Exercise and Diet
Exercise and Headaches
Exercise offers countless benefits for everyone. It helps strengthen the muscles, increase endurance and keeps the heart and other vital organs healthy. Another important result of exercise is the release of endorphins. Endorphins are the body’s natural painkillers. They are made in the brain, and when released into the nervous system, can improve the way you feel (your mood) and decrease the sensation of pain. For this reason, exercise is often recommended as part of a well-rounded treatment program for headache and other chronic pain conditions.
Exercise can include aerobic reconditioning and stretching exercises. Stretching exercises can help reduce muscle tightness and tenderness that often accompany chronic headaches. Always talk to your health care provider before starting any new exercise program. Also ask your physical therapist to recommend specific exercises that will be most helpful for you.
Regular aerobic exercise may significantly reduce migraine frequency and severity. In a recent study conducted in Sweden, 20 untrained migraine patients were enrolled in a 12-week indoor biking program.1 Biking occurred three times weekly, with each session including a 15-minute warm up, 20-minute exercise and five-minute cool down. At the end of the treatment, migraines were significantly better with a reduction in headache frequency by 28%, headache severity by 18%, and medication use by 24%. Good aerobic exercises include:
Aerobic exercise can also be combined with relaxation techniques. Researchers at Innsbruck University Hospital in Austria randomly assigned migraine patients to either a twice weekly exercise plus a relaxation program for six weeks or a control group.2 The exercise plus relaxation included 45 minutes of exercise and 15 minutes of relaxation training. The exercise included five minutes of warm up, 20 minutes of aerobics, 15 minutes of strength training and five minutes of stretching. Before treatment, migraine severity was rated as mild in only 20% of patients and moderate to severe in the remainder. After treatment, 60% of those receiving exercise and relaxation reported only mild headaches. All of the patients in the control group reported their headaches were moderate to severe after 12 weeks. Before treatment, 13% of patients reported having migraines at least once per week. After treatment, weekly or more frequent headaches were reported by only 7% after exercise with relaxation and 20% in the control group.
Tips for Successful Aerobic Exercise
Plan to do stretching exercises two times each day for about 20 minutes per session. Do stretches slowly so you feel a normal sensation of stretching, but not pain. Hold the stretch for five seconds, relax for five seconds, and then repeat each stretch about three to five times. You can do many stretching exercises while standing or sitting. You can use them as stress-releasers when sitting in a long meeting and in the car, or while waiting in line at the store or standing in the shower. Many people include stretching exercises with their favorite daily TV show to make sure they keep these exercises as part of their daily routine. Other people do stretching exercises before bedtime to help them sleep.
Stretches that help relieve headaches are listed below. Add these to a whole body stretching program and use them when headaches first start:
Tips for Successful Stretching
Exercise can include aerobic reconditioning and stretching exercises. Stretching exercises can help reduce muscle tightness and tenderness that often accompany chronic headaches. Always talk to your health care provider before starting any new exercise program. Also ask your physical therapist to recommend specific exercises that will be most helpful for you.
Aerobic Exercise
Regular aerobic exercise may significantly reduce migraine frequency and severity. In a recent study conducted in Sweden, 20 untrained migraine patients were enrolled in a 12-week indoor biking program.1 Biking occurred three times weekly, with each session including a 15-minute warm up, 20-minute exercise and five-minute cool down. At the end of the treatment, migraines were significantly better with a reduction in headache frequency by 28%, headache severity by 18%, and medication use by 24%. Good aerobic exercises include:
- Brisk walking
- Biking
- Swimming
Aerobic exercise can also be combined with relaxation techniques. Researchers at Innsbruck University Hospital in Austria randomly assigned migraine patients to either a twice weekly exercise plus a relaxation program for six weeks or a control group.2 The exercise plus relaxation included 45 minutes of exercise and 15 minutes of relaxation training. The exercise included five minutes of warm up, 20 minutes of aerobics, 15 minutes of strength training and five minutes of stretching. Before treatment, migraine severity was rated as mild in only 20% of patients and moderate to severe in the remainder. After treatment, 60% of those receiving exercise and relaxation reported only mild headaches. All of the patients in the control group reported their headaches were moderate to severe after 12 weeks. Before treatment, 13% of patients reported having migraines at least once per week. After treatment, weekly or more frequent headaches were reported by only 7% after exercise with relaxation and 20% in the control group.
Tips for Successful Aerobic Exercise
- Make aerobic exercise part of your weekly routine – use a calendar to monitor your progress
- Exercise for 30 to 45 minutes, three to five days per week
- Stay hydrated. Drink a bottle of water before you start an exercise session. Drink another when you finish exercising. Have water available to drink during exercise. You will need to drink about 15 eight-ounce glasses of water throughout the day on days when you exercise to stay well hydrated.
- Make sure you begin each exercise session with five to 10 minutes of gentle stretching and warm-up exercises
- End each exercise session with five to 10 minutes of cool down exercise
- Try to distract yourself during exercise to make it less boring – don’t watch the clock! Try to walk or bike outside, taking different routes to add variety. If you must exercise indoors, listen to your favorite music or books on tape while you exercise. You can also place your treadmill or bike in front of the TV.
Stretching Exercises
Plan to do stretching exercises two times each day for about 20 minutes per session. Do stretches slowly so you feel a normal sensation of stretching, but not pain. Hold the stretch for five seconds, relax for five seconds, and then repeat each stretch about three to five times. You can do many stretching exercises while standing or sitting. You can use them as stress-releasers when sitting in a long meeting and in the car, or while waiting in line at the store or standing in the shower. Many people include stretching exercises with their favorite daily TV show to make sure they keep these exercises as part of their daily routine. Other people do stretching exercises before bedtime to help them sleep.
Stretches that help relieve headaches are listed below. Add these to a whole body stretching program and use them when headaches first start:
- Neck range of motion: Tip your chin forward to your chest, upward to the ceiling, and then turn your chin to touch each shoulder.
- Shoulder shrugs: Shrug shoulders up, then up and forward, and then up and back.
- Neck isometrics: Place your palm on your forehead and press your head against it. Be very still and don’t move your head or hand as you press one against the other. Repeat with your hand on each side of the head.
- Head lift: Link the fingers of your hands together and hold then behind your neck at the base of your head. Pull your elbows forward and up so you can feel your head lifting up slightly from your neck.
Tips for Successful Stretching
- Stretch twice daily, in the morning and before bed
- Begin stretches after taking a warm shower or using a heating pad over your most painful area for 15 minutes
- Listen to music or watch your favorite TV show while you do your exercises
- Do each stretch slowly. Stretch until the first sensation of stretching is reached, then hold the stretch for five seconds. Relax and repeat three to 10 times.
- If you feel more pain after stretching, wrap ice in a towel and place it on your most painful area for 10 minutes
- If your pain is usually aggravated by stretches, reduce the amount of stretch and talk to your physical therapist about your exercise program
References
- Varkey E, Cider Å, Carlson J, Linde M. A study to evaluate the feasibility of an aerobic exercise program in patients with migraine. Headache 2008, in press.
- Dittrich SM, Günther V, Franz G, et al. Aerobic exercise with relaxation: influence on pain and psychological well-being in female migraine patients. Clin J Sport Med 2008;18:363-365