A recent study highlighted a link between exercise and migraine, and their often overlooked relationship. The study is entitled "Anxiety, sensitivity and intentional avoidance of physical activity in women with probable migraine," and it was led by Samantha G. Farris from Rutgers, Department of Psychology, the State University of New Jersey, NJ, United States of America. This study was published in the journal Cephalalgia, the official journal of the International Headache Society.
Lack of exercise and migraine
According to experts, migraine affects almost 10 to 15% of the world population, and among its most common diagnostic criteria include unilateral head pain, throbbing, hypersensitivity to sounds, lights, odors, and aggravation by activity. Even though regular aerobic exercise has been strongly recommended by clinicians as an option for migraine prevention, for 1/3 of patients who suffer from migraine, physical exercise can trigger migraine attacks. Exercise is then avoided to manage migraine, and it has become a strategy for some not to do any physical activities to prevent any attacks.
As observed with other pain conditions, anxiety sensitivity, which is referred to as the fear of experiencing anxiety because of harmful cognitive, physical, and socially-observable consequences, may be linked to PA avoidance in migraine patients. This is true especially with vigorous PA because this exercise intensity is known as potentially triggering or worsening of migraine attacks. However, light to moderate physical activity can actually be good for those who suffer from migraines.
Effects on health
The study that was published in the journal required the researchers to assess 100 women with probable migraine, who filled an online survey covering intentional avoidance of moderate and vigorous physical activity. Anxiety sensitivity, a self-rated perception that PA would trigger a migraine attack, and worse migraine symptoms. The intentional avoidance of moderate and vigorous PA was based on the Global Physical Activity Questionnaire.
The result of the assessment showed that increased anxiety sensitivity scores linked with PA avoidance of both moderate and vigorous intensities. The one-point increase in the anxiety sensitivity scale resulted in a 5% increase in the odds of avoiding physical activity. Concerns about the consequences of bodily sensations, such as difficulty in breathing, was linked with a 7.5-fold higher odds for avoiding vigorous PA. Cognitive consequences of bodily sensations, like inability to concentrate, is thought to reflect headache-related disability and is linked with a 5.2-fold higher odds for avoiding moderate PA. Anxiety sensitivity scores positively associated with stronger expectations of vigorous-intensity PA as triggering and worsening factor for migraine.
Why moderate PA is needed by migraine patients
This study showed a relevant yet overlooked aspect of migraine. Migraine is regarded as a highly prevalent and disabling neurological disorder, in which regular physical activity is part of the current, non-pharmacological treatment recommendations.
The authors of the study pointed out that patients with migraine and elevated anxiety sensitivity could benefit from multi-component and tailored intervention, including psychoeducation about the positive effect of physical activity on migraine and the detrimental effect of avoidance. It is also important to inform everyone about the perceived rates versus the actual rates of PA in triggering or worsening migraine and the use of gradual exposure to facilitate desensitization to avoided PA and other related bodily sensations.
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