Physically active women less reliant on pain meds for headache

A cross-sectional study by the German Migraine and Headache Society reports a lower use of analgesics among physically active women prone to headaches vs physically inactive counterparts.

The analysis was based on data from a random general population sample of 2,477 people aged 14–94 years. Over a third of respondents (39 percent) reported headache during the previous 6 months. Women reported headache more often than men (47.8 percent vs 29.8 percent; p<0.001). [Pain Ther 2022;doi:10.1007/s40122-022-00362-4]

Acute treatment of headache was assessed by asking participants, ‘‘How many days a month do you use analgesics on average?’’ and physical activity was surveyed with the dichotomous question, ‘‘Do you exercise regularly [ie, on average at least 2–3 times a week for 30 minutes or longer]?’’. Participants were categorized as physically active if they answered ‘‘yes’’ and as physically inactive otherwise.

Of the participants without headache, 42.6 percent were physically active vs 35.1 percent in the headache group (p<0.001). “While persons without headache showed a significant sex difference in physical activity [men, 47.4 percent; women, 36.5 percent; p<0.001], men and women with headache were comparably physically active [men, 37.5 percent; women, 33.6 percent; p=0.225],” noted the researchers.

Of participants with headache, 43.3 percent reported taking analgesics on <2 days a month, 40.7 percent on 2–5 days a month, 10.1 percent on 6–10 days a month, and 5.9 percent on >10 days a month. The frequency of analgesic use differed significantly for sex and physical activity (p<0.001 for both), with lower frequency of analgesic use among men vs women (mean days a month, 2.71 vs 4.25) and physically active vs inactive participants (mean days a month, 2.99 vs 4.05).

“Subordinate analysis of variance revealed that this effect was only driven by women, as analgesic use differed significantly between physically active and inactive women [p<0.001], but not in men [p=0.500],” highlighted the researchers. “Unlike men whose mean number of analgesic use days was the same regardless of physical activity, physically active women took analgesics on fewer days vs physically inactive women [mean days a month, 3.17 vs 4.79]. Furthermore, significant associations between physical activity and less frequent use of analgesics were observed both in women with migraine and women with headache other than migraine.”

In women, the statistically significant association between physical inactivity and higher analgesic consumption remained significant even after controlling for age, marital status, headache frequency, headache impact, headache duration, migraine, obesity, and depression. “Women with high analgesic use should be educated about the solid evidence on physical activity being of prophylactic value in headache management and, in addition, about the risk of medication overuse,” advised the researchers.