By Cara Munez, HealthDay

Anyone who gets frequent migraine symptoms knows the experience: the throbbing, the pain, the visual disturbances.

Exercise has long been a potential way to reduce migraine triggers, but a new study suggests it could be especially effective with combating triggers such as stress, depression, and trouble sleeping.

“It’s a complex relationship, but we know that exercise, generally speaking, helps increase levels of good neurotransmitters, like dopamine, norepinephrine, and serotonin, which contributes to not only fewer headache days, but also better mood and overall well-being,” said study author Dr. Mason Dyess, a senior fellow at the University of Washington School of Medicine.

Exercise also improves heart health and that helps with weight management, which is also associated with better migraine control, Dyess said.

The study included more than 4,600 people diagnosed with migraine disease. Approximately 75% of the participants had 15 or more migraine days per month. The remaining 25% of participants had 14 or fewer migraine days.

Study participants completed a questionnaire about their migraine characteristics, sleep, depression, stress, and anxiety. They also answered questions about how much moderate to vigorous exercise they participated in each week — jogging, very brisk walking, playing a sport, heavy cleaning, and bicycling, for example.

Researchers divided participants into five groups by frequency of exercise ranging from none to more than 150 minutes per week. The study found that just 27% of the study participants got the recommended amount of exercise per week. The World Health Organization (WHO) recommends that adults aged 18–64 years do at least 150–300 minutes of moderate-intensity aerobic physical activity, or at least 75–150 minutes of vigorous-intensity aerobic physical activity; or an equivalent combination of moderate- and vigorous-intensity activity throughout the week. WHO has different recommendations for people living with disabilities or chronic illnesses.

Participants who got less exercise than recommended had increased rates of depression, anxiety, and sleep problems, the study found.

Researchers found that 47% of the people who did not exercise had depression; 39% had anxiety, and 77% had sleep problems.

By comparison, approximately 25% of the most active group had depression; 28% had anxiety, and 61% had sleep problems.

The study also found a link between exercise and headache frequency. In the no-exercise group, 5% had zero to four headache days per month, while many more — 48% — had 25 or more headache days per month.

In the high exercise group, 10% had low headache frequency and 28% had high headache frequency.

Dr. Mark Green, a member of the National Headache Foundation’s Health Care Leadership Council, and a professor of neurology at the Icahn School of Medicine at Mount Sinai in New York City urged people living with migraine disease to be cautious about their exercise routines.

“Consistency is key, whether it comes to exercise or other activities that can be beneficial, such as controlling caffeine, wake and sleep hours, eating and hydration”, said Green, who wasn’t part of the study.

He suggests his patients begin a routine of walking on a treadmill for 3 1/2 miles at an incline of 4 degrees every day. He recommends “increasing the angle, not the speed, if someone wants a more vigorous workout.”

“I don’t want it to be jogging. I want it to be walking fast. Three and a half miles doesn’t sound like anything, but it’s actually faster than you think at 10 degrees,” Green said. “That tends to work out well.”

“Migraine is complex and people who experience it do so for a variety of reasons. Yet there are some vital common denominators,” Green said.

“In general, it’s influenced by genes. To give you an example, if you have migraine disease, your children have a 50% higher risk of developing migraine. If both parents have migraine, the risk is about 80% of developing migraine,” Green said.

Green recommends that his patients do low-impact exercise, eat multiple small meals a day, stay sufficiently hydrated and maintain a consistent sleep schedule.  “I tell people with migraine that you have a brain that doesn’t like change — it likes consistency,”

Researchers noted that the study only shows a link between exercise and migraine triggers and doesn’t prove cause and effect.

The findings will be presented at the American Academy of Neurology’s annual meeting, held online April 17-22. Research presented at meetings is typically considered preliminary until published in a peer-reviewed journal.

Dyess suggested that people living with migraine disease slowly add more activity into their daily life. He recommended starting with gentle yoga, then building up to a brisker routine. That could include jogging, depending on the patient, he said.

“Exercise is such a cheap and accessible treatment option for people that’s just widely underutilized,” Dyess said. “I think awareness is powerful in this situation. It really can change lives anywhere and everywhere if utilized by patients.

SOURCES: Mason Dyess, DO, senior fellow and acting instructor, University of Washington School of Medicine, Seattle, and member, American Academy of Neurology; Mark Green, MD, professor, neurology, anesthesiology, and rehabilitation medicine, and emeritus director, Center for Headache and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York City, and member, National Headache Foundation, Health Care Leadership Council; American Academy of Neurology, annual meeting, online, April 17-22, 2021