Migraines are the most common form of headache that can cause severe throbbing pain – usually on one side of the head – and severely affect quality of life. A migraine attack can last hours or days and often comes with nausea, vomiting and extreme sensitivity to light and sound.
According to a 2018 Deloitte Access Economics Report, almost 5 million people in Australia live with migraine, with 7.6% of them – around 400,000 people – experiencing chronic migraine, which means more than 15 migraine days per month.
Migraines are much more common in women than men and more prevalent in working-age people.
“During a flare, all people want to do is lie in a cold dark room and not do anything,” says Adnan Asger Ali, a physiotherapist and the deputy national chair at Musculoskeletal Physiotherapy Australia. But research shows regular exercise may have a preventive effect in reducing the number and intensity of migraines. One of the main reasons physical activity may help relieve migraines, says Ali, is that the body releases endorphins (natural painkillers) during exercise.
“Physical therapy can complement the pharmacological management of migraines,” he says. “It might mean that they take two Panadol instead of two codeine, and that’s still going to be a win because they’re not taking the hard stuff.”
A proper physical assessment is necessary to tailor a treatment plan to the individual, and individuals should consult with a health professional before embarking on a new exercise regime, but here are some suggestions on physical exercise that might help manage migraine.
The class: yoga and tai chi
Ali says slow movements, meditation and relaxation have significant beneficial effects on people who suffer from migraines. That includes activities such as yoga and tai chi.
In a recent randomized clinical trial that involved 114 patients aged 18 to 50 years with a diagnosis of episodic migraine, researchers found that people who practised yoga as an add-on therapy had less frequent and less intense migraines than those who received medical treatment alone.
Tai chi can also serve as a preventive measure for migraines. In a 2018 randomised controlled trial of 82 Chinese women with episodic migraines, researchers found that after 12 weeks of tai chi training, the women experienced significantly fewer migraine attacks.
The move: chin tuck
Neck stiffness and postural issues can be a driver for migraines, says Ali. He suggests the chin tuck, or cervical retraction, exercise to strengthen neck muscles and improve mobility.
The chin tuck exercise can be performed standing or sitting. Begin by sitting upright and looking straight ahead, keeping your neck and shoulders relaxed. Place a finger on your chin and gently glide your chin down – tuck your chin to your neck. Don’t hold your breath, move your head up or down or bend your neck forward.
You might feel a gentle pull at the base of the head and top of the neck. Hold the position for about five seconds and repeat the exercise 10 times – as long as it doesn’t cause any pain.
Aerobic exercises such as walking, jogging, running and cycling might help mitigate migraine.
A systematic review of studies on exercise and migraine published in The Journal of Headache and Pain in 2019 found that moderate-intensity exercise – physical activities that elevate your heart rate and cause you to breathe harder but still allow you to carry on a conversation – can decrease the number of migraine days.
“Any activity that people will do consistently and that they enjoy will be good for them,” says Ali.
The hard pass: high-intensity interval training
Ali warns against HIIT workouts, which alternate short bursts of intense cardio exercise with rest or lower-intensity exercise. “Very high-intensity exercise is discouraged if it triggers your migraine,” he says.
In some people, high-intensity exercise can trigger a migraine attack. But research has shown that regular HIIT workouts might be more beneficial than moderate exercise for others, highlighting the importance of a personalized exercise plan.
By: Manuela Callari
Other symptoms commonly associated with a migraine include:
- feeling sick
- being sick
- increased sensitivity to light and sound, which is why many people with a migraine want to rest in a quiet, dark room
Some people also occasionally experience other symptoms, including:
Not everyone with a migraine experiences these additional symptoms and some people may experience them without having a headache. The symptoms of a migraine usually last between 4 hours and 3 days, although you may feel very tired for up to a week afterwards.
- visual problems – such as seeing flashing lights, zig-zag patterns or blind spots
- numbness or a tingling sensation like pins and needles – which usually starts in 1 hand and moves up your arm before affecting your face, lips and tongue
- feeling dizzy or off balance
- difficulty speaking
- loss of consciousness – although this is unusual
Aura symptoms typically develop over the course of about 5 minutes and last for up to an hour. Some people may experience aura followed by only a mild headache or no headache at all.
When to get medical advice
You should see a GP if you have frequent or severe migraine symptoms that cannot be managed with occasional use of over-the-counter painkillers, such as paracetamol. Try not to use the maximum dosage of painkillers on a regular or frequent basis as this could make it harder to treat headaches over time.
You should also make an appointment to see a GP if you have frequent migraines (on more than 5 days a month), even if they can be controlled with medicine, as you may benefit from preventative treatment. You should call 999 for an ambulance immediately if you or someone you’re with experiences:
- Paralysis or weakness in 1 or both arms or 1 side of the face
- stroke or meningitis, and should be assessed by a doctor as soon as possible.
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- Genetics of migraine and pharmacogenomics: some considerations”. The Journal of Headache and Pain. 8 (6): 334–9. doi:10.1007/s10194-007-0427-2. PMC 2779399. PMID 18058067.
- The Headaches. Lippincott Williams & Wilkins. p. 424. ISBN 9780781754002. Archived from the original on 8 September 2017.
- “Cluster Headache”. American Migraine Foundation. 15 February 2017. Archived from the original on 9 May 2018. Retrieved 23 October 2017.
- Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010″. Lancet. 380 (9859): 2163–96. doi:10.1016/S0140-6736(12)61729-2. PMC 6350784. PMID 23245607.
- Wells, John C. (2008). Longman Pronunciation Dictionary (3rd ed.). Longman. ISBN 978-1-4058-8118-0.