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Migraine affects 39 million people in the United States.

There is no cure for migraine, but there are several ways to manage pain and prevent attacks, including over-the-counter pain relievers like ibuprofen and aspirin, prescription medication, and lifestyle modifications like:

Here, we go over the impact exercise has on migraine, how to exercise safely, and what you should do if you experience migraine during physical activity.

If migraine pain is interfering with your life, you may want to consider exercise as an intervention for managing symptoms and reducing the frequency of attacks. While the research is mixed, there is some support for including mild to moderate aerobic exercise in an overall treatment plan for migraine.

In a 2011 randomized control study, researchers compared exercise, relaxation, and medication as methods to prevent migraine attacks. They determined that the highest percent reduction in attacks was from exercise.

A 2019 review of studies found that regular aerobic exercise may lead to a reduction of migraine episodes. Participants experienced a decrease of 0.6 migraine days per month, along with lower pain levels.

Researchers looked at aerobic exercise because of the role it plays in managing pain processing. Endorphins are released during exercise and how they are a form of natural pain relief.

Additionally, a 2018 review of studies suggests aerobic exercises like cycling and walking are preferred for people with migraine over high-intensity activity with muscle building.

To help prevent headaches while exercising, it’s important to follow a few safety steps before, during, and after physical activity.

In addition to the tips listed below, it’s also a good idea to get the OK from your doctor if your migraine headaches, another chronic health condition, or medications you’re taking may have negative side effects when combined with exercise.

Fuel up

Eat a snack or small meal 1 to 4 hours before exercising. This pre-workout meal should consist of carbohydrates and a small amount of protein and fat. For example, Greek yogurt with berries or a peanut butter and banana sandwich. The post-workout meal is also important. Aim for a small meal of carbohydrates and protein following exercise.

Stay hydrated

Proper hydration with water before, during, and after physical activity is critical for overall health and to prevent headaches or migraines. If you’re participating in endurance activities lasting more than 1 hour, consider hydrating with a sports drink.

Warm up and cool down

Warm up your body for at least 3 to 5 minutes prior to engaging in physical activity. Try walking, jogging in place, dynamic stretching, or a modified version of the activity you plan on doing. Carve out 5 minutes at the end of each workout for gentle stretching and time for your blood pressure and heart rate to come down.

Find the right activities

You may find that certain activities trigger headaches more than others. The good news is aerobic exercise is associated with a reduced number of migraine episodes per month. This includes:

  • walking
  • cycling
  • jogging
  • yoga
  • stretching

Exercise may trigger migraine in some people. According to a 2013 study, the lifetime prevalence of exercise-triggered migraine attacks was 38 percent (39 out of 103 participants) who experienced at least two migraines a month.

The most common type of activity reported by study participants was high-intensity exercise. Unfortunately, this study did not look at substituting other types of activity to see if a different routine could decrease migraine frequency.

Some people experience primary exercise headaches or exertional headaches during physical activity. Exercise is designed to increase heart rate and blood pressure, and doing this is how we gain the benefits from exercising.

“For people who get primary exertional headaches, caution needs to be taken to make sure there is no underlying medical condition causing these headaches,” says Clifford Segil, DO, a neurologist at Providence Saint John’s Health Center in Santa Monica, California.

These headaches are different from migraine headaches because they are often triggered by exercise and occur during or after physical activity. They can last anywhere from 5 minutes to 48 hours and most often occur in hot weather or high altitude.

If you have a migraine headache, you might be wondering if it’s OK to exercise while experiencing symptoms. While the exact answer will depend on your situation, treatment plan, and doctor’s recommendation, in general, if the pain is severe, you should probably put your workout on hold.

“Exercising with an active migraine headache is discouraged since the potential for worsening a migraine is greater than improving a migraine,” Segil says. “Migraine head pains are due to a change in blood vessel diameter in the meninges surrounding the brain, and exercise also affects these blood vessel sizes making exercising with a migraine a worrisome endeavor.”

If you’re dealing with persistent headaches when you exercise, Segil says you should see a doctor to make sure the exercise is not making a silent medical condition surface.

Additionally, people with whose headaches get worse with exercise should take their blood pressure before, during, and after exercise, Segil says. Untreated hypertension can show symptoms with exercise.

Adding exercise to your migraine treatment plan may help lessen the severity and frequency of headaches. To keep a migraine headache from occurring while working out, make sure to stay hydrated, fuel up before exercise, and consider activities that are less likely to trigger attacks.

If you gave an attack while exercising, stop what you’re doing and follow your normal treatment plan for managing symptoms. If migraine episodes increase or symptoms worsen during physical activity, see a doctor.