Moreover, pain aggravation induced by routine physical activity is typically reported by patients during migraine attacks and is therefore included in the diagnostic criteria of migraine according defined by the International Headache Society. This might be a reason why the interictal behaviour of migraine patients frequently includes reduced physical activity. On the other hand, some migraineurs report exercise as a triggering factor for their attacks. Moreover, exercise has been shown to improve self-esteem which is also associated with alleviating symptoms of migraine. Interestingly, this includes conditions comorbid with migraine such as depression, anxiety and sleep disturbances. Thus, there is an unmet need for evidence-based non-pharmacological approaches to complement pharmacotherapy in migraine prevention.Įxercise can be used for management of several chronic pain conditions. In addition, lack of adherence is a phenomenon often observed among patients who are prescribed prophylactic drugs. Although physicians possess several pharmacological options to treat migraine attacks, these drugs are often not effective for the individual patient, and they may have side effects. Furthermore, it is a risk factor for cardiovascular diseases. Moreover, migraine is a disabling condition causing absenteeism from work and social life and large monetary losses in society of approximately 1200 Euro per person annually. In some patients, attacks are accompanied by an aura with focal neurological symptoms. Usually the headache is aggravated by physical activity. It is a cyclic disorder characterized by recurrent attacks of headache accompanied by nausea, photo- and phonophobia. Migraine is the most common neurological disorder affecting around 15% of the European population. However, the frequency and intensity of exercise that is required is still an open question, which should be addressed in future studies to delineate an evidence-based exercise program to prevent migraine in sufferers. This is most likely due to an altered migraine triggering threshold in persons who exercise regularly. In conclusion, it seems that although exercise can trigger migraine attacks, regular exercise may have prophylactic effect on migraine frequency. Mechanisms for migraine prevention by exercise may include increased beta-endorphin, endocannabinoid and brain-derived neurotrophic factor levers in plasma after exercise. Possible mechanisms for how exercise may trigger migraine attacks, include acute release of neuropeptides such as calcitonin gene-related peptide or alternation of hypocretin or lactate metabolism. In experimental studies exercise has been reported as a trigger factor for migraine as well as migraine prophylaxis. Low levels of physical exercise and high frequency of migraine has been reported in several large population-based studies. The review was based on a primary literature search on the PubMed using the search terms “migraine and exercise”. Here, we review the associations between physical exercise and migraine from an epidemiological, therapeutical and pathophysiological perspective. However, what exact role exercise plays in migraine prevention is unclear. Exercise can be used in the treatment of several pain conditions, including. There is an unmet need of pharmacological and non-pharmacological treatment options for migraine patients.
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