Yoga guide
Yoga added to usual treatment may make migraine attacks less frequent: in the largest trial, 3 months of yoga plus medicines reduced how often headaches came, and their impact, more than medicines alone. The evidence is low quality, yoga hasn't been tested during an attack, and for tension-type headaches the evidence is very thin.
The sessions in that trial, as a 2023 guideline describes them, were mostly breathing and relaxation, with gentle loosening and a few easy poses. This guide covers what the trials found, breathing and relaxation, poses to start with, what can bring on a headache in a class (heat, hard effort, skipped meals, head-down poses and forceful breathing), a 20-minute routine to do between headaches, and the warning signs that need urgent help.
In the largest trial, 160 adults with migraine took their usual medicines with or without yoga for 3 months. With yoga, headaches came less often, hurt less and had less impact. Across 5 trials, yoga reduced how often headaches came, but not clearly how bad they were.
The trials were small, people knew which group they were in, and a 2020 review rated every result very low certainty. Even so, a 2023 exercise guideline graded yoga B for migraine, at 3 or more sessions a week for 6 weeks or more.
There are only two small trials, one from 1981, and the 2020 review's result for tension-type headache came from a meditation trial. The NHS suggests relaxing activities "like exercise, yoga and massage".
The NHS lists relaxation techniques among the treatments that help prevent migraine. In small trials, alternate nostril breathing 3 times a day, and daily breathing practice with relaxation, cut migraine attacks or headache days.
No study has tested yoga during an attack, and the Migraine Trust says exercise "is unlikely to stop the migraine attack". Practise between headaches, alongside your usual treatment.
Much harder effort than usual, heat, skipped meals, not drinking enough and fast, forceful breathing can set off a headache. A headache triggered or made worse by coughing, sneezing, bending down or exercising needs an urgent GP appointment or a call to NHS 111.
The NHS describes migraine as "a throbbing headache" that "can be severe, often on 1 side of the head and can be worse when you move around", with feeling or being sick and sensitivity to light and sound. A tension-type headache is pressing or tight on both sides, and NICE (the National Institute for Health and Care Excellence) describes it as "not aggravated by routine activities of daily living". Our migraine and tension headache guides cover each in full.
Yoga programmes for migraine combined poses, breathing practice (pranayama), relaxation and meditation, mostly supervised, 3 to 7 times a week for 6 to 12 weeks, at 60 to 75 minutes a session, most of them alongside usual medicines. Some included a nasal rinse (jala neti) and kapalabhati, a fast, forceful breathing technique.
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Every trial tested regular practice to make attacks less frequent; none tested yoga during an attack. During an attack, moving about often makes migraine worse, and the NHS suggests sleeping or lying down in a darkened room.
In the CONTAIN trial in India, 160 adults aged 18 to 50 with episodic migraine were randomly assigned to yoga plus medicines or medicines alone for 3 months, and 114 finished. With yoga, headaches came less often, hurt less and had less impact on daily life, and people took fewer pills. People knew which group they were in (though the person measuring the results didn't), and the yoga group started with more frequent headaches, so the authors rate it as weaker (Class III) evidence.
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Across 5 trials (356 people), yoga reduced how often migraine came and its impact, but not clearly how bad the pain was. Another analysis of 6 trials found less pain, fewer and shorter headaches and less disability, with wide differences between trials.
A 2020 review of 6 trials (240 people), 5 of them from India, found fewer, shorter and milder headaches overall, but the migraine trials on their own didn't reach significance, and every result was rated very low certainty. None of its trials reported side effects.
A 2023 clinical practice guideline on exercise for migraine says yoga is "likely to improve headache frequency and disability" with programmes of 3 sessions a week for 6 weeks or more, and graded it B, alongside steady aerobic exercise. Our migraine guide covers the aerobic exercise.
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In a network analysis of 28 studies, yoga did better than medicines alone for how often and how badly migraine came, on very low-quality evidence. Another, of 27 trials, ranked yoga below combined aerobic and strength exercise and strength exercise, on very low to low certainty evidence. Rankings come from indirect comparisons between small trials.
Yoga 5 days a week for 12 weeks (72 adults) and for 6 weeks (60 adults) reduced migraine more than self-care or usual care alone. In a 2022 trial in which only 34 people finished, adding yoga made no clear difference except to pain scores.
In 90 adults with chronic migraine, 12 weeks of daily guided breathing practice (pranayama) and relaxation added to treatment cut headache days by about 7 a month, against about 5 with treatment alone, with no side effects reported. In 86 adults, alternate nostril breathing 3 times a day for 3 months reduced how often attacks came (a median of 15 to 12, against 18 to 17) and disability, but not how bad they were. People knew their group, and whole health centres were assigned together.
Only two small trials have tested yoga-based practice for tension-type headache: relaxation lying down (shavasana) against biofeedback in 13 people in 1981, and a meditation course in 50 people. The 2020 review's result for tension-type headache came from the meditation trial alone, though NCCIH (the US National Center for Complementary and Integrative Health) reports the review's effects as "seen mostly in people with tension headaches". A 2007 study of 15 people, without randomisation, found less jaw-muscle tension after a yoga-based lifestyle course.
Relaxation and psychological treatments have better evidence for tension-type headache; our tension headache guide covers them.
Strengthening exercises for the neck and shoulder blades helped headaches that come from the neck, in a Cochrane review (moderate-quality evidence). Yoga hasn't been tested for them; our guide to headaches from the neck covers the exercises.
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Studio classes vary, so these are the programmes that were tested. Our workout is modelled on the CONTAIN sessions as the 2023 guideline describes them.
The trial ran for 3 months, as its abstract says. A 2023 guideline's summary of the trial describes its sessions as 60 minutes, 3 times a week for 4 weeks, made up of:
Other trials ran 60 to 75-minute sessions 3 to 7 times a week for 6 to 12 weeks, with poses that stretch the neck, shoulders and back, breathing, relaxation and meditation. One also used a nasal rinse (jala neti) and kapalabhati, which this guide leaves out.
The American Migraine Foundation advises beginners to go to classes rather than follow videos, to tell the teacher about their migraine, and to avoid classes that "involve a lot of heat, are very vigorous or require extreme postures". It suggests gentle yoga that focuses on breathing and meditation and avoids straining the neck, and says restorative yoga, with poses fully supported by props, may suit people with migraine.
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The NHS breathing exercise: breathe in gently and regularly, counting steadily from 1 to 5 if it helps, then let the breath flow out gently, counting from 1 to 5 again, for at least 5 minutes. There's no breath hold in it. Relaxation techniques are among the treatments the NHS lists for preventing migraine.
In the 86-person trial, people practised it 3 times a day for 3 months, and had fewer attacks. Breathe slowly, closing one nostril and then the other, without holding your breath (our suggestion for people with headaches).
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Daily guided breathing and relaxation sessions for 12 weeks, alongside treatment, cut headache days in chronic migraine and raised measures of the body's calming, rest-and-digest activity.
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In one trial of yogic breathing, 15 people had minor side effects, including headache and neck pain, "in particular with kapālabhātī, a fast/high-frequency breathing technique". Straining with the breath held can set off a cough headache. Some migraine trial programmes included kapalabhati; this guide leaves it out, and leaves out breath holds (our suggestion).
Breathe slowly with no holds in all of these. Slow breathing for at least 5 minutes is the NHS's dose; alternate nostril breathing's page suggests 3 to 5 minutes once or twice a day (an editorial dose), and the migraine trial used it 3 times a day.
3D demoSlow breathing (6 breaths a minute)Beginner · No equipment
3D demoAlternate nostril breathing (Nadi Shodhana)Beginner · No equipment
3D demoBreath reachBeginner · No equipment
3D demoCorpse pose (Savasana)Beginner · No equipment
3D demoReclining bound angle pose (Supta Baddha Konasana)Beginner · Firm cushion
3D demoCrocodile breathing (prone diaphragmatic breathing)Beginner · No equipmentThe Migraine Trust says strenuous exercise, or even moving around, often makes people feel worse during a migraine attack. Some people find gentle stretching or yoga helps them cope, and that's safe, but it "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.
A tension headache usually lets you carry on with daily activities. The NHS suggests painkillers, activities that help you relax such as exercise, yoga and massage, and a low, firm pillow with heat or cold packs if you have neck pain with your headaches.
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The Migraine Trust names exercise that is very intense or much more than you're used to, not eating or drinking enough, and lights or noise as possible triggers. It advises building up gradually, eating 1 to 2 hours before, and drinking before, during and after. Heat exhaustion can cause a headache, and dehydration can cause headaches or make migraine worse.
"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."
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No study has measured headaches caused by upside-down or head-down poses. They raise eye pressure while you hold them, and short-lived headaches are among the problems reported after yoga. Our migraine guide suggests skipping head-down poses if they bring on symptoms, and leaving out full inversions such as headstand and shoulder stand is a sensible precaution.
Fast, forceful breathing caused headaches in a breathing trial, and NICE lists headache "triggered by cough, valsalva (trying to breathe out with nose and mouth blocked) or sneeze" among the features a doctor should assess.
A headache brought on by exercise is more common in hot weather and at altitude. The first time one happens, doctors need to rule out bleeding around the brain, a tear in an artery and a sudden narrowing of the brain's blood vessels. The NHS says to ask for an urgent GP appointment or call 111 for a headache triggered or made worse by exercising, and the Migraine Trust says a first headache or migraine after exercise should be checked.
Case reports describe a bleed around the brainstem after a sudden, startled backward movement in a yoga session, and a spinal fluid leak causing a headache that changed with posture after a yoga class. In a Japanese survey of 2,508 class-goers, 0.7% had a headache after a class, and teachers reported one bleed on the brain. These are rare, but a sudden, extremely painful headache is a 999 call.
Slow, small movements within comfort; stop if you feel dizzy. With a sore neck, do nods, tilts and turns one at a time, each held for 5 seconds, 5 times (the move page's dose, from an NHS leaflet).
These are the poses on our migraine guide. Breathe slowly and steadily in each, with no straining, for 3 to 5 breaths (our editorial starting point). Rest your forehead on a block in child's pose, and skip it if having your head low brings on symptoms.
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 equipmentLeave out headstand, shoulder stand and plough, fish pose (its page advises against it with migraine) and deep backbends. Keep downward dog, wide-legged folds and legs up the wall brief and supported, or skip them if head-down poses bring on symptoms. Leave out fast, forceful breathing such as kapalabhati, and breath holds.
3D demoSupported headstand (Salamba Sirsasana)Expert · A wall
3D demoSupported shoulderstand (Salamba Sarvangasana)Advanced · No equipment
3D demoPlow pose (Halasana)Advanced · No equipment
3D demoFish pose (Matsyasana)Intermediate · No equipment
3D demoCamel pose (Ustrasana)Intermediate · No equipment
3D demoWheel pose (Urdhva Dhanurasana)Advanced · No equipment
3D demoDownward-facing dog (Adho Mukha Svanasana)Beginner · No equipment
3D demoWide-legged standing forward fold (Prasarita Padottanasana)Beginner · No equipment
3D demoLegs up the wall (Viparita Karani)Beginner · A wallYoga sessions 3 to 7 times a week for 6 to 12 weeks, 60 to 75 minutes each, mostly supervised; breathing practice daily for 12 weeks, or 3 times a day for 3 months.
NICE suggests keeping a headache diary for at least 8 weeks, and reviewing preventive treatment 3 to 6 months after starting it. About 3 months is a fair time to judge yoga too (our suggestion).
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Our 20-minute workout 3 times a week, plus 5 to 10 minutes of slow breathing on most days, alongside your usual treatment. Judge it after about 3 months, and don't stop or change a medicine without talking to your doctor.
Start with the 20-minute yoga for headaches workout 3 times a week, between headaches. The breathing workout suits most days (skip its breath-hold rounds if holding your breath brings on symptoms), and the cycling workout covers the aerobic exercise with the best migraine trial.
A calm 20-minute practice for between headaches: slow breathing, gentle neck and shoulder movement, a few easy poses and a long rest, with no heat and no breath holds.
20 minBeginner14 movesFirm cushionA 6-minute breathing routine: slow breathing, crocodile breathing, alternate nostril breathing, box breathing and 4-7-8 breathing.
6 minBeginner5 movesNo equipmentA 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 45-minute restorative yoga sequence: five fully supported poses held for 4 to 10 minutes each, with slow breathing and a long final rest.
45 minBeginner6 movesFirm cushion, A wallA 12-minute reset for stressful days: 4 minutes of brisk movement, 3 minutes to loosen your neck, shoulders and back, then 5 minutes of slow breathing.
12 minBeginner10 movesA bench or box, A wallThe 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 wallCall 999 (911 in the US) if you or your child have a headache and any of these. Don't drive yourself to A&E.
A first headache brought on by exercise needs checking, and a headache that comes on with coughing or straining has another cause in about 40% of cases, so it needs checking too. A headache that is worse sitting or standing and eases lying down, starting after a class, can mean a spinal fluid leak: get it checked. In a hot room, a headache can be a sign of heat exhaustion, so leave the room, cool down and drink.
Added to treatment, it probably makes attacks less frequent, on low-certainty evidence. It doesn't cure migraine, and it shouldn't replace medicines.
We found no study showing it. Head-down poses raise eye pressure while you hold them, and our migraine guide suggests skipping them if they bring on symptoms.
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No study has tested yoga during an attack, and exercise "is unlikely to stop the migraine attack".
Only two small trials have looked at it, and the review result came from a meditation trial. The NHS suggests relaxing activities, including yoga, and relaxation and psychological treatments have better evidence.
Fast, forceful breathing (kapalabhati) was linked with headache and neck pain in a breathing trial.
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Heat, hard effort and not drinking enough are common triggers, heat exhaustion causes headaches, and the American Migraine Foundation advises avoiding hot classes.
Often it is, but a first headache brought on by exercise needs checking, and the NHS says a headache triggered or made worse by exercising needs an urgent GP appointment or a call to 111.
It may make migraine attacks less frequent when added to usual treatment, but the evidence is low quality. For tension-type headaches the evidence is very thin: two small trials, one from 1981.
Probably, a little: in the largest trial, 3 months of yoga plus medicines reduced how often headaches came, and their impact, more than medicines alone. Across 5 trials, yoga reduced how often headaches came, but not clearly how bad the pain was.
A gentle, unheated class that focuses on breathing and relaxation; the sessions in the largest trial were mostly breathing exercises, loosening exercises and relaxation. The American Migraine Foundation advises avoiding hot classes, very vigorous classes and extreme postures.
No single pose has been tested. The trial sessions were mostly slow breathing and relaxation, with gentle neck and shoulder movement and a few easy poses, such as cat-cow, a supported child's pose and a lying twist.
There's no evidence it can: no study has tested yoga during an attack, and exercise is unlikely to stop one. Some people find gentle stretching helps them cope, but rest in a dark room and take your usual treatment.
Sometimes: hard effort, heat, skipped meals and not drinking enough are common triggers, and some people find head-down poses or forceful breathing bring one on. A first headache brought on by exercise or straining needs an urgent GP appointment or a call to 111.
It can be a trigger: heat, dehydration and hard effort are common triggers, and the American Migraine Foundation advises avoiding hot classes. Choose a gentle, unheated class.
Slow breathing without holds, such as the NHS exercise (in for a count of up to 5, out for the same, for at least 5 minutes), and alternate nostril breathing, which cut migraine attacks in one trial. Avoid fast, forceful breathing such as kapalabhati.
It's sensible to skip headstands and shoulder stands, and to skip head-down poses if they bring on symptoms. This is a precaution rather than a trial finding.
It may help as a way to relax, and the NHS suggests relaxing activities such as exercise, yoga and massage. But only two small trials have looked at it, so relaxation and psychological treatments have the better evidence.
The trials ran for 6 to 12 weeks, 3 or more times a week, and the 2023 guideline's grade applies from 6 weeks. Keep a headache diary and judge after about 3 months.
Call 999 for a headache that came on suddenly and is extremely painful, or that comes with weakness or numbness, a drooping face, problems speaking, loss of vision, confusion, a seizure, or a stiff neck with a fever. Get an urgent GP appointment or call 111 for a migraine lasting over 72 hours, or a headache triggered or made worse by coughing, sneezing, bending down or exercising.
Exercise education, not a personal prescription, and clinical review of these guides is pending. If you are pregnant, have a health condition such as glaucoma, high blood pressure or osteoporosis, or have had recent surgery, check with a doctor, midwife or physiotherapist before starting, and stop for sharp or increasing pain. Health disclaimer.
