A migraine is a headache disorder characterized by moderate to intense throbbing pain, nausea, and heightened sensitivity to external stimuli or the environment.

You may have experienced a migraine if you’ve:

  • had a headache so overwhelming that it was difficult to work or concentrate
  • felt a pulsating pain in your head that was accompanied by nausea
  • experienced extreme sensitivity to bright light or loud sound
  • seen stars or spots in your field of vision

Certain triggers can bring on a migraine attack. For some, exercise is the culprit.

A variety of causes and risk factors have been linked to migraine pain, though they’re not universal. The contributing factors that lead to a migraine attack vary from person to person.

Causes

While migraine triggers can bring on an attack, many people experience spontaneous migraine episodes in absence of triggers. Researchers are working to understand why. So far, the exact underlying cause of migraine is unclear. Though researchers have identified a few contributing factors:

  • electrical activity in the brain
  • levels of serotonin in the body
  • genetics
  • environmental factors

Risk factors

A variety of factors may play a role in your risk of migraine:

  • Age. Migraine episodes can start at any age, but they occur most often in adults between ages 25 and 55.
  • Sex. Women are three times more likely to experience a migraine than men, according to the Migraine Research Foundation. Women between ages 20 and 45, and women who are menstruating are especially susceptible.
  • Family history. People with a family history of migraine attacks are also more likely to experience migraine.

You should talk with your doctor if you’re in your 50s and suddenly develop symptoms of a migraine. People who experience migraine very often typically start experiencing these headaches at an earlier age, sometimes even in high school. Headaches that begin later in life need further evaluation to make sure there isn’t something else that’s causing them.

Your average tension headache is generally mild to moderate, steady, and felt throughout or across your head. Tension headaches don’t cause nausea or sensitivity to light or sound.

On the other hand, migraine pain is generally severe. The pain is often isolated to one particular spot or side of the head. Migraine can also cause nausea or vertigo. In severe cases, it may even cause vomiting.

Other common migraine symptoms include:

  • severe, throbbing pain
  • pain that occurs in one specific spot on the head
  • sensitivity to light
  • sensitivity to sound
  • vertigo
  • nausea
  • vomiting

Approximately 25 to 30 percent of people affected by migraine also experience an unusual visual phenomenon called aura, according to the American Migraine Foundation. Aura can occur before or during a migraine episode. Aura may appear to you like:

  • wavy lines
  • zigzags
  • sparkles
  • flashing light
  • strobing light

Migraine with aura can even cause short-term vision loss, blind spots, or tunnel vision. It’s possible to experience the visual disturbances of an aura without ever feeling a headache.

These symptoms may feel worse when you move around, walk, or climb stairs.

You may also experience neck pain as a symptom of a migraine. Neck pain can be seen as the first symptom of an exercise-induced migraine.

You should see your doctor immediately if you have neck pain and a headache along with a fever. You may have meningitis. Meningitis is an infection of the membrane covering the brain.

The best treatment for migraine is to prevent an attack before it starts. If exercise is one of your migraine triggers, you don’t have to give it up. Here are some tips to help you prevent or reduce exercise-induced migraine.

Consider the weather

Exercising in hot, humid weather may make you more likely to develop exercise-induced migraine. When the weather is hot and sticky, try these tips to keep a migraine attack at bay:

  • Keep yourself hydrated.
  • Exercise in a cool, temperature-controlled environment if possible, such as an air-conditioned gym.
  • Wait until the worst of the heat and humidity has passed if exercising outside.
  • Consider switching your workout time to the early morning when it’s generally cooler, especially during hot summer months.

Learn more: Understanding why the weather affects your migraines

Consider the altitude

If you’ve recently moved to or are visiting a location at a high altitude, wait 2 days before beginning your exercise regimen. This will allow your body to get used to the lower oxygen levels. Drinking more fluids and staying away from alcohol can also help.

Warm up and cool down

Spend 15 minutes warming up before engaging in intense activity and five minutes cooling down afterward.

Stay hydrated

For some, dehydration is a migraine trigger. Carry a water bottle with you while you exercise and sip often.

Additional preventive methods

As with any migraine episode, exercise-induced or not, you should also take other preventive measures, such as:

  • sticking to regular eating and sleeping times
  • reducing stress and anxiety
  • cutting back on or avoiding caffeinated and alcoholic beverages
  • taking over-the-counter (OTC) nonsteroidal anti-inflammatory drugs, such as ibuprofen or naproxen
  • taking anti-inflammatory drugs, such as indomethacin, or blood pressure medication, such as propranolol, which have been shown to help prevent headaches

If exercise-induced migraine episodes persist, you may ultimately need to switch to a new sport or exercise regimen that doesn’t worsen your symptoms. Aerobic exercise like fast walking or lower intensity options that also promote relaxation, like yoga, may reduce or eliminate migraine symptoms.

For some, exercise — especially an intense, rigorous workout — can trigger a migraine attack. This is known as exercise-induced migraine.

One study found 38 percent of participants experienced migraine because of or in association with exercise. Of those people, more than half stopped engaging in their chosen sport or exercise to reduce or eliminate migraine attacks.

Although the cause is unclear, movement often triggers a migraine episode. Actions such as rotating your body quickly, turning your head suddenly, or bending over can all trigger or aggravate migraine symptoms.

An exercise-induced migraine episode tends to occur more often in association with certain vigorous or strenuous sports or activities, including:

  • weightlifting
  • rowing
  • running
  • tennis
  • swimming
  • football

A migraine attack, particularly one with aura, may occur during exercise or sports that require great or sudden physical exertion.

For those who experience exercise as a migraine trigger, the environment can also be a risk factor for an attack. Exercise-induced migraine is more likely to occur in people who are working out in hot, humid weather, or at high altitudes.

Other migraine triggers

In addition to exercise, other migraine triggers include:

  • emotional or physical stress
  • inconsistent or inadequate sleep or eating patterns
  • strong sensory encounters, such as bright sunlight, noise or noisy environments, or strong scents
  • hormonal changes
  • foods and beverages that contain alcohol, caffeine, aspartame, or monosodium glutamate
  • disturbances to your body clock, or circadian rhythms, such as when you travel or experience periods of insomnia

Your doctor will ask you various questions. Your answers can help them diagnose the root cause behind your symptoms. Be prepared to answer these questions:

  • How often do you experience a migraine attack?
  • When did you first experience headaches?
  • What are you doing when a migraine episode occurs?
  • What types of symptoms do you experience?
  • Do any of your close relatives experience migraine?
  • Have you noticed anything that makes your symptoms better or worse?
  • Have you recently had any dental problems?
  • Do you have seasonal allergies, or have you recently had an allergic reaction?
  • Do you have any symptoms of fever, chills, sweats, lethargy, or periods of incoherence?
  • What changes or major stresses might you have experienced recently in your life?

No exact medical test exists to screen for migraine. Your doctor cannot diagnose migraine headaches through:

  • blood tests
  • an X-ray
  • a CT scan
  • an MRI scan

However, your doctor may order certain tests to try to determine what’s causing migraine.

If you experience exercise-induced migraine attacks, your doctor will want to rule out potentially dangerous underlying conditions related to your head pain before diagnosing migraine. That includes things like:

  • intracranial aneurysm
  • Chiari malformation
  • tumor

If you experience a migraine episode while exercising, stop the activity. Lying down in a cool, dark, quiet place until the attack passes may help relieve your symptoms.

You may also take a prescription or over-the-counter pain reliever or anti-inflammatory as soon as the first signs of a migraine episode occur. Medications known to help relieve migraine symptoms include:

  • ibuprofen (Advil)
  • naproxen (Aleve)
  • acetaminophen (Tylenol)
  • aspirin
  • sumatriptan (Imitrex)
  • zolmitriptan (Zomig)
  • dihydroergotamine (Migranal)
  • ergotamine tartrate (Ergomar)

There’s currently no cure for migraine. If left untreated, migraine symptoms generally last between 4 and 72 hours.

It’s important to address your migraine symptoms. Hoping they will just go away will not help. For some, an occasional migraine can recur more and more often, eventually becoming chronic.

It’s important that you work with your doctor to find ways to prevent and treat migraine to help stop your condition from getting worse.