Having a plan is the first step to preventing migraine headaches triggered by exercise.
Regular, moderate exercise is typically recommended as part of a healthy lifestyle. So what do you do if working out is triggering your migraines?
Workouts are actually a fairly common migraine trigger. In fact, if you get migraines, there’s a good chance you’ve had one that was triggered by some form of exercise.
A 2013 study conducted at a Dutch headache clinic and published in The Journal of Headache and Pain showed that out of 103 people with migraines, 38 percent of them reported that they had experienced one that was brought on by physical activity.
“Physical activity as a trigger is not uncommon to observe in migraine sufferers,” says Joey Gee, a neurologist based in Mission Viejo, California.
“One of the diagnostic criteria for migraine is that the pain can worsen or be triggered by activity and certain movement,” he says.
Deena E. Kuruvilla, a neurologist and the medical director of the Westpoint Headache Institute in Westport, Connecticut, agrees, saying that the “vast majority” of people with migraine experience symptoms that can worsen when they exert more energy.
The good news is that there are things you can do to prevent post-workout migraines before they start.
Learning about what causes post-workout migraines (and what we still don’t know about why they happen) can be your first step.
What do migraines happen after workouts?
It’s pretty well-established within the medical community that exercise can cause migraines. But like many things about migraine, the exact link between migraine and exercise is frustratingly elusive.
“No one really knows why movement can trigger a migraine, other than that there seems to be a connection between [migraines and] sudden strenuous activity,” says Gee.
The UK-based Migraine Trust notes that working out can be a catalyst for several migraine risk factors, leaving your body more vulnerable to them.
Dehydration, falling blood sugar levels, and increased demand for oxygen from your lungs — all of which can happen when you work out — can all play some part in triggering a migraine.
Exercise can also elevate your blood pressure, which the American Migraine Foundation says can be a factor.
Post-workout migraines sometimes have an environmental component, too. “Research has found that exercise-induced migraines occur more often when exercising in hot, humid weather or at high altitudes,” says Gee.
The symptoms of a workout-triggered migraine tend to be similar to other migraines, with sensitivity to light, sounds, smells, and other forms of stimuli in addition to throbbing head pain, says Kuruvilla.
According to Gee, symptoms of one brought on by physical exertion may be more likely to include aura.
Interestingly, participants in the Dutch study who had exercise-triggered migraines were more likely to experience neck pain as one of their initial migraine symptoms during the migraine attacks they have during their “normal life” (not necessarily brought on by exercise).
How are post-workout migraines treated and prevented?
If you’re having frequent head pain after you work out or exert yourself, you need to speak to your doctor to make sure migraine is what you’re really dealing with.
“The first thing we always do is rule out dangerous causes for the headache brought on by exercise, or migraine triggered with exercise.
Aneurysms, brain tumors, and blood in the brain could present with a headache that comes on with exercise, so we end up getting neuroimaging and other diagnostic workup to rule out these things,” says Kuruvilla.
Once the less common possibilities for your symptoms are ruled out, your doctor will distinguish if you have a condition called primary exercise headache, or if you’re having exercise-triggered migraines. According to Kuruvilla, migraine is more common than primary exercise headaches, and there are more treatments available.
“For the acute treatment, we recommend non-steroidal anti-inflammatory medications (NSAIDs) such as naproxen, to take prior to the workout to stop the headache,” explains Kuruvilla.
She adds that regular NSAID use can be hard on your stomach, so it’s important to be monitored by your doctor if you’re relying on them for migraine relief.
Prescription-strength medications, like beta blockers or stronger NSAIDs, may be used to prevent migraines triggered by physical exertion, says Kuruvilla.
A growing body of research even suggests that an exercise routine can be part of some people’s migraine treatment plan. A review published in 2018 in the Journal of Headache Pain analyzed 44 papers on the subject of exercise-triggered migraines.
The review’s authors concluded that while migraines can be triggered by exercise, regular exercise can be an effective preventative treatment for migraine.
The review acknowledged that exactly how much and what kind of exercise would work best is still unknown, but moderation may be the key.
A small study with 45 participants published in 2021 in the European Journal of Applied Physiology found that moderate aerobic exercise was a better treatment for migraine than intense aerobic exercise.
The best way to treat any type of migraine is to stop it before it starts. Gee says that avoiding exercise in hot, humid weather, drinking plenty of water during a workout, and exercising in air conditioning whenever possible can help reduce your chances of triggering a migraine during a sweat session.
If you’re traveling to a higher altitude, rest for two days after you arrive to help your body acclimate to your new environment before you get a workout in.
“If you do suffer from migraines, it’s best to avoid excessive weightlifting, running, rowing, swimming, and football. It does not mean you cannot participate in these activities, just be cautious,” says Gee.
The American Migraine Foundation recommends paying careful attention to your hydration before, during, and after a workout, as well as eating protein about an hour and a half before you start your exercise.
If you have migraines, it may be especially important to warm up for 5 to 10 minutes before you start any form of vigorous exercise.
Ultimately, you do have plenty of options for the treatment and prevention for migraines; even ones that are triggered by exercise.
The best treatment plan will take into account your specific symptoms and lifestyle. “These decisions are best made with the help of your doctor after your medical history has been reviewed,” Kuruvilla says.
This originally appeared on Allure US