"This non-pharmacological approach (physical activity) may be an option for the prophylactic (preventative) treatment of migraine in patients who do not benefit from or do not want daily medication," wrote Dr Emma Varkey, lead author of a Swedish study published in the journal Cephalalgia in October.*

The aim of the research was to evaluate the effect of exercise in warding off migraine – a chronic neurological disorder characterised by moderate to severe headaches and nausea, which affects 10 per cent of people around the world.

Doctors use a variety of methods to prevent migraines, including topiramate – an anti-epilepsy drug – and relaxation exercises. While exercise is also prescribed, there has not previously been sufficient evidence to demonstrate that it works.

Three-month study
Conducted by scientists at the University of Gothenburg, the randomised, controlled trial comprised 91 migraine patients aged 18-65 attending a headache clinic. All were women – the disorder is known to be more prominent in females – suffering from headaches two to eight times a month.

The women were split into three groups. One-third were prescribed a daily dose of topiramate – slowly increased to the individual’s highest tolerable level (with a maximum of 200mg a day). Another third carried out common forms of relaxation, breathing and stress-management techniques according to a recorded programme. The final group exercised on a static bike for 40 minutes, for three times a week, under the supervision of a physiotherapist.

Throughout the three-month study, the patients’ migraine status, quality of life, aerobic capacity and level of physical activity were evaluated before, during and after their respective treatment.

Surprising results
The results show that migraine attacks decreased by approximately 75 per cent across all three groups and that there was no significant difference between them.

Commenting to Reuters Health, Dr Varkey said: “Topiramate is a drug of first choice that’s shown great effects in studies. It was a bit surprising and very interesting that the change in the number of migraine attacks was similar in all three groups. The only parameter where topiramate was better than exercise and relaxation was the reduction of pain intensity.

“On the other hand, the non-pharmacological options were free from adverse events and the exercise group increased oxygen uptake, which is very positive.”

While women in the exercise and relaxation groups had no issues, eight women taking topiramate had side-effects – tingling, fatigue, depression, vertigo and constipation – and consequently three left the study.

Varkey told Reuters Health: “From a wider health-based perspective, it should be stressed that patients with migraine are less physically active than the general population, and that exercise has positive effects in terms of general wellbeing and the prevention of disease.

“Additional and larger studies are, of course, needed to verify our results and to gain evidence for exercise as migraine treatment, but our results are hopeful.”

*Varkey, E et al. Exercise as migraine prophylaxis: A randomized study using relaxation and topiramate as controls. Cephalalgia. Vol 31, no 14, 1428–1438, Oct 2011.