Migraine is a medical condition involving the brain and nervous system that triggers waves of disruptive, disabling symptoms, including regular, painful headaches. Pilates, and exercise in general, may help with migraine triggers.

Stress, limited sleep, and migraine symptoms often go hand in hand. An irregular sleep schedule and a high stress level can trigger painful migraine attacks, according to the American Migraine Foundation (AMF).

In turn, migraine can increase stress levels and interfere with sleep quality. Regular exercise is one way that a person with migraine may be able to reduce the impact of these triggers on migraine frequency and daily life.

However, as exercise can act as a migraine trigger in some people, it is important to choose an approach carefully. Pilates is a gentle, low impact option that some people practice to stay fit and feel better. It may help people manage some symptoms of chronic migraine but is not a widely recommended method for preventing attacks.

This article explores whether Pilates can aid migraine, looking at the benefits and risks.

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Research has not directly explored the relationship between Pilates and migraine.

A 2018 research review suggested that moderate intensity aerobic exercise may help reduce how often migraine attacks happen. However, while people can engage in Pilates at a range of intensities, it is a slow core and flexibility focused practice that does not bring the heart rate up as far as aerobic exercise.

For example, a 2019 study found that participants who practiced Pilates for 24 weeks had an average heart rate (HR) of 86 beats per minute (bpm), but those engaging in a walking exercise for the same time had an average HR of 123 bpm.

It does not seem likely that Pilates can reduce migraine episode frequency. However, it might help people with migraine handle symptoms that contribute to neck and lower back pain, slouched posture, and post-exercise high blood pressure.

What is Pilates?

Pilates is an exercise program that consists of about 50 different motions that focus on breathing, body alignment, and precision. It is a nonimpact discipline that is safe for people of all ages.

A German conditioning enthusiast called Joseph Pilates developed the method after World War I to help fellow prisoners while interned as a prisoner of war in England. He combined elements of yoga, ancient Roman and Greek exercises, and Zen Buddhism.

Stemming from its original form as “mat work,” people now practice Pilates on a padded mat. Some of its exercises require specialized equipment, such as:

  • reformers, which feature pulleys and cables that people push or pull with their hands or feet
  • Cadillac, which is a raised table surrounded by four posts that have springs, straps, bars, and levers to challenge core strength
  • handholds
  • supports
  • positioning bars

Learn more about migraine.

Pilates is a gentle, generally safe, and widely practiced exercise method that may support stamina, strength, coordination, and mobility.

There is no direct evidence that it can directly reduce headache pain or manage the frequency of migraine symptoms. However, any safe form of regular exercise can help the brain produce feel-good chemicals called endorphins that act as natural pain relief. The AMF recommends that people with migraine exercise for this reason.

One 2011 research review found that Pilates may:

  • reduce the force applied from walking in people with lower back pain, improving gait and reducing pain
  • be as effective as other conservative treatments for managing lower back pain
  • help improve balance and prevent falls in older adults
  • reduce pain and improve quality of life for people with fibromyalgia and breast cancer
  • support obesity management

However, the review also acknowledged that there is a limit to the number of studies, and the studies available are quite weak.

Benefits of Pilates for people with migraine

Outside of specific studies, Pilates may help people with migraine avoid triggers. Once again, the research is of low quality and limited in scope. However, Pilates may improve the following factors with possible links to migraine episodes:

  • Stress relief: This is a common migraine trigger. In a 2013 study, Pilates improved mindfulness scores for a group focused on Pilates movements over 15 weeks more than a group doing other forms of exercise. Even though this study was small, the AMF recommends daily exercise to reduce stress as a possible migraine trigger.
  • Posture improvement: The AMF recommends exercises that strengthen the core and back to improve posture, as poor posture can trigger migraine attacks in some people. Pilates’ approach can support better strength in both of these areas.
  • Blood pressure management: Pilates might also reduce blood pressure. A 2020 study involving 13 adults ages 44–66 found that blood pressure dropped by 5–8 millimeters of mercury (mm Hg) after a single session of Pilates. Some inconclusive evidence links unmanaged high blood pressure to migraine episodes.

As a low impact exercise, Pilates does not carry many risks when carried out under supervision.

However, if people attempt Pilates and use incorrect forms, they may experience lower back pain or make current injuries worse.

People who live with a chronic health condition should touch base with their doctor before trying Pilates, as with any new exercise.

There is no research that directly links Pilates to fewer or less painful migraine attacks. However, some studies have found that Pilates might reduce some indirect effects of migraine episodes.

May reduce migraine-induced neck pain without triggering a migraine attack

A 2013 study of 103 people attending a headache clinic found that exercise triggered migraine attacks in 38% of participants. The triggering exercises in the study included running, cardio fitness, and racket sports, as well as head trauma from boxing.

While the study does not mention Pilates, the authors did note that a higher percentage of people who experienced exercise-triggered migraine attacks experienced neck pain than in “normal-life attacks.”

A small 2023 study found that Pilates may be a safe, effective nonclinical method for soothing neck pain. It could serve as a way to address a common exercise-triggered migraine symptom.

Improving lower back pain in people with headache disorders

Lower back pain occurs more in people with headache disorders than those without, according to a 2019 review of 14 studies. These studies accounted for several types of headaches, including migraine and tension headaches.

Several studies cautiously support Pilates as a back pain remedy, although stronger evidence is necessary. Pilates’ effectiveness for lower back pain might also vary depending on the cause.

Supporting therapies and approaches can help improve everyday life with migraine, including:

  • getting regular exercise
  • having a consistent sleep schedule
  • staying hydrated
  • excluding potential trigger foods
  • managing weight loss and maintenance

Pilates may form a relatively harmless and low impact part of this daily approach.

However, many people with migraine will need regular medication to prevent attacks and manage pain symptoms when episodes occur. People can take the following to reduce migraine episodes:

When headaches occur, several medications can make this easier, including:

Resting in a dark room with closed eyes and placing a cool towel on the forehead may also provide some relief.

Pilates is an exercise method that focuses on breathing, flexibility, and core strength. People with migraine might be able to use Pilates to reduce and address triggers such as stress, poor posture, and high blood pressure.

Pilates might also help with neck and back pain if those accompany migraine episodes, though there are limits to the evidence.

People with migraine may want to stay active as part of their treatment plan. However, people living with migraine should speak with their doctor before attempting Pilates as an intervention.