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Exercise and Migraine Prevention: a Review of the Literature

  • Psychological and Behavioral Aspects of Headache with Pain (D Buse, Section Editor)
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Purpose of Review

This review intends to characterize the recent literature pertaining to the role of aerobic exercise in the prevention of migraine. Areas of consensus within that literature may be used to guide clinical practice, allowing for the promulgation of evidence-based practice recommendations.

Recent Findings

The past decade has seen the publication of numerous high-quality studies that explore aspects of exercise’s effects on migraine prevention, including its success as a stand-alone prevention strategy, as well as its non-inferiority to some pharmacologic preventive measures.


Exercise often tops providers’ lists of recommended lifestyle modifications that help reduce migraine burden. Biologically, exercise suppresses inflammatory modulators, including numerous cytokines, and stress hormones, like growth hormone and cortisol. Exercise has also been shown to affect microvascular health, which may be implicated in cortical spreading depression. Psychologically, there is evidence that exercise improves migraine self-efficacy and internalizes the locus of control, leading to reduced migraine burden.

Randomized control trials have demonstrated that a sufficiently rigorous aerobic exercise regimen alone is sufficient to yield a statistically significant reduction in migraine frequency, intensity, and duration. Higher-intensity training appears to confer more benefit. Studies have also demonstrated non-inferiority of exercise compared with certain pharmacologic prophylactic interventions, like topiramate. However, the addition of exercise to a traditional preventive regimen may provide added benefit. Special populations, like those with comorbid neck pain or tension headache, may benefit from exercise; and patients who cannot tolerate high-impact exercise may even benefit from low-impact exercise like yoga. Therefore, exercise is a reasonable evidence-based recommendation for migraine prevention.

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Busch V, Gaul C. Exercise in migraine therapy--is there any evidence for efficacy? A critical review. Headache. 2008;48(6):890–9.

    Article  PubMed  Google Scholar 

  2. •• Irby MB, Bond DS, Lipton RB, et al. Aerobic exercise for reducing migraine burden: mechanisms, markers, and models of change processes. Headache. 2016;56(2):357–69. excellent review of proposed mechanisms of how exercise can improve migraine.

    Article  PubMed  Google Scholar 

  3. Wells RE, Bertisch SM, Buettner C, Phillips RS, McCarthy EP. Complementary and alternative medicine use among adults with migraines/severe headaches. Headache. 2011;51(7):1087–97.

    Article  Google Scholar 

  4. Hanssen H, et al. Effects of different endurance exercise modalities on migraine days and cerebrovascular health in episodic migraineurs: a randomized controlled trial. Scand J Med Sci Sports. 2018;28:1102–12.

    Article  Google Scholar 

  5. Darabaneanu S, Overath CH, Rubin D, et al. Aerobic exercise as a therapy option for migraine: a pilot study. Int J Sports Med. 2011;32(6):455–60.

    Article  CAS  PubMed  Google Scholar 

  6. Pertovaara A, Huopaniemi T, Virtanen A, Johansson G. The influence of exercise on dental pain thresholds and the release of stress hormones. Physiol Behav. 1984;33:923–6.

    Article  CAS  Google Scholar 

  7. Oliveira AB, Bachi ALL, Ribeiro RT, Mello MT, Vaisberg M, Peres MFP. Exercise-induced change in plasma IL-12p70 is linked to migraine prevention and anxiolytic effects in treatment-naïve women: a randomized controlled trial. Neuroimmunomodulation. 2017;24:293–9.

    Article  CAS  PubMed  Google Scholar 

  8. Koseoglu E, et al. Aerobic exercise and plasma beta endorphin levels in patients with migrainous headache without aura. Cephalalgia. 2003;23:972–6.

    Article  CAS  Google Scholar 

  9. Seng EK, Holroyd KA. Dynamics of changes in self-efficacy and locus of control expectancies in the behavioral and drug treatment of severe migraine. Ann Behav Med. 2010;40:235–47.

    Article  Google Scholar 

  10. •• Lemmens J, et al. The effect of aerobic exercise on the number of migraine days, duration and pain intensity in migraine: a systematic literature review and meta-analysis. J Headache Pain. 2019;20:16. most recent meta-analysis of studies regarding exercise and migraine prevention, which found overall good evidence that exercise reduces migraine days and pain intensity.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Kroll L, et al. The effects of aerobic exercise for persons with migraine and co-existing tension-type headache and neck pain. A randomized, controlled, clinical trial. Cephalalgia. 2018;38(12):1805–16.

    Article  PubMed  Google Scholar 

  12. • Varkey E, Cider A, Carlsson J, Linde M. Exercise as migraine prophylaxis: a randomized study using relaxation and topiramate as controls. Cephalalgia. 2011;31(14):1428–38. great study showing that exercise is as helpful for migraine prevention as relaxation and topiramate.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Santiago MDS, Carvalho DS, Gabbai AA, Pinto MM, Moutran ARC, Villa TR. Amitriptyline and aerobic exercise or amitriptyline alone in the treatment of chronic migraine: a randomized comparative study. Arq Neuropsiquiatr. 2014;72(11):851–5.

    Article  PubMed  Google Scholar 

  14. Koppen H, van Veldhoven PL. Migraineurs with exercise-triggered attacks have a distinct migraine. J Headache Pain. 2013;14:99.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Amin F, et al. The association between migraine and physical exercise. J Headache and Pain. 2018;19:83.

    Article  Google Scholar 

  16. Büssing A, Ostermann T, Lüdtke R, Michalsen A. Effects of yoga interventions on pain and pain-associated disability: a meta-analysis. J Pain. 2012;13(1):1–9.

    Article  Google Scholar 

  17. John P, Sharma N, Sharma CM, Kankane A. Effectiveness of yoga therapy in the treatment of migraine without aura: a randomized controlled trial. Headache. 2007;47:654–61.

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Anna Pace.

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Mark Barber and Anna Pace declare no conflict of interest.

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Barber, M., Pace, A. Exercise and Migraine Prevention: a Review of the Literature. Curr Pain Headache Rep 24, 39 (2020).

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