Israeli study proposes groundbreaking treatment approach to reduce migraine pain in people who exercise at least two hours per week.
Researchers from Soroka University Medical Center, part of Clalit Health Services, and Ben-Gurion University of the Negev have published a comprehensive study in the scientific journal Cephalalgia examining the challenges of physical activity for people living with migraines.
Migraine, which is characterized by moderate to severe headaches, is often accompanied by one-sided throbbing pain, nausea, and heightened sensitivity to light and noise. While moderate exercise is widely recognized as an effective natural method of preventing migraine attacks, the new study highlights a built-in paradox that makes it difficult for many patients to follow this recommendation.
Data collected from hundreds of participants in southern Israel showed that individuals who exercised for at least two hours per week experienced significant improvements in their condition.
Those participants reported an average of just three migraine days per month, compared to five migraine days among those who did not exercise. They also used significantly fewer triptan medications, which are commonly prescribed to stop migraine attacks, and reported higher overall quality of life and lower levels of workplace burnout.
At the same time, the researchers identified a significant barrier among patients who experience four or more migraine days each month. In this group, the likelihood of maintaining a regular moderate exercise routine falls below 50 percent. According to the study, this creates a vicious cycle in which frequent migraines, combined with stress and low mood, discourage patients from exercising, while the lack of physical activity further worsens migraine symptoms.
To address this challenge, the research team, led by Dr. Ido Peles of the Clinical Research Center at Soroka and Prof. Gal Ifergane, head of the Neurology Department at Soroka, proposes a two-stage treatment model known as PEPA (Pharmacological Exercise Promotion Approach).
The model begins with preventive medication designed to reduce abnormal brain activity and lower the monthly frequency of migraine attacks below a critical threshold. Once the condition stabilizes and the burden of pain decreases, patients are encouraged to begin exercising safely.
According to the researchers, preventive medication is not intended as the final goal but rather as a bridge that enables patients to benefit from the physiological advantages of exercise, including improved blood vessel function and pain modulation. Over time, regular physical activity may become an independent therapeutic tool, potentially allowing patients to reduce their reliance on preventive medication.
Prof. Ifergane explained, "If you are unable to exercise because of migraine, do not blame your willpower. You may simply be above the 'exercise threshold,' trapped in a vicious cycle. Appropriate preventive treatment that reduces the frequency of attacks is not only a solution for the pain-it is the key that can help you return to an active and healthy life."