The phrase “exercise induced headaches” appears frequently on sites like Web MD, Mayo Clinic, and Healthline, but in my own experience I’ve found the term to be misleading. As a runner with chronic tension type migraines I’ve certainly had many dehydration induced headaches, heat-sickness induced headaches, and headaches from running 8 miles or more. But for me exercise has more often worked as a therapy for my migraines rather than a trigger. Am I alone in this?
Perhaps not. The International Classification of Headache Disorders defines exercise-induced headaches as, “headache precipitated by any form of exercise in the absence of any intracranial disorder.” According to this definition, exercise induced headaches are distinct from classic migraines in that they are not neurological in nature. In a 2014 New York Times article, neurologist Rashmi Halker said that exercise induced headaches are more likely caused by changes in blood circulation associated with exercise. That would mean that the classic migraine patient, whose symptoms originate from changes in brain activity, is not necessarily more likely to get an exercise headache than a person without migraine. Furthermore, Halker suggested that this type of headache can be minimized by avoiding dehydration, maintaining proper blood sugar levels, and by easing into workouts with a long, gentle warm-up. And with few months of regular training these headaches are expected to happen less frequently or stop altogether.
This isn’t to say that strenuous exercise won’t occasionally trigger headaches in even the most seasoned athletes. It also doesn’t mean that exercise can’t trigger a true migraine. But I think the important takeaway from Halker is that migraine sufferers probably don’t need to shy away from exercise as long as they do it responsibly and with their doctor’s guidance. In my experience running has been a tremendous source of pain relief! And according to the American Migraine Foundation, one study shows that a regular exercise regimen of three 40 minute workouts per week can be as effective as one popular migraine drug, topiramate, at preventing migraines. The foundation hypothesizes that the chemical changes that take place in the brain during exercise are largely responsible for this pain relief.
Doctors recommended exercise in moderation for almost every chronic condition I can think of except for neurological ones. Why shouldn’t we consider using exercise as a form of physical therapy for migraines too? Doesn’t exercise have just as many benefits to the brain as it does to the rest of the body?
If anyone else out there is using running or other forms of exercise as a migraine therapy I’d love to hear your stories! Ditto to anyone with other neurological conditions and chronic pain conditions. Let me know whether your condition improved or worsened as a result of your exercise routine!