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Exercise, Exertion and Migraine Headaches

Although regular exercise can reduce the frequency or severity of migraine headaches, recent studies show that intense exercise without a proper warm-up can cause exercise exertion migraines which defeats the purpose of your exercise routine. These headaches, triggered by the intensity of exercise, can wind up sneaking up on you four to six hours later.

According to one recent preliminary study, exercise exertion migraines appear to be triggered by a spike in nitric oxide, a chemical that can dilate blood vessels. Migraine headaches have been recognized as the most common vascular headache (headache caused by blood vessel abnormalities) since the 17th century, so the findings of this study seem to make sense.

More than 2000 years ago, Hippocrates noticed the connection between exertion and getting headaches. However, it's important to recognize the difference between exertion and exercise as well. For those who suffer from migraine headaches, the key phrase to limit attacks is “regular exercise” preceded by an adequate warm-up. A slow warm-up may limit the surge of nitric oxide that ignites exercise exertion migraines.

Dr. Alan Rapoport, director and cofounder of The New England Center for Headache in Stamford, Connecticut says that those prone to migraines, who exercise regularly, report fewer and less severe migraine headaches, but those who start exercising as a way to control migraine headaches need to build up slowly. Any exercise routine needs to be built up slowly but this is doubly true if you suffer from migraines.

Another factor in curbing exercise exertion migraines may be in limiting the length of exercise sessions. Dr. Judy Lane, medical director at the Head Pain Center of the Colorado Neurological Institute has noted that headaches develop after longer periods of exertion, remarking that many of her patients say, “I don’t exercise because it gives me a headache.”

Although it’s possible that science will find a way to treat exercise exertion migraines by reducing nitric oxide levels, until then, the best advice to stem migraine headaches caused by over-exertion is to add a slow warm-up to regularly scheduled exercise.

Niall Roche

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