Migraine Triggers: Exercise, Physical Activity

Exercise has a chicken-and-egg relationship with migraine. This can be confusing for people with migraine because:^1-3

• Many studies show that regular exercise reduces how often someone has migraine attacks and the severity of those attacks. Exercise also works as well as preventive migraine drugs to reduce the number of attacks, but...
• One of the official symptoms used to diagnosed migraine is that the head pain gets worse with normal activities such as climbing stairs, walking, or moving the head
• Strenuous exercise sometimes triggers what is called a weightlifter’s or sports-related migraine
• Rest in a dark room is a common way to treat migraine

Said another way, exercise and physical activity help prevent migraine, but it is also a migraine trigger for some people. Plus, pain during exercise or movement is a migraine symptom.

How often exercise triggers migraine varies widely. Studies have found that between 9 and 57 percent of people report exercise or physical activity triggering a migraine, or making migraine head pain worse.¹

Some people report that exercise triggers a migraine only after intense exercise, like a long run on a hot day. Others report that exercise triggers a migraine some days but not others, or at one age but not another. The head pain may begin during exercise or after.¹

Why can exercise trigger migraine?

Doctors have some theories for why exercise sometimes triggers a migraine. Many believe exercise triggers the release of brain chemicals that are involved in sleepiness, fatigue, energy metabolism, or pain response. These brain chemicals include:¹

• Hypocretin
• Calcitonin gene-related peptide (CGRP)
• Beta-endorphin
• Endocannabinoid ligand anandamide
• Brain-derived neurotrophic factor

How can you avoid an exercise triggered attack?

Some people with migraine avoid certain physical activities in the hopes of preventing an attack. However, a lack of exercise contributes to poor health and extra pounds. Obesity is linked to more frequent migraine attacks.

A little planning helps many people with migraine exercise without triggering a migraine. Common suggestions include:^1-3

• If you are not already active, start slowly and gradually add more physical activity into your routine
• Make sure you are well-hydrated before, during, and after exercise. If you feel thirsty, it means you need to replace fluids. If you are not sweating during vigorous exercise or when it is hot outside, you may be dehydrated and need to drink more water.
• Eat foods with protein about 1½ hours before exercise to keep your blood sugar levels up during exercise. Low blood sugar levels can trigger a migraine.
• Keep a regular schedule. For example, if you walk every morning or every day after lunch, stick to that routine. Changes in routine can trigger a migraine.
• Be sure to warm up before you exercise by slowly walking before running or stretching before lifting weights. Sudden, vigorous exercise can trigger a migraine.
• Try to avoid exercise during hot weather or in high altitudes because migraines are more likely in these conditions

Why might exercise be good for you?

Exercise can be an effective non-drug treatment to help you manage migraine. The body releases endorphins during exercise, which are brain chemicals that reduce pain and lift mood. Exercise also helps reduce other migraine triggers, such as stress and depression, and improves sleep quality.^2,3