be unique, and sometimes it makes more sense to trust our own experience and observations than the advice of others.

  • Yoyo
    3 years ago

    I walk and fit into my regular activities. Work requires frequent trips up and down two flights of stairs. If I have to buy something I try to go to a store in walking distance even if I don’t think they carry the item. If I have to drive to a store I park as far away as possible (but can still find my car because the memory issues sometimes leave me wondering in the parking lot). Work helps during the winter months. Lastly I am in the process of finding a physical therapy provider that can accommodate my work schedule and off self payment plans so I don’t have issues with insurance denials. In addition to migraines I have degenerative disc disease ans TMJ. It is so difficult to keep performing but for me movement keeps me moving, I think of it like basic physics – objects in motion stay in motion. But I agree when health care workers see migraine patients they do tend to assume we are inactive. Why don’t they ask us about our lifestyle before assuming all we do is lay on the couch?

  • Trisha27
    3 years ago

    As a 20 year migraine sufferer, I realized years ago that strenuous exercise is a big trigger for me. I had always been very thin and could eat like a trooper. Then menopause set in. I look at food and my thighs grow! I found walking as often as I can is the best exercise for me. I does not make sense to take Zomig or another Triptan to constrict my blood vessels when I have a migraine, and then try and get my heart rate up.

  • FlyDragonfly
    3 years ago

    You said exactly what I have been saying to myself these last few years. I feel it is not a good idea to try to exercise and get my heart rate up when I read all of the contradictions about Relpax. I know what it does and exercise and Relpax just don’t mix. I can try to fit in exercise when I’m not having migraines back to back but it’s very hard to get a good routine down and stick to it. This has been a difficult realization for me having been an avid exerciser since my teen years.

  • Julianne
    3 years ago

    Amen, sista! I’m right there with you. Except I haven’t gone through menopause yet as I’m 35. But I’ve put on weight since my headaches have gotten worse because if I get my blood pumping, it triggers a headache. Not to mention weight gain seems to be a side effect of every medication…

  • jns192 moderator
    3 years ago

    Thank you so much for sharing your experience (and humor) with us!
    Strenuous exercise is a trigger for many of our community members.
    I thought you might enjoy reading this article written by The Migraine Girl and her take on walking: https://migraine.com/blog/a-brisk-walk-made-me-pain-free-for-a-bit/
    Jillian (Migraine.com Team)

  • Judy H
    3 years ago

    I don’t mean to be a “Debbie Downer”. I have had migraines for 40 years. They blew way out of proportion after my kids were born in my early 30s. Up until that time I had been very active – marching band, color guard, aerobics. Then when my migraines worsened so much in intensity and frequency, I discovered that for me, aerobics was a trigger. I tried going through the motions with a lot less vigor, and I have to admit, I merely got very annoyed at strangers in the class who “encouraged me to work out harder”. UGH. Now I walk my neighborhood at my pace. I am looking forward to retiring in a couple of years so I can walk more often and for longer periods of time.
    I don’t mean to be discouraging, but it can be depressing discovering that you have to back off your activity level. Avoid being in denial if your head tells you that you can’t sustain vigorous exercise anymore. You can still enjoy walking. 🙂

  • jns192 moderator
    3 years ago

    Judy H,
    Thank you so much for your comment. You don’t sound like a debbie downer at all! In fact, it sounds like though you miss how active you were before your kids were born, you have accepted that certain activities no longer work for you. Instead of becoming a couch potato, you have found a wonderful alternative in walking!
    I think you will really enjoy this article on knowing when to rest or not to rest: https://migraine.com/blog/know-advice-take-rest/

    Jillian (Migraine.com Team)

  • Coley
    3 years ago

    I just started slowly exercising again in the past two weeks. The past 3 years I haven’t been able to at all without it triggering a migraine, even if it was just a short 10 minute walk.

    Now since I know that my main trigger was with food, (caramel color). Last week I just started going on small walks. I started with a short walk and I am going every 4 days or so now. I’ve noticed so far *knock on wood* it hasn’t triggered a migraine for me. I know when I get them I’m completely out for a few days. I’ve also learned that since stress is a trigger for me too, recently I’ve discovered spearmint tea. It helps with my own stress levels which has helped not trigger a migraine for me as well.

    I have had a lot of problems over the last 3 or so years, I’m just slowly adding exercise back in. I’m not doing too much to overdo myself either. Taking baby steps is the key for me. I’ve noticed what helps too, is walking with a friend. That way I can talk to her while I am walking and it keeps me less focused on whats going on with me.

    Some days, I only do a little bit of cleaning and count that as exercise. Everything adds up, but also taking time to myself for me has helped a bunch too. I still get about 6 migraines a month, but it beats the 20 that I was getting.

    I wish you luck and hope you find a nice medium that works for you. 🙂

  • jns192 moderator
    3 years ago

    Thank you for sharing your story and inspiring others to try something again that had once triggered a migraine. As a fellow migraineur, I know how easy it is to avoid things that I have labeled as triggers. I give you a lot of credit for dipping your toes back into exercise. I think it is great that you are taking baby steps and seeing how your body responds to this new (and very healthy!) addition to your life.
    I think that several points in this article resonate with your experiences: https://migraine.com/blog/exercise-tips-to-move/

    Lastly, I wanted to share an infographic with you about managing stress!

    Hope to hear from you soon.
    Jillian (Migraine.com Team)

  • jojobaggins
    3 years ago

    I just had my first appointment with a (new to me) migraine specialist in Chicago, and he recommended two things that I’m not already doing.

    The first is to go for a walk every day. Not for exercise, but for my mind. He said to find a park with trees, and walk leisurely, meander, and just be relaxed. He said it raises serotonin levels.

    The second thing he said when I mentioned that I get depression and anxiety sometimes was that I should see a therapist and that there are therapies that are designed to change the way your mind handles stress. That you can recognize when you are about to be triggered by a migraine, and this therapy can help avoid it. I’m still waiting for his summary email with more discussions, but it sounds intriguing.

    Then what I’m already doing that he recommends to people is to eat regularly, sleep 7+ hours per night, drink only clear alcohol, if any, and only with food.

  • Jojiieme
    3 years ago

    Great article! And timely, given change of seasons. 🙂
    Two quick suggestions:
    Find yourself a sympathetic exercise physiologist OR occupational therapist. What you want is a “McGyver” of exercise.
    *it’s hard and impractical to do press-ups. But we can stand facing a wall and push against it, as if it were the floor. Uses the same muscles, does the work, but doesn’t kill us (it’s actually an allowed modification for age/injury/disability)
    *when you’re placing things in cupboards and on shelves, find a way to incorporate stretches! lifts and bends into your movements. These might be based on ballet barre exercises. (Again, these are often suggested for people ho are aged/recovering from injury/living with disability). Don’t forget to include pegging out washing on the line, weeding the garden (a raised bed is fine), walking/marching the bin out for collection…
    This whole concept is called “incidental exercise” and is quite valid. 🙂

    The other suggestion is:
    Futurelearn.com is a consortium of top universities around the world. It offers FREE online courses, on just about anything. They’re short, and there are no prerequisites. In June, there’s a great course on the Exercise Prescription for preventative health and wellbeing. Goes for about 3or 4 weeks, just a couple of hours each week, whenever you can manage it over that week. It’s about how to design the exercise ‘prescription’/solution for a particular kind of situation!
    Check it out!!

  • Jojiieme
    3 years ago

    Sorry about typos. Can’t find the edit button.

  • jns192 moderator
    3 years ago

    I really enjoyed reading this article!
    As an avid exerciser (if that is a word), it was very difficult for me to cut back when my migraines reached their peak about 2 years ago. At that time I was dealing with a headache everyday and a migraine ~20 days a month. I decided that working out was no longer a priority because my head always hurt too much.
    I gained a lot of weight and just felt unusual overall.
    It took me a while to get back into it. I don’t begin working out if I am in the middle of a bad attack but if it is mild I will walk on the treadmill or something low intensity.
    Today I am back into a regular and more intense workout routine and am so happy to say that I am only getting about 10 migraines a month.
    On the whole, I definitely think that aerobic exercise has helped bring my migraine frequency down.
    As far as fitting it into my schedule, I literally put it in my calendar as an event. If I am absolutely exhausted I will listen to my body and skip the gym. But if it’s just that day to day fatigue, I will push myself and am usually glad I did.
    If I can, I prefer to go to the gym in the morning so I can’t make excuses as the day progresses. I also feel great the rest of the day.
    Sometimes, I listen to a lecture for school or even just a podcast I have always wanted to listen to while doing my aerobic exercise. This helps me feel like I am being duly productive!
    I hope some of these tidbits might work for you 🙂

    Jillian (Migraine.com Team)

  • KateMcC
    3 years ago

    I count anything that works up a sweat. I use a pedometer app on my phone, but I also count vacuuming, marathon cooking and cleaning sessions in the kitchen, etc. For me it’s about priority. When I feel good (which we all know is relative), cleaning the bathroom is better exercise than going to the gym.

  • jns192 moderator
    3 years ago

    Thank you so much for sharing. I love your outlook.
    My friend recently introduced me to the “health” app that is automatically on every iphone. I didn’t realize that it served as a pedometer and distance tracker. It is a really helpful tool to visualize my activity and motivates me to do even more.
    I think that counting housework as exercise is a great way to kill two birds with one stone. I know I break a sweat carrying my laundry down to the basement and then back up to my bedroom.
    Thanks for being a part of our community and sharing such wonderful insight.
    Jillian (Migraine.com Team)

  • JayAnne
    3 years ago

    I read an article that said that a recumbent bike was the least jarring, and thus, the best exercise option for migraine patients. Excercise is a definite trigger for me, so I use it for a short amount of time, and I DO NOT try to break a sweat or get my heart rate up. So far so good.

  • Kerrie Smyres moderator
    3 years ago

    In a talk I heard from Dr. Rob Cowan, he said that the most important thing is movement. Even mild aerobic movement releases endorphins, which can go a long way in minimizing the impact of migraine. It’s still hard to prioritize when I’m trying to cram every other part of life into the non-migraine time I get, but the endorphin is a good motivator for me.

  • Holly H.
    3 years ago

    This is timely, for now my 4th diagnosed sub-type of migraine is a brain-stem type that is crazy spiked by any type of seemingly over-exertion, much less exercise. I am a long-time 24/7 migraine-with-aura person, but just one of the things I am dealing with now with this brain stem migraine is sudden partial to total passing out right where I stand or sit. This type of migraine itself came to light when I was exercising and losing weight; but I would turn scary pale and everyone would tell me that I needed to sit down, and then “the sledgehammer” would hit that started the cyclical episode. Then they came more often, until these brain stem migraine cyclical episodes became part of my 24/7 migraine life also. So, exercise is not at all an option.

  • RecipeRenovator
    3 years ago

    I have gradually built up (over many patients months) adding in more exercise. My goal at first wasn’t “aerobic” but just movement as Luna suggests. Wearing an activity tracker has been super helpful for me. While I shoot for 10,000 steps a few days a week, I am also monitoring the weather, etc. If necessary, I get up early now to walk before sunrise if we’re having hot/bright weather. I also have to be careful because I can trigger fibro symptoms if I do too much. So it’s a balancing act. I’m building gentle exercise into the Plan that will be in my upcoming migraine book.

  • Mr FBP
    3 years ago

    Try the five minute HIIT routine, proven to have many of the benefits of regular exercise.

    i. One minute warm up (easy pace),
    ii. twenty seconds as intense as you can manage
    iii. one minute easy pace
    repeat ii & iii another two times.

    total five minutes

    Do this routine 3 times per week. Proven to reduce risk of conditions such as diabetes in all tested participants, shown to improve athletic ability (VO2 max) in most tested particiapants.


    The headline say “Three minutes of execise per week” but it’s only referring to the high intensity component.

  • Mr FBP
    3 years ago

    Just to add, when I do this routine running, I don’t time myself – I can’t look at a watch and run fast – but estimate 180 steps per minute and run flat out counting thirty times I put my right foot down (60 steps total).

  • Luna
    3 years ago

    I do not worry about aerobic activity but movement is my goal. When the inner and outer weather permits I walk “around the block”(1.5 miles of up and down terrain). Just going to the mail box is 1/4 mile downhill. I walk in place for even just 5 to 10 minutes at a time, hopefully several times during day. When aerobic activity is possible then I have several youtube videos to exercise with. Now that it is spring, mowing has to be done regularly and my yard is not level. Have options for what fits with your day.

  • gertface
    3 years ago

    I’m terrified of exercise for that very reason. I know I need to, but it seems like everything in my life is a trigger. So, how do I even start?

  • 3 years ago

    I can totally relate. Just bending over to paint my toenails can trigger at certain times. I’d dearly love to go back to Zumba but that was what triggered my chronic migraine over 3 years ago. As I understand it, aerobic exercise increases blood flow to the brain, which is why triptans work by restricting blood flow. Maybe it’s a matter of starting off gently and eventually training your blood vessels?? But like you, it terrifies me!

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