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Chronic Migraine Patients Who Exercise Regularly May Reduce Migraine Triggers

Presenter: Mason Dyess, DO

Chronic migraine patients who do a minimum of 2½ hours of moderate-to-vigorous exercise per week have reduced rates of migraine triggers, such as stress, depression, and sleep problems.

Scientific studies show that exercise can be an effective migraine prophylaxis in some patients. Yet, more than two-thirds of chronic migraine patients do not get enough exercise.

“Migraine is a disabling condition that affects millions of people in the United States, and regular exercise may be an effective way to reduce the frequency and intensity of some migraines,” said Mason Dyess, DO, of the University of Washington in Seattle. “Exercise releases natural pain-killing endorphins, helps people sleep better, and reduces stress. But if patients with migraine are not exercising, they may not be reaping these benefits.”

Researchers set out to quantify the number of patients referred to a large tertiary headache clinic who achieved the minimum recommended amount of exercise per week, evaluate if low levels of exercise were associated with an increased risk of chronification, and assess exercise in migraine patients as it relates to other common comorbidities. The study included 4,879 migraine patients, 74.7% (3,644 patients) with chronic migraine and 25.3% (1,235 patients) with episodic migraine, who completed a detailed patient intake questionnaire about their migraine characteristics, sleep, depression, stress, anxiety, and the amount of moderate-to-vigorous exercise they got each week.

Results show only 27% (1,270 patients) of those who exercised reported achieving 150 minutes (2½ hours) of moderate-to-vigorous exercise weekly, the minimum level recommended by the World Health Organization. Moderate-to-vigorous exercise included jogging, very brisk walking, playing a sport, heavy cleaning, and bicycling.

Patients who got less than 2½ hours of moderate-to-vigorous exercise per week had increased rates of depression, anxiety, and sleep problems. Depression was reported by 47% of patients who did not exercise, as compared with 25% of patients who exercised the most. Anxiety was reported by 39% of patients in the no-exercise group compared with 28% of patients in the high-exercise group. Sleep problems were reported by 77% of patients in the no-exercise group compared with 61% in the high-exercise group.

An association between exercise and the risk of migraines was also observed. In the no-exercise group, 5% of patients had low headache frequency, defined as zero to four headache days per month, and 48% had high headache frequency, defined as having 25 or more headache days per month. In the high-exercise group, 10% of patients had low headache frequency and 28% had high headache frequency.

“Patients with migraine should consider incorporating more exercise into their daily life as a safe, low-cost way to manage and minimize some of the problems that often accompany migraine,” said Dyess.

A limitation of the study was that participants reported weekly exercise minutes rather than having their activity monitored with a device. This research only shows associations between exercise and migraine triggers, but does not prove cause and effect.

In conclusion, Dyess said, “Chronic migraine patients may warrant a greater degree of attention in the headache clinic, as they may have more significant opportunities in modifiable risk factors. Counseling patients with migraine on recommended exercise levels should be considered by any medical provider.”

Link to abstract: Exercised Brain in Pain: Quantification of Exercise in Migraine Patients Seen at a Large Tertiary Headache Center

Mason Dyess, DO, reported nothing to disclose.

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