Correlates of Pain Associated With Physical Activity in Obese Women With Migraine

A large variability in the impact of physical activity on pain during acute migraine attacks was found in women who were overweight and obese, according to research published in Cephalagia.¹

Dale S. Bond, PhD, of the Department of Psychiatry and Human Behavior at the Alpert Medical School, Brown University, Providence, Rhode Island, and colleagues evaluated women with neurologist-confirmed migraine who were also overweight or obese. Dr Bond and colleagues used prospective diary data from participants enrolled in a weight loss intervention (Women’s Headache and Migraine trial; WHAM²) to examine the frequency and consistency of migraine-related pain worsening with the onset of physical activity.

Researchers enrolled 132 women in the current study (Behavioral Weight Loss as a Treatment for Migraine in Obese Women; ClinicalTrials.gov identifier NCT01197196). The enrolled study participants (average age: 38.5±8.1; average body mass index [BMI]: 35.5±6.6) recorded headache activity for 27 consecutive days by means of a smartphone headache diary, followed by a 7-day period of objective physical activity monitoring. Participants noted occurrence of a migraine attack, maximum intensity of pain, duration, and accompanying symptoms. Additional assessments including the Headache Impact Test, The Pain Catastrophizing Scale, and the Allodynia Symptom Checklist, were used to measure migraine severity.

Over 28 days, an average of 5.5±2.8 migraine attacks were reported. The average attack duration was 20.1±15.9 hours, with moderate maximum pain intensity (5.9±1.5). Chronic migraine prevalence was 12.1%.

During the study period, 9.8% of participants reported worsening pain with physical activity in all migraine attacks; 34.8% reported that activity worsened pain, 61.8% reported that activity had no effect on pain, and 3.4% reported that activity improved pain. Researchers tentatively associated physical activity-related worsening of migraine pain with a higher BMI (P =.02).

“Findings support the validity of [physical activity]-related pain worsening as a diagnostic feature of migraine,” the researchers concluded. “A minority of people who consistently experience [physical activity]-related pain worsening may require tailored interventions to assist in increasing [physical activity] and exercise.”

References

1. Farris SG, Thomas JG, Abrantes AM, et al. Pain worsening with physical activity during migraine attacks in women with overweight/obesity: a prospective evaluation of frequency, consistency, and correlates [published online December 13, 2017]. Cephalagia. doi:10.1177/0333102417747231
2. Bond DS, O’Leary KC, Thomas JG, et al. Can weight loss improve migraine headaches in obese women? Rationale and design of the Women’s Health and Migraine (WHAM) randomized controlled trial.Contemp Clin Trials. 2013;35(1):133-144.