If you've experienced a migraine, you know it can be downright debilitating. But you might be wondering if it's a good idea to hit the gym or turn on your favourite YouTube workout video when your symptoms strike. After all, no pain, no gain, right? Wrong. Two experts warn against exercising during a migraine, but they agree that exercise can help prevent migraines in the long run.
What Is a Migraine?
Migraines typically occur on one side of the head and are more severe than a tension headache, said Sara Crystal, MD, neurologist, and headache specialist at the NY Headache Centre and Cove medical adviser. She told POPSUGAR that migraines tend to last longer, often can't be treated by over-the-counter medication, and usually require a personalized treatment plan. Migraines are accompanied by specific symptoms such as nausea, vomiting, and light and sound sensitivity. You can also get a migraine with aura, meaning that you experience neurological symptoms like bright spots or stripes of light, loss of vision, and even slurred speech. Pinpointing the exact cause of migraines is difficult, but some triggers include stress, hormones, and certain foods — and many of these triggers differ from person to person.
Here's a stat for you: three times as many adult women as men suffer from migraines. Why? Dr. Crystal said that hormonal changes play a significant role. "Migraine incidence rises at the onset of menstruation. Menstrual migraine is very common and occurs when estrogen levels drop," she explained. It's unknown exactly how estrogen affects migraine, "but we do know that estrogen influences not only the susceptibility to migraine, but also the processing and perception of pain."
Exercise Can Prevent Migraines
"One of the best ways to prevent migraines is to manage stress in your life," Dr. Crystal said, noting it's well-documented that increasing aerobic exercise can help prevent migraines, predictably because it's helpful with stress relief. "With exercise, it can be a ripple effect. Besides releasing endorphins, which reduce pain, exercise can help reduce stress and improve sleep, which in turn can help reduce headache frequency."
Elizabeth Barchi, MD, clinical assistant professor of orthopedic surgery at NYU Langone Health and expert in sports medicine, agreed. She said that working out regularly can potentially help with chronic daily headaches too, not just migraines, though exercise can cause headaches due to intense exertion and increased blood pressure. It's generally a good idea to start with light cardio, she advised, and build your heart rate from there. But "getting enough sleep, eating a healthy diet, and regular exercise can help reduce chronic headaches if you're someone who's susceptible to them," she noted. "Especially tension headaches."
Should I Work Out If I Have a Migraine?
No. "As a general rule of thumb, don't exercise if you're in the middle of a migraine, as it can make the pain worse," Dr. Crystal said. "However, when you are symptom-free, exercise can be effective at preventing future migraines." Dr. Barchi stressed the importance of rest if you're going through a migraine. Don't head to the gym; instead, try to treat it, she said. Avoid excessive physical activity that could exacerbate the pain.
Other Preventative Measures and Treatment For Migraines
Preventative measures and treatment are different for everyone, but if over-the-counter pain medication doesn't work for you, Dr. Crystal said that some of the common preventive tactics include blood-pressure-lowering medications like beta blockers, anti-seizure medications such as gabapentin and topiramate, and antidepressants. In terms of treatment, Botox is effective for patients with chronic migraine, she said. "It is a series of injections to the forehead, temples, back of the head and shoulders, given in the office. Insurance companies typically require that patients fail at least two of the standard oral preventive medications mentioned above before paying for the treatment." The FDA also approved a first-of-its-kind monthly injection in May 2018, which works to block calcitonin gene-related peptide (CGRP), a molecule involved in migraine attacks.
At the first sign of a migraine, Dr. Crystal recommends taking medication like a triptan, if prescribed to you, and to use an anti-nausea medication if needed. Anti-inflammatories can be used in conjunction with triptans, she said. Of course, consult your doctor for the best treatment plan for you, and treat your symptoms before trying to get your workout on. The treadmill and Class FitSugar can wait until tomorrow.