Attacking migraine attacks with exercise
Regular exercise is good for you, in moderation. No denying that.
You might be incentivised by endless social media posts showing buff bodies promising that if we work harder and longer we will be stronger and, of course, better looking. And because exercise stimulates the release of natural pain-controlling chemicals, endorphins, and anti-depressant chemicals, enkephalins, the ‘exercise high’ is both motivator and reward. It could also lead to reducing drug intake, such as OTC medications for pain and prophylactics. Obviously, lifestyle choices, such as diet, wellbeing, work-life balance, sleep – are also important health factors to lower the risk of disease and improve mental health, but what if you are prone to migraine – does exercise help or hinder?
Self-management is key if you have migraines, and specialists will likely suggest you keep a headache diary so you can establish patterns and trends, and notice how your daily routine correlates to migraine onset, duration and severity. Evidence suggests that moderate exercise can reduce the frequency and severity of, and even prevent, migraine. On the contrary some have found it to be a trigger. Everyone has their own experience, and although there are, potentially avoidable, contributing reasons as to why this might happen, it is possible that exercise might not be your “cure”. But you could always give it another go.
Set a goal – plan ahead, don’t start too fast and too hard, try it out for at least 6 weeks before making your mind up. Get the correct gear, feel comfortable. Eat before (at least 90 mins), drink fluids before, during, and after warm up and cool down. Most importantly, find an activity that is right for you (preferably something you enjoy). And write it all down in your diary.
Cold water swimming is one such activity. For now, there is no direct evidence that this relieves a migraine attack, although reported use of ice therapy for pain is found in medical literature going back to the 1900s. There is a common understanding that it improves mental health. But can it reduce chronic pain and can it reduce migraine attacks?
Despite ice treatments not being recommended for chronic pain, one interesting case – a 28-year-old keen triathlete suffering from neuropathic pain – says differently. He explains: “My entire body tingled with the cold. I just knew if I didn’t keep swimming, I’d soon freeze. After a few moments I actually enjoyed it – it was just an immersive rush of adrenaline. When I came out of the water, I realised the neuropathic pain had gone away. I couldn’t believe it.”
Another case, a 26-year-old female who was having up to 28 migraines a month, with tinnitus, blind spots, nausea, and other debilitating symptoms, started swimming off the Welsh coast (very cold waters trust me) for 100 days over winter. “As I dip under the waves, I take a deep breath – preparing for the cold and knowing that, within a few minutes, my whole body will be tingling, numb and red. More than this, though, I am bursting with adrenalin. Swimming like this makes me feel alive, and it’s the best feeling on earth…. My overall health has improved, and I now have about 16 migraines a month, nearly half the amount compared to when they were at their peak, and the effects aren’t as debilitating”.
Whether it is connecting with nature – the restorative powers of the ocean – or a chemical or biological reaction in the body, my own experience of winter sea swimming (with no wetsuit for maximum exposure and impact) has had a profoundly positive affect on my mental health, and with the help of prophylactics, has (more often than not) kept my migraine attacks at bay.
Therefore, with the added personal investment I have very much enjoyed working with fantastic experts to create and deliver a multimedia modular program on migraine, one that will help primary care professionals and clinical specialists develop the optimal individual therapies for their patients.
Migraines are often dismissed as headaches that can be remedied by popping a pill and this is a misleading narrative that only scratches the surface of how migraine can impact quality of life.
Let’s talk about migraine: For our latest independent and free program on the acute treatment of migraine, including videos, interactive eLearning activities, case studies, and a webcast, see https://migraine-acute-treatment.ime.springerhealthcare.com/
Mole TB, Mackeith P. Cold forced open-water swimming: a natural intervention to improve postoperative pain and mobilisation outcomes? Case Reports 2018; https://casereports.bmj.com/content/2018/bcr-2017-222236