Exercise guide
Regular aerobic exercise and yoga can reduce migraine a little. In the only trial that compared exercise with a preventive medicine, 40 minutes of indoor cycling 3 times a week cut attacks about as much as the medicine, without its side effects. Exercise works alongside migraine treatment rather than replacing it, and it's unlikely to stop an attack once one has started.
Exercise can also set off attacks in some people, usually when it's very hard or much more than they're used to, or when they haven't eaten or drunk enough. This guide explains how to build up gradually with a long warm-up, what to do if exercise triggers your migraines, which headaches with exercise need a doctor, and a cycling workout based on the trial, with moves to follow on the 3D figure.
Across 6 studies, regular aerobic exercise cut about 0.6 migraine days a month, on moderate-quality evidence, and it eased migraine pain by a small to moderate amount, on very low-certainty evidence. It's a modest effect, not a cure.
91 adults did 40 minutes of indoor cycling 3 times a week, a daily relaxation programme, or took the preventive medicine topiramate, for 3 months. Attacks fell by about one a month in every group, and no side effects were reported with exercise or relaxation, against a third of people taking topiramate.
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Exercise isn't among the preventive treatments the National Institute for Health and Care Excellence (NICE) recommends, but the NHS lists getting regular exercise among the things you can do yourself, with regular meals, plenty of sleep and managing stress. Keep taking your medicines: in one observational study, regular exercise went with fewer headache days only in people also taking a preventive.
A 2023 exercise guideline gave a B grade to steady aerobic exercise (3 times a week for 8 weeks or more) and yoga (3 times a week for 6 weeks or more), above strength training, interval training and relaxation, which got a C. Aim for 30 to 50 minutes 2 to 3 times a week, starting with up to 15 minutes of gradually building effort, and keep going for at least 8 to 12 weeks.
In a study of 1,207 people at a headache clinic, exercise was among the less common triggers people named. Attacks are more likely when exercise is very hard or much more than you're used to, or when you haven't eaten or drunk enough. Even in people who name exercise as a trigger, a hard exercise test set off an attack only some of the time. Build up gradually.
Being made worse by routine activity is one of the defining features of migraine, and exercise is unlikely to stop an attack. A headache brought on by exercise needs an urgent GP appointment or a call to 111, especially the first time, and a sudden, extremely painful headache needs 999.
Migraine causes attacks of a throbbing headache, often on one side and worse when you move around, with feeling or being sick and sensitivity to light and sound. Some people get aura first, such as zigzag lines or flashing lights, or numbness or tingling, which shouldn't last more than an hour. Attacks usually last 4 hours to 3 days. The international classification counts being made worse by routine activity, such as walking or climbing stairs, or avoiding it, as one of the features of migraine.
About 1 in 7 people worldwide get migraine, about 10 million in the UK. It's 2 to 3 times more common in women, and most common between the ages of 25 and 55; up to 1 in 3 people with migraine have aura. Most people find attacks slowly ease as they get older, and in women migraine often gets better after the menopause.
NICE tells them apart like this. Tension-type headache is on both sides, pressing or tightening, mild to moderate, isn't made worse by routine activity, and comes without other symptoms. Migraine is on one or both sides, throbbing, moderate or severe, made worse by routine activity, and comes with sensitivity to light or sound, or feeling sick.
Chronic migraine means headache on 15 or more days a month for more than 3 months, at least 8 of them with migraine features. Menstrual migraine is suspected when attacks fall mainly between 2 days before and 3 days after a period starts, in at least 2 of 3 cycles; these attacks are often longer and more severe. Taking painkillers too often can cause more headaches, so the NHS advises not taking them on more than 2 days a week.
A European Headache Federation review describes both sides: a hard session may set off an attack through chemical messengers released during exercise, while regular exercise may raise the threshold for attacks. These are ideas, not proven. In 46,648 Norwegian adults, people with migraine were less active, the more so the more often they had headaches. Over 11 years, inactive people were a little more likely to develop headaches other than migraine, with no such link reported for migraine, which the authors read as headaches making people less active rather than inactivity causing migraine.
Mostly women in their 30s and 40s: 90% of people in the topiramate trial were women, with an average age of 44, and across 21 trials in one review there were nearly 7 women for every man. Evidence in men, teenagers and older adults is thin. NICE's guideline covers people aged 12 and over.
Across 6 studies, aerobic exercise cut about 0.6 migraine days a month (moderate-quality evidence). In 10 trials with 508 people, it reduced pain and how often and how long attacks lasted, in the short term, though there were signs that less favourable studies may be missing. A 2022 review found it eased migraine pain by a small to moderate amount and reduced use of medicines, on very low to low certainty evidence.
In a Swedish trial, 91 adults with 2 to 8 attacks a month did 40 minutes of indoor cycling 3 times a week, a recorded relaxation programme every day, or took topiramate, for 3 months. Attacks fell by 0.93, 0.83 and 0.97 a month, with no clear difference between the groups, and 30%, 23% and 26% of people halved their attacks. Topiramate eased pain a little more. A third of the topiramate group reported side effects; none were reported with exercise or relaxation. It's one trial of 91 people.
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In a trial of 160 adults (114 finished), adding yoga to usual medicines for 3 months reduced how often headaches came and their impact more than medicines alone, though people knew which group they were in. Across 5 trials with 356 people, yoga reduced how often headaches came, but not clearly how bad they were. The 2023 guideline graded yoga B.
In a network analysis of 21 trials with 1,195 people, strength training ranked first, ahead of high-intensity and moderate aerobic exercise and the medicine topiramate, but those rankings come from indirect comparisons between small trials. A 2025 analysis ranked combined aerobic and strength training first, on very low to low certainty evidence. The 2023 guideline graded strength exercise C, below aerobic exercise and yoga.
The NHS lists relaxation techniques among treatments to prevent migraine, and daily relaxation did about as well as exercise and topiramate in the Swedish trial. The 2023 guideline graded it C. A review of progressive muscle relaxation says it needs regular daily practice to help, and in a trial of 139 people, a version delivered by smartphone gave small improvements that weren't statistically clear.
In 94 adults with migraine, regular moderate to vigorous exercise went with 5.1 fewer headache days a month only in people taking a preventive medicine. It's a small observational study, so it can't show cause and effect.
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The trials are small and mostly of low quality. A 2024 network analysis of 28 studies found yoga and moderate or high-intensity aerobic exercise did better than medicines alone for how often attacks came, on very low-quality evidence. Network rankings compare treatments indirectly, so they don't prove that one beats another.
In the topiramate trial, each session was 40 minutes on an exercise bike: a 15-minute warm-up building to 11 to 13 out of 20 for effort, 20 minutes at 14 to 16, and a 5-minute cool-down back at 11 to 13, 3 times a week for 3 months. Our migraine cycling workout follows it.
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It graded steady, moderate aerobic exercise B, at 3 times a week for 8 weeks or more, and yoga B, at 3 times a week for 6 weeks or more. In its trials, aerobic sessions had a 5 to 15 minute warm-up of gradually rising effort, 20 to 30 minutes at 13 to 16 out of 20 (or about 70% of your maximum heart rate) and a 5 to 10 minute cool-down, 2 to 3 times a week for 5 to 12 weeks.
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An international panel of experts recommended 30 to 60 minutes of moderate aerobic exercise 3 days a week, plus 5 to 20 minutes of relaxation and breathing every day, building up gradually. The American Migraine Foundation suggests 30 to 50 minutes of moderate aerobic exercise 3 to 5 days a week, and one of its doctors recommends starting "very easy, very slow with minimal impact".
On the Borg scale of 6 to 20, 11 is light, 13 is somewhat hard (breathing harder, not so easy to talk) and 15 is hard. The trial's main block, 14 to 16, is around hard: close to what the NHS calls vigorous, when you can't say more than a few words without pausing (our reading).
For most workouts, 5 to 10 minutes of warm-up is enough (our warm-up guide). Migraine trials used 5 to 15 minutes of gradually rising effort, and the topiramate trial used 15. The American Migraine Foundation says that when headache pain is mild or builds slowly, warming up before exercise may help reduce how often attacks come and how long they last. Our editorial starting point: 10 to 15 minutes of easy, gradually building effort before anything hard.
A 2026 analysis of 15 small studies found the biggest effect at about 900 to 950 minutes of aerobic exercise in total, for example 30 minutes 3 times a week for 10 to 11 weeks; it's a preliminary finding. NICE suggests reviewing preventive treatment 3 to 6 months after starting it, and about 3 months is a fair time to judge exercise too (our suggestion).
Weeks 1 and 2: 3 sessions of 20 to 30 minutes of walking or cycling at an easy, comfortable effort (11 to 13 out of 20), starting with 10 minutes of very gentle effort, and 10 minutes of relaxation or slow breathing most days.
Weeks 3 and 4: lengthen the sessions to 30 to 40 minutes, with 10 minutes at somewhat hard (13 to 14) after the warm-up. Add 2 short strength sessions if you like them.
Weeks 5 to 12: the migraine cycling workout 3 times a week, or the same shape walking, on a cross-trainer or swimming. If a session sets off an attack, go back a step and build more slowly.
High-intensity interval training was graded C, from 3 small trials. It's for people who already exercise without setting off attacks, not a starting point (our reading).
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In a study of 1,207 people at a headache clinic, exercise was among the less common triggers people named: stress, hormonal changes in women and not eating were named far more often. At a Dutch headache clinic, 38% of 103 people said exercise had set off an attack at some point, and more than half of them had given up that sport. In 14 people who said exercise was a trigger, an all-out cycling test, done twice, set off an attack after both tests in 3, after one test in 5, and after neither in 6.
Start with low-intensity exercise you can manage, which can be as little as step-ups onto a stair, and build up how long and how hard over time. The Migraine Trust warns that fear can lead to avoiding exercise altogether, and then exercise is more likely to trigger an attack because your body isn't used to it.
"It's important not to go overboard on days where you feel well, then follow this with periods of inactivity", says the Migraine Trust: "It is this inconsistency that is most likely to trigger migraine attacks." Keep to the same days and times each week.
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Eat enough beforehand, leaving at least 1 to 2 hours to digest, and drink before, during and after: water can be enough, or an isotonic drink. Regular meals and staying well hydrated are part of the NHS self-help advice too.
Bright gym lights or noise can be triggers: a cap or headphones may help. Exercise headache is more common in hot weather and at altitude, so in hot weather exercise in the cooler part of the day or indoors with a fan (our suggestion).
Record your exercise (what, how hard and when) alongside your attacks to see whether exercise really is a trigger for you; NICE suggests keeping a headache diary for at least 8 weeks. Even in people sure that exercise is a trigger, hard exercise doesn't always set off an attack.
Stop. Away from home, carry your usual treatment for attacks, a snack and a drink, and have details of someone you can contact if you need help getting home.
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Being made worse by routine activity is part of how migraine is defined, and the Migraine Trust says strenuous exercise, or even moving around, often makes people feel worse. Some find gentle stretching, yoga or a short walk in fresh air helps them cope, and that's safe, but exercise "is unlikely to stop the migraine attack". The NHS suggests sleeping or lying down in a darkened room, and taking painkillers as soon as the headache starts.
Some people get a separate headache brought on only by strenuous exercise, during or after it, lasting less than 48 hours. It's more common in hot weather and at altitude, and one recognised form is known as weight-lifters' headache. A migraine set off by exercise is still classed as migraine.
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The first time a headache like this happens, doctors need to rule out bleeding around the brain, a tear in an artery that supplies the brain, and a condition that suddenly narrows the brain's blood vessels. The NHS says to ask for an urgent GP appointment or get help from 111 for a headache triggered or made worse by coughing, sneezing, bending down or exercising, and NICE lists headache triggered by exercise as a feature to check. The Migraine Trust says a first headache or migraine after exercise should be checked by your doctor.
Short bursts of straining with the breath held are linked with a related headache, cough headache, while exercise headache usually follows longer, hard effort. When you lift, breathe out as you push and don't hold your breath (our cue).
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Taking painkillers on more than 2 days a week can cause more headaches and make migraine harder to treat. NICE describes medication overuse headache after 3 months or more of triptans, opioids or combination painkillers on 10 or more days a month, or paracetamol, aspirin or anti-inflammatory painkillers on 15 or more.
For attacks, a triptan with an anti-inflammatory painkiller or paracetamol, or one of these on its own. To prevent attacks, after discussing the benefits and risks, propranolol, topiramate or amitriptyline; if these don't work or don't suit you, up to 10 sessions of acupuncture over 5 to 8 weeks. NICE says riboflavin (vitamin B2, 400 mg a day) may help some people. Medicines that target calcitonin gene-related peptide (CGRP) are for adults with at least 4 migraine days a month after 3 preventives haven't worked or suited them. Topiramate should not be used in pregnancy, or by women who could become pregnant unless the conditions of a pregnancy prevention programme are met. Exercise isn't on NICE's list.
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Preventive treatments include medicines (such as beta blockers, antidepressants and epilepsy medicines), acupuncture, relaxation techniques and cognitive behavioural therapy (CBT), and vitamin B2, alongside eating at regular times, drinking less caffeine, getting regular exercise and plenty of sleep.
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The American Headache Society says behavioural therapies such as CBT, biofeedback, relaxation and mindfulness may be appropriate for prevention, and that CGRP medicines are a first-line option.
In the one head-to-head trial, exercise cut attacks as much as topiramate, topiramate eased pain a little more, and only topiramate caused side effects. Network analyses rank exercise above topiramate, but only through indirect comparisons. In everyday life, regular exercise went with fewer headache days only in people already taking a preventive.
The trial's authors suggested exercise as an option for people who don't benefit from, or don't want, a daily preventive medicine. For everyone else it's a sensible addition. Don't stop or change a preventive without talking to your doctor; NICE suggests a review 3 to 6 months after starting one.
A stiff neck can be an early sign of an attack, and neck pain is a common trigger. In people whose attacks are set off by exercise, neck pain was more often the first symptom of their usual attacks.
In a trial of 42 people with migraine, 8 weeks of neck strengthening didn't reduce how often or how badly migraine came, compared with sham ultrasound. The 2023 guideline graded neck strengthening C against, as a migraine treatment.
In 52 people with migraine plus tension-type headache and neck pain, aerobic exercise 3 times a week reduced the overall burden of migraine and the impact of neck pain, though attacks didn't fall clearly more than in the control group.
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The Migraine Trust says strengthening exercises can help the neck pain that often comes with migraine. Do neck exercises for neck pain if they help, and see our guide to headaches from the neck if your headaches start there.
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The NHS lists relaxation techniques among treatments to prevent attacks, and an expert panel recommended 5 to 20 minutes of relaxation and breathing every day. The NHS breathing exercise is one way: breathe in gently for a count of up to 5 and out for the same, with no holds, for at least 5 minutes.
Progressive muscle relaxation has long been used to prevent migraine. This version, adapted from two NHS trust leaflets, tenses one group of muscles at a time, gently, then lets it go:
10 to 15 minutes a day is our editorial starting point: a review says progressive muscle relaxation needs regular daily practice to help migraine, and the NHS Lothian leaflet says to practise every day. Tense gently: a little tension is enough. If any part causes discomfort or cramp, ease up, stop or skip that area, and if your neck hurts, keep the shoulder shrug small or leave it out (our advice).
Yoga programmes in the trials combined poses, breathing and relaxation, 3 or more times a week for 6 to 12 weeks, and some included fast, forceful breathing. Keep the breathing slow if you're new to yoga, skip fish pose (which our move page already advises against with migraine), and skip head-down poses if they bring on symptoms (our suggestion).
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2 to 3 times a week for 30 to 50 minutes, starting with up to 15 minutes of gently building effort; swimming, dancing and team sports count too.
3D demoStationary cyclingBeginner · Cardio machine
3D demoTreadmill walkingBeginner · Cardio machine
3D demoTreadmill joggingIntermediate · Cardio machine
3D demoElliptical trainerBeginner · Cardio machine
3D demoTrail running and walkingBeginner · No equipment
3D demoStanding marchBeginner · No equipment2 days a week, starting with 2 to 3 sets of 12 to 15 at a moderate weight and building over 8 to 12 weeks, as in the strength trials; breathe out as you push and don't hold your breath.
3 times a week for 6 weeks or more, breathing slowly throughout, with no fast, forceful breathing.
3D demoEasy pose (Sukhasana)Beginner · No equipment
3D demoCat-cowBeginner · No equipment
3D demoMountain Pose (Tadasana)Beginner · No equipment
3D demoWarrior II (Virabhadrasana II)Intermediate · No equipment
3D demoChild's Pose (Balasana)Beginner · No equipment
3D demoSupine spinal twist (Supta Matsyendrasana)Beginner · No equipment10 to 15 minutes a day: slow breathing, then progressive muscle relaxation lying still, using the steps above.
For neck stiffness that comes with migraine, not as a migraine treatment: move slowly, and stop if you feel dizzy or get tingling.
The cycling workout 3 times a week (or the same shape walking, on a cross-trainer or swimming), yoga or breathing on other days, and strength twice a week if you enjoy it. If exercise can set off your attacks, make the easy cardio workout's warm-up 10 to 15 minutes.
The cycling session from a migraine trial: 15 minutes of gently building warm-up, 20 minutes at a fairly hard effort and 5 minutes easy, 3 times a week.
45 minBeginner4 movesCardio machine, A wallA steady 30 to 45 minute cardio session at talk-but-not-sing pace: walk, cycle, row or cross-train, counting toward weekly activity guidelines.
40 minBeginner3 movesCardio machine, A wallA 25-minute walk with short faster bouts: notice your heart and breathing speed up, then settle. A gentle way to get used to the feelings of effort.
25 minBeginner5 movesCardio machine, A wallA 25-minute gentle yoga class for complete beginners and over-50s: slow breathing, a warm-up, supported standing poses, floor poses and a closing rest.
25 minBeginner14 movesNo equipmentA 6-minute breathing routine: slow breathing, crocodile breathing, alternate nostril breathing, box breathing and 4-7-8 breathing.
6 minBeginner5 movesNo equipmentA 20-minute full-body dumbbell workout: two supersets of squats, rows, Romanian deadlifts and push-ups. Twice a week covers the minimum dose.
20 minBeginner8 movesA dumbbell, A bench or boxShort strength sessions and walks, building over 4 weeks. Keep to the same days and times each week.
Call 999 (911 in the US) if you or your child have a headache and any of these. Don't drive yourself to A&E.
Exercise is among the less common triggers, and even in people who name it, hard exercise set off attacks only some of the time. Regular exercise reduced attacks in trials, and the Migraine Trust warns that avoiding exercise makes attacks more likely when you do exercise. Build up gradually instead.
In the only head-to-head trial, exercise matched topiramate for how often attacks came, and topiramate eased pain a little more. Claims that exercise beats medicines come from network analyses, which compare treatments indirectly across small trials. In everyday life, exercise went with fewer headache days only in people also taking a preventive.
It ranked first in one network analysis, but from indirect comparisons between small trials, and a 2023 guideline graded strength exercise C, below aerobic exercise and yoga (B). Combining aerobic exercise with strength work is a sensible choice if you enjoy both.
8 weeks of neck strengthening didn't reduce how often or how badly migraine came in a trial, and the 2023 guideline graded it C against for migraine. Neck exercises help headaches that come from the neck, which is a different condition.
Being made worse by routine activity is part of how migraine is defined, and exercise is unlikely to stop an attack. Rest in a dark room and take your treatment early.
Often it is, but a first exercise headache needs checking, because bleeding around the brain and torn arteries must be ruled out. NICE lists headache triggered by exercise as a feature to check, and the NHS says to get an urgent GP appointment or call 111.
A little. Regular aerobic exercise cut about 0.6 migraine days a month across 6 studies, and eased pain by a small to moderate amount on very low-certainty evidence. In one trial, 40 minutes of cycling 3 times a week cut attacks about as much as the preventive medicine topiramate, without its side effects.
Steady aerobic exercise, such as cycling, brisk walking, jogging or swimming, and yoga have the most support: a 2023 guideline graded both B. Strength training ranked well in some analyses, but from indirect comparisons between small trials. Choose something you enjoy and can do regularly.
Yes, in some people, though it's among the less common triggers. It's more likely when exercise is very hard or much more than you're used to, when you haven't eaten or drunk enough, or when it's hot. Even then, hard exercise doesn't always set off an attack, and building up gradually helps.
Start easy and build up over weeks, warm up gradually for 10 to 15 minutes, eat 1 to 2 hours before, drink before, during and after, and keep cool. Exercise on the same days each week rather than in bursts, because inconsistency is a common trigger. Keep a diary to check whether exercise really is a trigger for you.
Usually not: being made worse by activity is part of what defines migraine, and exercise is unlikely to stop an attack. Some people find gentle stretching, yoga or a short walk in fresh air helps them cope, and that's safe. Otherwise, rest somewhere dark and take your usual treatment early.
About 30 to 50 minutes, 2 or 3 times a week, for at least 8 to 12 weeks, at a moderate to fairly hard effort after a gradual warm-up. The topiramate trial used 40 minutes of cycling 3 times a week for 3 months. The American Migraine Foundation suggests 30 to 50 minutes 3 to 5 days a week, starting very easy.
In the one trial that compared them, exercise reduced attacks about as much as topiramate, though topiramate eased pain slightly more and caused more side effects. Exercise isn't one of NICE's recommended preventive treatments, so use it alongside them. Don't stop or change a preventive without talking to your doctor.
Probably, a little. Adding yoga to usual medicines reduced how often headaches came and their impact more than medicines alone in a trial of 160 people, and a 2023 guideline graded yoga B. Choose gentle yoga, keep the breathing slow, and skip fish pose.
Not for the migraine itself: neck strengthening didn't reduce migraine in a trial. They can help the neck pain that often comes with migraine. If your headaches start in your neck, see our guide to headaches from the neck.
Common causes are migraine set off by exercise, not eating or drinking enough, and heat. Some people get a separate exercise headache that comes only with strenuous exercise and lasts less than 48 hours. Get an urgent GP appointment or call 111 for a headache triggered or made worse by exercise, especially the first time, and call 999 for a sudden, extremely painful headache.
For most people, yes: strength training was studied in migraine trials and is part of a balanced routine. Breathe out as you lift and don't hold your breath or strain, build up gradually, and get any new headache with lifting checked.
Vestibular rehabilitation, a kind of exercise therapy for dizziness and balance problems, may help some people with vestibular migraine, and the Migraine Trust advises talking to a health professional before trying it. The advice on this page about building up gently still applies.
Exercise education, not a diagnosis or treatment plan, and clinical review of these guides is pending. Stop and get advice for chest pain, unusual breathlessness, dizziness or fainting, or new pain, and check with your doctor or midwife first if they have told you to limit activity. Health disclaimer.
