Ward off migraines by pacing yourself

My Hormonology

Ward off migraines by pacing yourself

BY GABRIELLE LICHTERMAN

 

  • Key finding: “Activity pacing”–keeping a steady, consistent level of daily activity and balancing rest with tasks–may reduce migraine frequency and intensity, research shows.

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MARCH 24, 2021—If you get migraines, then you’ve probably already pinpointed some of your triggers–factors that can spur one of these intense head-throbbers. One common trigger is hormone fluctuations in your menstrual cycle, for example, before or during your period or right after ovulation. Other common triggers include stress, bright sunlight, weather conditions, dehydration, skipped meals and certain foods or beverages.

Some of these triggers can be avoided (for example, skipping citrus fruit) while with others you just have to power through and hope your pain remedy kicks in (menstrual migraines, anyone?).

Well, here’s another migraine trigger that’s important to know because, fortunately, it’s the kind you can often avoid: overactivity.

The risky bursts of action on non-migraine days

Take a moment to think about whether this sounds like you: Say you just get over a migraine or wake up and realize it’s not a migraine day. Filled with glee, you then decide you’re going to tackle all the things you can’t get done on those days when your head is pounding–either because you’ve already fallen behind on your to-dos during your last migraine or you want to ensure you get it all in before the next migraine hits.

So, you write a to-do list that’s about three pages long and includes a wide array of tasks, such as running errands, working on a project for work, working on your personal project, putting in extra time to practice an instrument, doing an extra-long workout, making all those calls or answering all those emails that have been piling up, etc.

Or maybe you decide you’ll focus on one big task and get it started and completed in a single day, such as installing a new garden or writing a report for school. In other words, when not in a migraine episode, you plan a big burst of activity.

Unfortunately, while you may assume you’re making up for time lost to migraines by doing a lot all at once, there’s a major pitfall: Taking on far more than usual on non-migraine days can actually lead to more frequent and more intense migraines in the future. 

The good news? Researchers who’ve been studying this phenomenon in migraineurs have discovered the easy solution: Activity pacing. 

What is activity pacing?

Activity pacing is about planning your life so that you avoid heaping all your tasks into one big burst. Instead the goal is to space out whatever it is you want to do, taking on a bit at a time at a regular pace to maintain “consistent activity levels,” notes a research team from the U.K. in the journal Quality of Life Research.

Frequently used as a coping mechanism for patients with ongoing health challenges, such as chronic pain and fatigue, the researchers explain, “The aims of activity pacing include to reduce overactivity-underactivity cycling (fluctuating between high and low levels of activity) in order to improve overall function and reduce the likelihood of exacerbating symptoms.”

But, the researchers point out that this doesn’t mean you’re forcing yourself to be less productive. You’re encouraged instead to adopt various strategies: “planning, prioritizing, alternating activities and gradually increasing activities.” This way, you can still complete as much as you want while staying on an even keel.

Activity pacing also includes acceptance of your physical challenges and, with that, balancing activity with rest by slowing down, taking breaks and conserving energy, which you can do by delegating tasks to someone else or eliminating tasks that aren’t essential.

So, what’s the benefit of activity pacing on your migraines? Believe it or not, this simple strategy can help curb migraine pain intensity and even reduce the number of migraines you experience.

The impact of pacing on migraine 

In a 2012 study out of the Calgary Headache Assessment and Management Program at Canada’s Foothills Medical Center, researchers had occupational therapists teach the principles of activity pacing to 20 patients who experience migraine or tension headaches.2

The results: Patients who used activity pacing were able to prevent increases in migraine and tension headache intensity by 70%, reduced pain intensity by 65% and had 40% shorter headache episodes. Additionally, 70% of patients used activity pacing to prevent migraines and tension headaches from starting.

How it works

Big swings of activity and inactivity make you more prone to migraines by ratcheting up physical and mental stress.

Stress is a key trigger for these types of headaches. So, sidestepping stress by spreading out tasks and taking regular breaks is an important way to manage your migraines.

The takeaway

You may be able to curb migraine pain and reduce their frequency by keeping a consistent level of activity, balancing rest with activity, and lightening your load by delegating or ditching tasks.

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SOURCE:
(1) Deborah Antcliff, “Activity pacing: moving beyond taking breaks and slowing down”, Quality of Life Research, 27 (2018): 1933-1935
(2) Allison McLean, Kathryn Coutts, Werner J. Becker, “Pacing as a treatment modality in migraine and tension-type headache”, Disability and Rehabilitation, 34 (2012): 611-618

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