Migraine from even low-impact exercise, preventive?

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  • Full Question:

    Every time I work out even if it is low impact I get a migraine. Most of the time it is when I bend over. I cannot do that at all. I used to be able to work out for 1 hour at a time now I cannot even due low impact without getting a headache. I used to use a treadmill but that got to jarring for 20 minutes, or ride a stationery bike for about 20 minutes now I cannot even due that. I have a swimming pool in my back yard and I am even afraid to do exercises in the pool. Please help is there a drug or preventive that I can use so I can exercise once again. Its been 3 months I want to exercise again even if it is just a 1/2 hour each day. Thanks, Paula.


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    Full Answer:

    Dear Paula;


    Thank you for this very important question. Exercise induced headaches can be very frustrating, especially since we know that good general physical health is important for migraine management.


    While it is not uncommon for exercise to worsen a migraine attack once it is started, it's also not common for low level exercise to trigger a migraine. Although very uncommon, there are a couple of important things to ensure are not the cause of your exercise induced migraines.

    • First, consider checking your blood pressure to make sure it is not getting significantly elevated during exercise.
    • Second, you may want to ask your primary physician about a stress test, as there are rare cases of cardiac ischemia (not enough blood and oxygen getting to the heart) causing headaches.
    • Lastly, if this is a new problem and you have not already done so, it may be important to get an MRI scan of your brain to look for vascular malformations, masses, or constriction of blood vessels.

    Most people think that exercise headaches are caused by distension of arteries or veins in the head, and in a recent study 70% of patients with exercise headaches showed incompetence of the internal jugular valves, possibly leading to venous congestion.


    Assuming that none of the above concerns turn out to be the case (which they rarely do), then indomethacin dosed either daily or prior to exercise is often effective and reducing the tendency to develop headaches with exercise.


    We encourage you to see your primary physician and discuss these issue with him/her and whether you need to be referred to a headache and migraine specialist for further evaluation. If you need to locate a migraine and headache specialist, this should help — Migraine and Headache Specialist Listings.


    If you'd like more information about migraine triggers, see our migraine triggers infographic.


    Thank you for your question,
    David Watson, MD, and Teri Robert


    About Ask the Clinician:

    Dr. David Watson is a UCNS certified migraine and headache specialists and director of the Headache Center at West Virginia University. Je and Lead Health Guide Teri Robert, team up to answer your questions about headaches and Migraines. You can read more about Dr. Watson or more about Teri Robert.


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    Last updated September 12, 2014.


Published On: September 12, 2014