 Exercise and Headaches
Frequently Asked Questions
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Exercise and Headaches (by Alvin Lake III, PhD)
Doesn't exercise make headaches worse?
Many people with migraine find that even simple movements—much less vigorous exercise—increase
the pain of migraine. In fact, pain that is worsened by climbing stairs or similar
physical activity is one of the diagnostic symptoms of migraine headache. All the
same, much evidence shows that maintaining a consistent schedule of exercise between
attacks can help prevent migraine headaches. There is less evidence that exercise
has direct benefits for cluster or tension-type headache, although regular exercise
appears to benefit chronic pain conditions in general by improving pain tolerance.
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How do I get motivated to begin and maintain
an exercise program?
1. Choose an activity that is easy to do. Walking is excellent, and requires little
more than a good pair of walking or running shoes, comfortable clothes, and a safe
place to walk. Don't wait until you can buy a piece of exercise equipment or join
a gym, or you may never get started.
2. Choose an activity you enjoy, or at least one you don't hate. Water aerobics
classes-offered at many public pools-fitness walking, and bicycling are all good
choices.
3. Set realistic step-by-step goals. Set an initial goal that will make a difference
but is not so demanding that you can't keep it up. Once you have reached that goal,
set another goal that will increase your fitness but remains attainable, given the
other demands on your time.
Goal 1 - Exercise without triggering severe headaches. Some people make the mistake
of starting an exercise program at full intensity and then give up because it gives
them a headache. Instead, start at a lower intensity, and stop before any headache
starts to build significantly. For example, if you find that 20 minutes of activity
leaves you holding your head in a darkened room, than try exercising for only 15
minutes at a lower level of intensity.
Goal 2 - Exercise at least 3 days per week for 15-20 minutes of continuous movement
at a low to moderate intensity. Then gradually increase the intensity of your exercise,
speeding up during the first 5 minutes, maintaining a higher intensity for 5-10
minutes, and then gradually slowing down for 5 minutes. This is enough to derive
benefit if you maintain a regular schedule. The 3-day minimum is critical, because
you begin to lose benefits if you go more than 1 or 2 days without exercising.
Goal 3 - Push but pace, pace but push. If you only pace yourself (keeping the intensity
and duration at a low level) you will not progress. If you push yourself too hard,
you may trigger headaches or become overly exhausted, and then give up. Look for
the right balance between these two concepts. Gradually increase the duration and
frequency of your exercise. Each additional day or longer period of exercise will
increase the benefit.
Goal 4 - Target the equivalent of walking 10-12 miles a week. If you walk at a moderate
pace, you will go 1 mile in about 20 minutes. If you walk quite fast, you might
do it in 15 minutes. If you figure a 20-minute mile, then 9-12 miles a week would
work out to 3 to 4 hours of moderate exercise a week - between 30-45 minutes of
exercise a day, 5-7 days a week. If you prefer to bicycle, figure 3 miles of cycling
equals 1 mile of walking or jogging. 4. Keep an exercise diary. A simple calendar
works well. You can record the number of minutes you exercise each day, unless you
have a way of recording distance (such as laps around a track) or effort (such as
calories burned on a stationary exercise machine). Diaries show you your accomplishments
and can be excellent motivators.
4. Exercise with a friend or friends. You'll find the time passes quicker, you'll
have more fun, and you and your friend can motivate each other to stick to it. However,
remember to continue to exercise even if a friend(s) is unable to join you during
your exercise routine.
5. Make exercise a priority. If you wait until everything else is done, you will
find that there never seems to be time left for exercise. On the other hand, you
may discover that a bit of exercise helps clear your mind, lift your mood, and give
you more energy to deal with those other things. You want exercise to become as
much a part of your life as eating and sleeping.
6. Keep this thought in mind - some is better than none. Even if you feel too busy,
too tired or too stressed, then a 5-minute walk is better than none at all. Sometimes
that 5 minutes may energize you to go farther than you planned. This experience
can help you maintain exercise at times when other demands make it difficult.
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