How much exercise is effective in controlling migraine?


Exercise increases our endorphins, the natural painkillers in our brains, so by exercising we can help relieve migraine pain. We should exercise at least 20 minutes three times a week to have a consistent level of endorphins. Sometimes exertion can  trigger a migraine. To avoid that it’s best to warm up first.


“So exercise is very interesting because there's actually been several studies done with exercise and migraine. So what happens in
exercise is that it increases our endorphins. Endorphins are natural painkillers. They actually modulate the pain system. So if we exercise we can naturally basically build up those endorphins to actually relieve our own pain. So it's a great part of your lifestyle changes that you can do to empower yourself against your neurobiological disorder of migraine. What I typically would recommend for patients, to have that consistent elevation of endorphins, is about 20 minutes of exercise at least three times a week.

“You want to kind of start small and build up. In fact there's some data that talks a little bit about that warm up period while you're exercising and how that's so important. There is a type of headache disorder, exertional headaches, which is really defined as basically any type of exertion or exercise is what triggers the headache. There have been studies that demonstrated that for those individuals, if you lengthen that low impact warm up activity that you're able to prevent that exertional headache. I suspect the same would apply for our migraine patients, make sure if you want to run don't step out of the house and just start running, but rather make sure you do that warm up activity. And for you it might need to be a little bit longer than the average patient who may not have migraine.”


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Amaal J. Starling, MD, FAHS, FAAN

Mayo Clinic, Arizona

Dr. Amaal J. Starling is an associate professor of neurology at the Mayo Clinic College of Medicine. She joined the Mayo Clinic in 2012 and is currently a consultant within the Department of Neurology. Dr. Starling received her medical degree from the Drexel University College of Medicine in Philadelphia. She completed a transitional year residency, a neurology residency, and a headache fellowship at the Mayo Clinic College of Medicine in Scottsdale, Ariz.

Dr. Starling is an active member of numerous migraine advocacy organizations, including the American Headache Society (AHS), the American Migraine Foundation, and the American Academy of Neurology (AAN). She is also involved in events supporting migraine, including Headache on the Hill, Miles for Migraine, and the Alliance for Headache Disorders Advocacy. Dr. Starling is currently serving on the AHS Board of Directors and is the chair of the AHS Advocacy Committee and a member of the AHS Diversity, Equity, and Inclusion Taskforce. Dr. Starling has been the recipient of numerous awards, including the AHS Above and Beyond Award for Service, Manfred D. Muenter Award for Excellence in Clinical Neurology, the AAN Annual Meeting Residency Scholarship, the 2012 Spirit of Mayo Clinic Award, and the Mayo Brothers Distinguished Fellowship Award.

Dr. Starling has authored numerous peer-reviewed publications and abstracts related to her fields of interest, which include migraine, concussion, post-traumatic headache, neuromodulation, and telemedicine. Dr. Starling’s hope is that her research and advocacy will advance care for people with migraine, post-traumatic headache, and other headache disorders. She envisions a future in which all people with headache disorders receive personalized, effective, and well-tolerated treatment options to improve their quality of life.

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