Migraine is considered to be one of the most disabling conditions experienced by young adults. There are a variety of treatment options that are available to these patients. Non-pharmacological treatments are one of the most attractive treatment strategies considering the possible adverse effects of many common migraine drugs. The paper included in this FastFact evaluates the possible role of aerobic exercise (AE) as a treatment for this common condition1.
It has been suggested that AE can be used to treat migraine. There are a number of possible mechanisms by which this might occur. AE may have a direct analgesic effect. It is hypothesised that this may be due to increased beta-endorphin levels and activation of the endogenous cannabinoid system. In addition to these analgesic effects exercise may also indirectly improve a patient’s symptoms through psychological and behavioural aspects leading to improved self-efficacy, better sleep and improved mood.
The aim of this systematic review and meta-analysis was to evaluate the effects of AE on pain intensity, frequency and duration of migraine and quality of life. To be included studies needed to compare AE with other forms of exercise therapy and/or minimal usual care (information, education or medication). A total of 10 studies were included in the systematic review, six of which were included in the meta-analysis. There were a total number of 508 participants (462 female, 37 male).
The results obtained from the meta-analysis showed that exercise has a significant effect, with statistically significant reductions in the frequency, intensity and duration of pain, as well as a statistically significant improvement in quality of life. Three of the studies showed improvements in the exercise group. In another three studies, improvements in both the intervention and control groups were found. Two studies did not obtain statistically significant results. In the only study that included intense exercise, improvements were shown to be superior to lower intensity exercise. One study showed an additional improvement when AE is combined with other therapies. No adverse events or sides effects were recorded in the AE groups while these were common among patients taking migraine medications (such as amitriptyline or topiramate).
Based on the results of this paper it appears that aerobic exercise can be an effective treatment for migraine sufferers and should be prescribed where possible. Whether this finding is generalisable to football, where physical activity may be more intense and/or anaerobic is not clear. We should also be mindful that the sample had a limited number of male participants. Finally, there is a great deal of heterogeneity among the studies analysed and significant concerns about bias.
1. La Touche R, Fernández Pérez JJ, Proy Acosta A, et al. Is aerobic exercise helpful in patients with migraine? A systematic review and meta-analysis. Scand J Med Sci Sports. 2020;30:965–982.