NEW YORK (Reuters Health) – Exercise therapy does not appear to reduce headache attack or duration in migraine patients, according to findings published in the June issue of Headache. However, exercise may reduce pain intensities in this population.

“Exercise in migraine is recommended and even promoted in almost every reference textbook, patient guidebooks, or on migraine webpages,” Dr. Volker Busch, of the University of Regensburg, Germany, and a colleague write. “Most of these recommendations refer to some anecdotal reports or observational studies in literature stating that regular exercise can reduce the frequency and severity of migraine or even eliminate it completely.”

In the current review, the researchers examined whether recommendations for exercise in migraine therapy are based on adequate data to meet the requirements of an evidence-based modern migraine therapy. The review summarizes all available studies and case reports that investigated exercise and endurance sports in migraine therapy. Aerobic endurance training programs were performed in all trials.

The authors searched Pub Med and Current Contents for articles from 1962 to July 2007. A total of eight studies and four case reports were included in the review.

The authors report that some results of the included trials were controversial regarding the efficacy of sports intervention in migraine therapy. Most studies did not find a significant reduction of headache attacks or duration due to regular exercise. Six of the studies demonstrated a reduction of pain intensity during the intervention. The grade of recommendation of exercise in migraine therapy is B-C.

“Due to numerous methodological limitations (uncertain diagnoses, small case numbers, mostly no control group, no detailed information about the headache before and after the treatment, etc.), the effect of aerobic exercise in migraine can only carefully be estimated in the reviewed studies,” the authors explain.

“To further recommend exercise in migraine based on evidence based medicine criteria, more studies are imperative.”

Headache 2008;48:890-899.

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