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Exercise, stress and headache: how they connect

The exercise-headache connection continues to vex scientists. Conducting genuine evidence-based science is hard because, first, the research conditions are difficult to standardize; second, many of the variables being assessed are highly subjective. Nevertheless, there is evidence that cardio training can have a positive impact on headache frequency and severity.

Exercise and migraine: it all depends on how you do it

Moderate physical activity that does not cause undue stress seems to help combat headache, migraine in particular. A Swedish study from 2011 compared the effects of three treatment strategies: exercise (indoor cycling), relaxation training, and migraine medication. After three months of treatment, the mean reduction in monthly migraine frequency was similar in all three groups (one less attack than before), corresponding to a 25% reduction.

Nevertheless, caution is advised as regards exercise type and intensity. Competitive sport is known to be a migraine trigger, partly due to the high level of stress associated with it. Sports that require short bursts of peak performance are notorious headache-inducers because of the high level of exertion involved. A prime example is weightlifting, which builds up massive tension in almost every muscle in the body within a few seconds and creates huge pressure inside the skull before the athlete thrusts the barbells over their head.

Moderate-intensity running and Nordic walking can help combat headaches by relieving tension and stress. Warm up well before you start. Pace yourself. Get things right and do your muscles a favor. If you prefer swimming, go for it – but proper technique is important. Neck strain from swimming can trigger a headache. Cycling seems ideal on all counts: readily available, low-impact, and you can easily control the intensity to suit yourself.

Check your exercise tolerance

First of all: remember you can get too much of a good thing. You don’t have to become a champion in your chosen discipline in a few weeks. If jogging is your thing, start at a pace you feel comfortable with – not one that leaves you gasping for breath. It hardly needs saying, but don’t forget to protect yourself from the sun and stay hydrated.

Practicing a sport to relieve stress and tension can be a great way to combat headache and migraine. But remember: especially when it comes to exercise and headache prevention, people are different. What feels like a slow jog to somebody else might feel more like a near-death experience to you... or vice versa. Be aware that the discomfort threshold differs between people, and never go beyond the point where a relaxing, enjoyable workout becomes its own source of stress. That way, you’ll be all set to reap the benefits of exercise as a way to prevent headaches and feel better!

  • Albers L, Ziebarth S, von Kries R. [Modifiable risk factors for primary headache. A systematic review]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2014 Aug;57(8):952-60. doi: 10.1007/s00103-014-1997-1. Review. German.

    Kernick DP, Goadsby PJ; Royal College of General Practitioners; British Association for the Study of Headache. Guidance for the management of headache in sport on behalf of The Royal College of General Practitioners and The British Association for the Study of Headache. Cephalalgia. 2011 Jan;31(1):106-11. doi: 10.1177/0333102410378046. Epub 2010 Jul 29.

    Koppen H, van Veldhoven PL. Migraineurs with exercise-triggered attacks have a distinct migraine. J Headache Pain. 2013 Dec 21;14:99. doi: 10.1186/1129-2377-14-99.

    Varkey E, Cider A, Carlsson J, Linde M. Exercise as migraine prophylaxis: a randomized study using relaxation and topiramate as controls. Cephalalgia. 2011 Oct;31(14):1428-38. doi: 10.1177/0333102411419681. Epub 2011 Sep 2.

    Wöber C, Holzhammer J, Zeitlhofer J, Wessely P, Wöber-Bingöl C. Trigger factors of migraine and tension-type headache: experience and knowledge of the patients. J Headache Pain. 2006 Sep;7(4):188-95. Epub 2006 Aug 11.

    Wöber C, Wöber-Bingöl C. Triggers of migraine and tension-type headache. Handb Clin Neurol. 2010; 97:161-72. doi: 10.1016/S0072-9752(10)97012-7.

    Internet: Website der Schmerzklinik Kiel, https://www.schmerzklinik.de/ (abgerufen am 11.4.2019).

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