Beneficial Effect of Aerobic Exercise in Migraine via Modulation of Avoidance Behavior

The effect of aerobic exercise on reducing migraine-associated burden in individuals with comorbid tension-type headache and neck pain may not be mediated by an effect on nociceptive pathways, but rather by a reduction in avoidance behavior, according to a study published in the European Journal of Pain.

Investigators randomly assigned 52 patients with migraine and co-existing tension-type headache and neck pain to follow a 45-minute-long aerobic exercise program of bike/cross-training/brisk walking 3 times a week for 3 months (n=26) or to continue with usual daily activities (control; n=26). Change in total tenderness score from baseline to 6-month follow-up was the study’s primary end point.

Total tenderness scores were comparable in the two groups at the end of treatment (P =.32) and at 6-month follow-up (P =.48). There was a reduction in total tenderness score from baseline to the end of treatment in the exercise group (P =.017), but there was no significant change at 6-month follow-up in this group compared with baseline (P =.30).

No between-group differences were observed in local tenderness score, pressure pain thresholds, pain rating of supra-threshold pressure pain, electrical pain threshold, pain rating of electrical pain supra-threshold, and temporal summation (secondary outcomes).

Findings from this study may not be applicable to the general population with headache.

“The effect of aerobic exercise on migraine burden may rather be explained by positive alteration of avoidance behavior,” rather than changes in pain modulation, the study authors concluded.

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Reference

Krøll LS, Hammarlund CS, Gard G, Jensen RH, Bendtsen L. Has aerobic exercise effect on pain perception in persons with migraine and co-existing tension-type headache and neck pain? A randomized, controlled, clinical trial [published online April 25, 2018]. EJP. doi:10.1002/ejp.1228