There are a whole host of lifestyle and exercise recommendations for fighting migraine. A fascinating study published this month in The Journal of Headache and Pain looked at how much solid evidence there is for various types of “therapeutic exercise”, and included studies of everything from high-intensity interval training to relaxation techniques.
Each type of exercise was given a grade from B to D. What will especially catch your eye are the specifics about aerobic exercise, so let’s take a closer look.
As I studied, I was surprised to discover that I was a little weak on the actual definition of “aerobic”. Citing The American College of Sports Medicine (ACSM), this article from the National Library of Medicine defines “aerobic exercise as any activity that uses large muscle groups, can be maintained continuously and is rhythmic in nature”. “Aerobic” refers to the use of oxygen, so think of anything that requires extra oxygen. But that’s not necessarily sprinting – it could be much less intensive, such as walking.
Other examples would include jogging, swimming, and stair climbing.
As you can tell, there is actually a wide range of aerobic activity. So what has the best evidence as a migraine-fighter? Several studies recommended aerobic exercise in general, and some specifically “moderate-intensity continuous aerobic exercise”. Low intensity did not seem to do as well as moderate intensity, but it still earned a “C” score on the evidence scale.
So basically, any aerobic exercise is a step in the right direction, with moderate-intensity having the most studied benefits. Moderate aerobics three times a week is the specific recommendation.
The benefits found in the studies included:
Decreased pain frequency
Decreased pain intensity
Decreased pain duration
Decreased disability
Increased quality of life
That may seem vague, but remember that these were studies specifically designed to measure improvement, so this is more than just “I seem to feel a little better”. This is a significant improvement.
For those with migraine, it seems to be wise to start slowly and gradually increase the intensity of your exercise, being sure to stay hydrated. The Cleveland Clinic has a great article introducing aerobic exercise here.
Also, the American College of Sports Medicine has a chart explaining “intensity” more specifically. Don’t get nervous – if you can add any kind of movement to your life, it should help your quality of life. These exercises don’t need to be intense – but you will need to push yourself a little. Here’s the chart: Tips for Monitoring Aerobic Exercise Intensity.
A new study is once again linking migraine and sugar – and yes, there’s something you can do about it.
We’ve talked a lot about the link between migraine and eating, in particular, sugar and refined grains. But how your body responds to foods is actually very complex, so there’s a lot more to say.
A diet that gives you a lot of spikes in sugar certainly seems to trigger more migraine attacks. For example, liquid sugar – drinking a lot of juice or carbonated sugary beverages, for example.
The study talked a lot about “insulin resistance”. Imagine it this way. There’s a lumber mill out in the forest, and trees are being cut down and made into planks for building houses, and so on. I might add that this is a very sustainable operation, and trees are being replanted and habitats protected. 🙂
The lumber mill salesman goes into the city with his planks and sells them to all the people, and the people go into action, building houses using wood for fuel and making little toys and whatever else they do with the wood. Wood is amazing.
But after a while, the lumberjack starts getting a little greedy and starts cutting down more and more trees. The lumber mill is having trouble keeping up, but it’s giving a lot of work to the salesman. The salesman, also getting greedy, is in the city constantly, shouting to all his clients about what they could do with more and more and more wood! More salesmen are trained for the “growing market”.
After buying the wood for a while, and storing the extra in the garage, the people in the city get fed up. They have too much wood, the salesman is simply annoying – they’re done. They get so fed up, they call the police on the salesman, put out a restraining order, and start putting up posters warning everyone to stop buying from this guy.
You can understand their concerns – but now a system that was working well is completely broken. A very useful system is ending up with unused wood gathering dust in the garage, and at the same time a supply-chain problem. But now the salesmen have too much wood – so the storehouses are getting full of wood, that’s simply not being used for anything.
Now, imagine that the wood is food you eat with sugar. It’s processed by the body, and a salesman – let’s call him Mr. Insulin – gets the sugar to the city (or perhaps stores some of the wood properly in the lumber storehouse – like the liver, for example). The city (cities) is like your cells.
Sometimes, for various reasons, the cells can become “resistant” to the salesman, Mr. Insulin. The salesman gets more aggressive – in fact, more salesmen are trained at the Pancreas School of Insulin, because obviously, something isn’t working. But more salesmen aren’t helping.
For a while, the sales trucks are full of wood, but eventually there’s too much wood (sugar) for the insulin. The body is simply getting overwhelmed.
The excess sugar is stored in the storehouses – we call it “fat”, and you might see this right around your waist.
Insulin Resistance and Migraine
With the system broken, you end up with all kinds of problems. Diabetes…. it may cause problems in the brain – dementia – and … migraine?
This particular study, as you may guess, did find a link between insulin resistance and migraine, as well as metabolic syndrome and migraine. Metabolic syndrome is defined by the Mayo Clinic as “a cluster of conditions that occur together, increasing your risk of heart disease, stroke and type 2 diabetes. These conditions include increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels.”
Researchers looked at various indications of metabolic syndrome and insulin resistance. For example, fat around the waist. Yes, more likely in the migraine group. Insulin resistance? More likely in a migraine patient. Higher levels of insulin? Yes. Metabolic syndrome? Same thing.
And looking at the situation in reverse, migraine patients with insulin resistance were more likely to have worse migraine disease – more disability, worse attacks, and so on. Metabolic syndrome, in this case, was not as closely related to worse attacks.
Now we need to remember that there are a number of things that can cause “supply chain” issues in the body. Think of our lumber mill. Maybe one city just tends to build houses more slowly and carefully. Maybe the lumberjack gets a more efficient chainsaw. Maybe the weather is bad for a season.
In the same way, problems people with certain genetics or medical histories – or family medical histories – may be more susceptible to “supply chain” problems.
This study doesn’t show that insulin resistance causes migraine, but it is another clue (along with many other studies) that general health should help fight against migraine.
If you’re tempted to go and spend a fortune on that new exercise equipment, or that pill promising to “melt” fat around your waistline, think twice. Before getting to “next level” options, you have the power to make a huge difference in your own health.
That’s right – we’re back to exercise and diet.
Consider “quitting sugar” (that is, drastically reducing the added sugars and refined grains in your diet). For tips, see How To Quit Sugar (1) and How To Quit Sugar (2). If you spend most of your time in a chair, start by adding some movement to your day. In other words, take small steps to get your body moving. This does not mean going from the armchair to 6 hours at the gym tomorrow. Small steps, but consistent, regular steps.
This post is for people who are saying, “I have a headache”, with the assumption that this headache is not “normal” for them.
I would like to have a series of posts that will help people find help for their headaches – and this is the place to start if you’re experiencing new symptoms, or a change in symptoms.
That is:
You “don’t get headaches”, but you have one now.
You’ve just noticed that your headaches are getting worse.
This is your “worse headache ever”.
Your symptoms have changed. For example, you’ve had headaches before, but this time you’re sick to your stomach. Or the pain is in a new location. And so on.
I have a headache – what should I do?
Recognize that this is not “normal”. Yes, I know that many people get headaches. Perhaps headaches are common in your family. Maybe you’re under stress, or going through hormonal changes, and someone tells you that it’s not surprising that you have a headache. I know that even some doctors (sadly) brush off patients with headaches, and don’t take them seriously. Set all of that aside. Headaches are not normal, you should not “just live with them”.
See a doctor or specialist right away.This is very important. I know that there’s no point in running to the doctor every time one has a headache. But remember – this advice is for people who have a new, different, or “worst-ever” headache. If it’s a severe and new headache, that can be a medical emergency – get to a doctor now. Worsening or changing headaches can also be a sign of something serious. Even a mild headache, when you “never get headaches”, is something that should be checked out as soon as possible.
Do not take someone else’s prescription medication. We’ll talk more about medications later, but it’s very important not to assume that you have such-and-such a headache, just like Aunt Sherry, and so you just just take one of the pills she offers you. Many medications today are specific to the headache condition of a certain person, and that includes the dose they’re taking.
Don’t panic. It can be easy to think the worst, especially when a severe headache comes out of nowhere. I assume you’re following my advice on #2 – if not, get to the doctor! But now that you’re on your way, remember that there are some great treatments and most of the time you’ll be able to find some help.
At the Doctor’s Office with a Headache
A doctor’s response can be confusing or concerning when you’re visiting with a new headache. So here are a few things to remember:
Most doctors do want to help you. Many have suffered from headaches themselves – in fact, there are many specialists (often neurologists) who entered the field because of their own experience with headache. Just because a doctor doesn’t give you the answers you were hoping for, or doesn’t spend the time with you that you wanted, or doesn’t have the best bedside manner, doesn’t mean that they don’t care.
You don’t necessarily need 57 tests right now. If your doctor does send you home with some painkillers, don’t assume that they’re just brushing you off. From their training and experience, they may feel that it’s best to try this first and wait a bit. As time goes by, the situation may be different. But even a serious ongoing headache does not necessarily mean, for example, that you need your head scanned.
Signs that you need a second opinion: That being said, sadly, some doctors are simply not in the right field. Or they’re having a bad day. Or they’re not educated when it comes to headache. If you’re told something like “women just get headaches” or “it’s probably stress”, and the doctor has no interest in exploring treatment or seeing you again – find another doctor, preferably a specialist.
You are the expert! All right, you don’t have the medical training of your doctor – that’s why you went to their office, or to emergency. But you are the expert of your own body. If you leave the doctor and still have a nagging feeling that you need another opinion – get one now. If your doctor doesn’t seem to understand just how bad the pain is – make it clear. Watch for other symptoms. Watch for changes. No matter how good a doctor is, they don’t know how you’re feeling as well as you do. That feeling you have, that you can’t even express in words – don’t ignore it. And don’t let anyone tell you to do so.
That’s enough to cover regarding that first visit to the doctor. There’s a lot of information to explore here at Headache and Migraine News – go ahead and look around!
Our informal motto around here is “it’s time to fight back”. It’s time to fight back against headache disorders, including cluster headache and migraine. It’s time to fight back against people who tell us “it’s just a headache”, or doctors who claim that there’s nothing they can do.
But sometimes it’s hard to fight back. And sometimes there is confusion about what fighting back really means. After all, does “fighting” mean that I will be constantly living with discontent and anger?
I don’t believe that it means that at all. Why? Because “acceptance” is not “fatalism”.
Yes, I believe that most people should be able to find major relief from the headache symptoms they suffer now. Yes, I believe that there are dozens of helpful treatments. (See 10 Critical Mistakes First Time Migraine Patients Make)
But I also know that the road to relief can be long and difficult. So, on one level, I believe that “acceptance” is important.
We need to learn to be content with our situation as it is now. We need to learn how to live at peace. Because anger and internal stress will not relieve headaches.
We need to accept that neurological conditions can take time and effort to treat. Acceptance means does not mean accepting that you will have headaches forever. But it does mean that you will live well now, without waiting until everything is better.
Because acceptance is not fatalism. One of the biggest challenges in headache treatment is when family members, doctors – even we ourselves – start thinking that headaches are just “normal”. “Our lot in life”. “I’ll just have to live with it”.
No. It is time to fight back. Even if that means taking a break once in a while. We’re not going to be fatalistic and give up. We’re not going to lose hope.
So yes – find contentment and peace in the present. But never give up, and never lose hope. It really is time to fight back. Let’s fight together.
Some women with migraine are avoiding pregnancy. The big question is – should they?
This is not a question that simple statistics can answer. However, there are a lot of good reasons why you should not allow migraine to be a deciding factor when you’re wondering whether or not you should start a family.
But this is not as high a percentage as you may think. These wasn’t a cross section of women with migraine, it was a group of women getting treatment from specialty headache centres, generally with severe symptoms. So the number would be much lower if you looked at all women with migraine. And lower still if you looked at how many woman finally decided to avoid pregnancy in the end.
Still, it’s concerning that migraine is having this effect. Most readers will understand some of the reasons that women gave – concerns that their child would have migraine, concerns that they wouldn’t be able to handle pregnancy or parenthood with migraine. These are valid concerns, absolutely.
But without getting into the benefits of having a family in general, there are a couple of good reasons why women with migraine, even a more severe or chronic form, should reconsider pregnancy.
First, there is a good chance that migraine may either improve, or be adequately handled with treatment, during pregnancy. If you’d like to see some actual statistics of migraine during pregnancy and afterward, check out this infographic: Migraine During and After Pregnancy
There are more and more excellent options for women during pregnancy. There are well studied and proven complimentary treatments, and even medications that may be safe for you and the baby, if you’re under the care of a headache specialist.
Second, you’re probably a lot stronger than you realize, especially if you have supportive people around you. If you’re feeling alone, you may need to seek out some people. But even mothers with few connections may be avoiding something that they really will be able to handle, and handle well, as the months and years go by.
It will probably be helpful for you to read The Myth-Busting Guide to Migraines and Pregnancy, so that you can start with some realistic expectations. Make sure you’re under the care of a headache specialist, if at all possible.
Don’t let migraine make you automatically give up on motherhood. But at the same time, don’t be afraid to seek out help from specialists, friends and family as you enter into this amazing adventure.
