Migraine is a complex neurological condition characterized by recurrent episodes of severe headaches, often accompanied by symptoms such as nausea, sensitivity to light and sound, and visual disturbances.
Unlike a typical headache, migraine involves a hyperexcitable brain that misinterprets sensory signals, leading to debilitating pain and discomfort.
For many, this condition significantly impacts daily life, limiting physical, social, and professional activities.
Despite its challenges, migraine management has evolved to include non-pharmacological interventions like exercise.
While exercise is widely recognized for its benefits to overall health, its role in managing migraine is often underappreciated.
Research and clinical experience reveal that regular, appropriate physical activity can help reduce the frequency and severity of migraine attacks.
Exercise promotes the release of endorphins—natural pain relievers—and fosters neuroplasticity, which helps the brain adapt and respond more calmly to potential triggers over time.
However, the relationship between exercise and migraine requires a nuanced approach. A sudden jump into intense physical activity can exacerbate symptoms, as the migraine brain dislikes abrupt changes.
Therefore, a thoughtful and gradual approach is essential. Starting with low-intensity activities and slowly increasing duration and intensity allows the body to adapt without overwhelming the nervous system.
With proper guidance, exercise can become a cornerstone of migraine management, helping individuals regain control of their health and quality of life.
How Exercise Impacts Migraine
The migraine brain is inherently hyperexcitable, often responding to everyday stimuli with exaggerated sensitivity. Dr. Lauren Natbony, a neurologist and headache specialist, explains, “The migraine brain is hyperexcitable, giving off pain signals inappropriately.”
This heightened sensitivity can lead to the misinterpretation of normal bodily changes, such as those induced by exercise, as threats—triggering or exacerbating migraine symptoms.
In the short term, exercise can feel like an additional trigger. As Dr. Natbony points out, “One of the diagnostic features of migraine is that it’s worsened by physical activity.”
Intense activity may temporarily increase the brain’s sensitivity to light, sound, and other stimuli, potentially leading to an attack. For this reason, many individuals with migraine are hesitant to incorporate physical activity into their routines.
However, the long-term benefits of exercise outweigh these initial challenges. Regular physical activity encourages the release of endorphins, the body’s natural painkillers, which help reduce the brain’s hypersensitivity over time. “Exercise produces endorphins, and over time, the more you produce endorphins, the more the brain calms down and starts to relax in response to exercise,” Dr. Natbony explains.
Beyond endorphins, exercise also promotes neuroplasticity—the brain’s ability to adapt and form new neural connections. This can help the migraine brain become less reactive to triggers over time, ultimately reducing the frequency and severity of attacks.
As I often tell my patients, while exercise may initially feel like a trigger, when approached correctly and gradually, it becomes one of the most powerful tools in managing migraine.
In essence, exercise serves as both a challenge and a remedy. While the journey may start with discomfort, its transformative potential lies in consistent practice and the body’s remarkable ability to adapt.
The key is to start slow and allow the brain to gradually acclimate, paving the way for long-term relief and improved quality of life.
Starting an Exercise Program Safely
For individuals with migraine, jumping into a high-intensity exercise program can worsen symptoms rather than provide relief. A gradual, thoughtful approach is key to reaping the long-term benefits of physical activity without triggering migraine attacks.
Starting with low-intensity activities, such as walking or yoga, can help the body adapt without overwhelming the migraine brain. “If you don’t exercise, let’s aim for two days a week of 10 minutes of getting your heart rate up,” says Dr. Lauren Natbony.
These short, manageable sessions form a foundation upon which intensity and duration can gradually build. Activities like mindful yoga or slow walking are ideal, especially in the early stages of an attack. As Dr. Natbony notes, “I’ve found that gentle movement can be beneficial, as long as it’s not too intense.”
Monitoring exercise intensity is crucial in identifying and respecting individual thresholds. Tools like heart rate monitors or the Rate of Perceived Exertion (RPE) scale provide objective and subjective measures of effort, helping individuals avoid pushing themselves into triggering zones.
“We need measurable ways for patients to gauge intensity,” I explain. “Whether it’s using heart rate monitors or asking how hard they’re working on a scale of zero to ten, these tools help them find a safe level.”
Recognizing personal limits and stopping before crossing into trigger territory is essential. This concept, known as sub-threshold training, allows individuals to slowly build tolerance to physical activity.
Dr. Natbony highlights the importance of this approach: “It’s about finding that point right before it would trigger an attack and stopping there. Then, over time, we can push it just a little further.”
By starting with low-intensity activities, using tools to monitor progress, and respecting thresholds, those with migraine can safely integrate exercise into their routine, transforming it into a powerful tool for long-term migraine management.
Tailoring Exercise for Migraine Sufferers
For individuals with migraine, a one-size-fits-all approach to exercise simply doesn’t work. Each person’s experience with migraine is unique, and so should their exercise routine.
“A prescription for exercise is important,” says Dr. Lauren Natbony.
“Just telling someone to exercise without guidance often leads to poor compliance.” Developing an individualized plan not only increases the likelihood of success but also ensures that specific needs—like addressing neck pain or posture—are met.
Posture and muscle imbalances play a significant role in migraine management. Strengthening the small stabilizing muscles of the neck can help reduce sensitivity and prevent attacks.
“When running or performing overhead exercises, fatigue in the neck’s suboccipital muscles can activate the trigeminal cervical nucleus, which may lead to an attack,” I explain.
Strengthening these muscles, along with the deep cervical flexors, helps improve neck stability and reduces the risk of triggering migraines during physical activity. Dr. Natbony adds, “It’s crucial to work on which muscle groups need strengthening and understand which ones are activated during specific exercises.”
A common myth about exercise and migraine is that high-intensity workouts are off-limits. However, research shows that this isn’t the case. “There was a study on high-intensity interval training (HIIT) for migraine,” Dr. Natbony points out.
“While it may worsen symptoms initially, long-term HIIT training has proven beneficial for many.” The key is to introduce high-intensity activities gradually, allowing the body to adapt over time.
By focusing on individualized plans, addressing musculoskeletal issues, and debunking myths about exercise intensity, those with migraine can incorporate effective and safe workouts into their routine.
Tailored exercise not only helps manage migraine symptoms but also empowers individuals to take control of their health.
Summary and Final Thoughts
Exercise is a powerful and underutilized tool for managing migraines. While the journey can be challenging, especially at the beginning, the long-term benefits make it worth pursuing.
As Dr. Lauren Natbony reassures, “I want to encourage everyone not to be afraid of exercise. It’s a really useful tool, not only for migraine but for overall health and well-being.”
The key to success lies in a gradual and consistent approach.
Start with low-intensity activities, such as walking or yoga, and slowly build from there. Regularity is crucial, as exercise needs to become a sustainable habit. “Think of exercise like medication—it needs to be taken consistently to work,” says Dr. Natbony.
For those struggling to find the right balance or who feel overwhelmed, seeking professional guidance can make all the difference. A tailored plan, designed around your unique triggers, lifestyle, and goals, ensures safe and effective progress.
“Having someone to guide you takes the burden off your shoulders,” I explain. “You can focus on following the plan and reporting back any challenges to adjust as needed.”
If you’ve been hesitant to start exercising or have faced setbacks, now is the time to take the first step. With the right approach and support, exercise can become a cornerstone of your migraine management strategy, helping you reclaim control over your health and well-being.