It might seem counterintuitive to assume that more exercise—more pounding, more sweating—could reduce the frequency and severity of migraines, but that’s what some preliminary research has found. These headaches affect an estimated 11 percent of the global population, including children.
A meta-analysis and systematic review published in 2019 in the Journal of Headache and Pain looked at data from six controlled clinical trials since 2004, of people with confirmed migraine diagnoses who underwent exercise training. Overall, it found that regular exercise reduced the number of migraine days. Three of the studies showed decreases in migraine pain intensity ranging from 20 to 54 percent, and decreases in the duration of migraines of 20 to 27 percent.
In particular, one of the studies found that an aerobic exercise program (consisting of 30 minutes of jogging, plus a warm-up and cool-down, done three times a week for 10 weeks) reduced the number of migraine days from about four episodes per month pre-training to about two episodes per month after. Another study in the analysis reported a reduction in migraine burden, such that the participants were better able to engage in household chores and family activities as well as in physical activities (often, people with migraines avoid activities they think will cause pain).
Researchers hypothesize that regular aerobic exercise may help tame the headaches by reducing stress and improving sleep (both known migraine triggers); releasing endorphins (neurotransmitters that act as natural painkillers and mood enhancers); and helping to control weight (there is a well-established link between obesity and migraine headaches). Another possible mechanism is that exercise may affect the ability of blood vessels to dilate and constrict, a function that may be altered in people with migraines.
The studies have been small and of short duration, however, so it’s not known what the optimal exercise “dose” would be (higher-intensity or higher duration might, for example, lead to better results) or whether any effects persist. Still, getting more physical activity is worth trying as a medication-free way to head off headache pain or as an adjunct to your migraine treatment. If you’re not used to exercising, start slowly to make sure the activity won’t trigger a headache, as happens in some cases. That could mean doing five to 10 minutes of brisk walking initially and working your way up to 30 to 45 minutes, three times a week, of whatever aerobic activity you enjoy.
Bottom line: Even if you don’t see dramatic results with exercise, at the very least, the evidence to date makes a good case for not letting migraines get in the way of engaging in regular physical activity for all the other benefits it provides, including improved cardiovascular health.
This article first appeared in the UC Berkeley Wellness Letter.
Also see 4 Nondrug Options for Headaches.