An Israeli study suggests that exercise can become a therapeutic tool for migraine sufferers, but only after the attack rate is brought under control. The research was published in the journal Cephalalgia by teams from Soroka University Medical Center, part of Clalit, and Ben-Gurion University of the Negev, and it examined the difficulty many migraine patients face in following advice to exercise regularly.
Migraine, the study notes, often causes moderate to severe headaches, typically throbbing and one-sided, along with nausea and sensitivity to light and noise. Among hundreds of participants in southern Israel, people who exercised for at least two hours a week averaged only three migraine days a month, compared with five days among those who did no exercise. They also used significantly fewer triptans, reported better quality of life, and had lower levels of work burnout.
But the study also found a clear barrier for patients with four or more migraine days a month. In that group, the chance of sustaining moderate exercise fell below 50 percent. Researchers described a vicious cycle in which pain, stress, and low mood make exercise harder, while inactivity worsens the migraines and keeps patients trapped.
To address that problem, the team led by Dr. Ido Pless of Soroka’s Center for Clinical Research and Prof. Gal Ifergan, head of neurology at Soroka, proposed a two-stage model called PEPA, or pharmacological bridge to exercise. First, preventive drug treatment is used to calm brain activity and reduce monthly attacks below a critical threshold. Only then can patients begin exercising safely, with the goal of gaining exercise’s blood vessel and pain-modulating benefits and possibly later reducing preventive medication. Ifergan said, “If you cannot exercise because of migraine, do not blame your willpower. You may simply be above the exercise threshold, trapped in a vicious cycle. The right preventive drug treatment that lowers attack frequency is not only a solution to pain, it is the key that opens the door back to an active and healthy life.”
