Exercise a Pain in the.... Head?

Exercise a Pain in the ... Head?

By Jennifer Green, MS

Photo of Jennifer Green who is a NCHPAD Visiting Information Specialist.
Jennifer Green, NCHPAD Visiting Information Specialist
Here at NCPAD, we have recently received many inquiries regarding migraines: Are they considered a disability? What are the exercise guidelines for migraine sufferers? What should I do if exercise causes my migraines? I've decided to address this issue in this month's training column.

It seems that migraines are becoming increasingly common. According to the National Institute of Neurological Disorders and Stroke, migraines can cause significant disability and costs American taxpayers $13 billion in missed work or reduced productivity annually. Those who suffer from migraines lose over 157 million workdays due to headache pain alone. The World Health Organization estimated in 2003 that 303 million people worldwide were migraineurs and a 2004 article suggested that there are almost 20 million migraine attacks happening every day. 25% of women and 8% of men get migraines sometime in their lifetime and about half of these people get their first migraine before the age of 20, and 98% before the age of 50. Of those who get migraines, 38% get 1-12 each year. 38% get 1-3 a month, 37% get 1 per week, and 11% get 2-6 per week.

Migraines are chronic headaches that can cause significant pain for hours or even days. Symptoms can be so severe that all you can think about is finding a dark, quiet place to lie down. Some migraines are preceded or accompanied by sensory warning symptoms or signs, such as flashes of light, blind spots, or tingling in the arm or leg. A migraine is often accompanied by nausea, vomiting, and extreme sensitivity to light and sound. They usually begin in childhood, adolescence, or early adulthood. A typical migraine attack produces some or all of these signs and symptoms:


  • Moderate to severe pain, which may be confined to one side of the head or may affect both sides
  • Head pain with a pulsating or throbbing quality
  • Pain that worsens with physical activity
  • Pain that interferes with your regular activities
  • Nausea with or without vomiting
  • Sensitivity to light and sound

Although much about the cause of migraines isn't understood, both genetics and environmental factors seem to play a role. Migraines may be caused by changes in the trigeminal nerve, a major pain pathway. Imbalances in brain chemicals, including serotonin, which helps regulate pain in your nervous system, also may be involved.

Research has shown that regular moderate-intensity exercise reduces the frequency, intensity, and duration of migraine headaches. This is thought to be due to the increased levels in endorphins as well as other chemicals that are caused by exercise. Studies suggest that a longer warm-up and cool-down are important for those with migraines because it increases oxygen intake levels. An exercise program should include at least a 10-minute warm-up, and a 10-minute cool-down session, according to the research. Other than the importance of an extended warm-up and cool-down to increase oxygen intake levels, a normal exercise prescription for otherwise healthy adults can be followed.

The important thing is to begin your program slowly and pay attention to migraine triggers your clients may have. Make sure you understand their symptoms and do not push them to continue if a migraine does come on suddenly. If you have never experienced a migraine before, it is important to remember that they can be much more severe than a regular headache and a variety of additional symptoms may follow.


End exercise induced headache. Retrieved December 13, 2010, from ( http://www.relieve-migraine-headache.com/)

Mayo Clinic Staff. (2009). Migraines. Retrieved December 13, 2010, from ( http://www.mayoclinic.com/health/migraine-headache/DS00120/DSECTION=lifestyle-and-home-remedies )

Sorgen, C. (2005). Exercise can be a pain. Retrieved December 13, 2010, from ( http://www.medicinenet.com/script/main/art.asp?articlekey=51909)


Please send any questions or comments to Jennifer Green at Jennifer Green.

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