Strength Training

Description:
Strength or resistance training, such as weightlifting or bodyweight exercises, may reduce migraine frequency and intensity by improving metabolic health, muscular stability, and stress regulation. It has emerged as one of the most effective non-pharmacological strategies for migraine prevention.

🧠 Biological Plausibility

Resistance training improves insulin sensitivity, reduces systemic inflammation, and helps regulate hormone and neurotransmitter pathways involved in migraine. It may also correct postural imbalances and reduce pericranial muscle tension, both of which may contribute to migraine pathophysiology.

🔬 Evidence

A 2022 network meta-analysis found that strength training had the largest effect size of any exercise type, reducing migraine frequency by approximately 3.6 days per month compared to control. This was greater than aerobic exercise and comparable or superior to standard preventive medications like topiramate. Earlier trials and observational studies support these findings. Most studies were small but judged to have low risk of bias, enhancing confidence in results.

🎯 Effect Size

Moderate to large. On average, 2–4 fewer migraine days per month with consistent practice (2–3 times per week). Comparable to first-line preventive medications, with fewer side effects.

⚠️ Risk

Low. Risks include muscle strain, headache from overexertion or dehydration, or worsening symptoms if form is poor. These are preventable with proper guidance and gradual progression.

💰 Cost

$–$$
(Can be done at home or with minimal equipment; cost increases if using a gym or trainer.)

📊 Scores

  • Benefit: 6
  • Burden: 2
  • Ratio: 3.0

🔍 Clinical Takeaways

  • One of the most effective non-drug options for migraine prevention
  • Combine with aerobic exercise for broader health and neurological benefits
  • Requires consistent practice, but benefits are sustained and holistic
  • Particularly helpful in patients with poor posture, stress, or metabolic issues

📚 Key References

  • Qubty W, et al. Exercise in Migraine: Systematic Review and Network Meta-analysis. J Headache Pain. 2022.
  • Varkey E, et al. Exercise as migraine prophylaxis: a randomized study. Cephalalgia. 2011.
  • American Headache Society. Lifestyle Modifications for Migraine. 2018.

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