When it comes to exercise and migraines, you've got two sides of a coin, says Lawrence Newman, MD, director of the Headache Institute at St. Luke's-Roosevelt Hospital Center in New York. Exercise can be an effective preventive measure against migraines in some people, he says, but in others, it can actually cause them. "We think migraine sufferers have a heightened neurological system," says Newman.
"They're more apt to develop a migraine when anything is out of the ordinary -- when they get up too early, go to bed too late, skip meals, etc." For that reason, Newman suggests that people prone to migraines establish not only a schedule of eating and sleeping regularly, but also of exercising on a regular basis.
When someone has a basilar migraine, there is a disturbance at the brainstem or base of the brain. Even before the migraine headache begins, the person may experience an ''aura,'' a cluster of sensations such as dizziness, double vision, and lack of coordination. An aura is a neurological phenomenon that occurs about 10 minutes to 45 minutes before the headache starts.
Basilar migraines are known by several different names:
"Once you're exercising, no matter who you are," says Newman, "you're usually taking better care of yourself."
Exercise releases endorphins, the body's natural painkillers, Newman says, which can help lessen the frequency and/or severity of migraines. Almost all forms of exercising are good, from aerobics to yoga to stretching to swimming.
Gain No Pain
What Newman does suggest limiting, however, is strenuous workouts such as heavy weightlifting, which can cause muscle spasms in the upper body. These spasms can bring on headaches.
"Too much stress on the body can induce a migraine," agrees George DeJohn, a Dallas-based fitness consultant and author of Three Minutes to A Strong Mind and a Fit Body.
Before DeJohn sets up an exercise program for clients plagued by migraines, he advises them to see their doctor to determine what kind of migraines they are. "Some are caused by muscle spasms. Some are vascular in nature," says DeJohn. "It's important to know which kind you have so you can plan the most effective workout for your situation."
Since fitness consultants frequently work with their clients' eating regimen, too. DeJohn suggests that those with migraines keep a careful diary for one week of what they eat. "That will help us identify any foods that could be triggering the headache."
Two Headache Types
Exercise can help many people cope with their migraines, but in others it can actually trigger a crippling headache, Newman says. There are, he says, two types of "exertional headaches," one benign, and the other more serious.
"Certain medical conditions can cause severe headaches when exercising, coughing, even having sex," says Newman. "If someone comes in complaining of a sudden headache with exertion, then I suggest an MRI to rule out such conditions as a tumor in the back of the brain or a ruptured aneurysm."
Symptoms that warrant a doctor's attention, Newman advises, are:
The sudden, explosive onset of pain upon exertion.
A headache that gets progressively worse.
Headaches that begin after the age of 50.
Headaches accompanied by numbness and tingling in your arms or legs, weakness on one side of the body, or visual disturbances.