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Primary exercise headache is a distinct clinical entity and requires careful assessment and exclusion of sinister pathology but may respond to specific management. Imprecise nomenclature and miscommunication can lead both patients and clinicians to become frustrated. In this narrative review, we summarise the epidemiology, phenotype, differential diagnosis and management of primary exercise headache and briefly discuss the relationship between exercise and migraine.<\/jats:p>","DOI":"10.1136\/pn-2025-004957","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T10:05:12Z","timestamp":1785146712000},"page":"pn-2025-004957","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Migraine and headache disorders: relationship to exercise and triggers"],"prefix":"10.1136","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4833-5507","authenticated-orcid":false,"given":"Jason Charles","family":"Ray","sequence":"first","affiliation":[{"name":"Department of Neurosciences, School of Translational Medicine, Monash University, Melbourne, Victoria, Australia"},{"name":"Department of Neurology, Alfred Brain, Alfred Health, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Usman","family":"Ashraf","sequence":"additional","affiliation":[{"name":"Wolfson Sensory, Pain and Regeneration Centre, IoPPN, King\u2019s College London, London, England, UK"},{"name":"School of Medicine, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Somayeh","family":"Nasergivehchi","sequence":"additional","affiliation":[{"name":"Department of Neurology, Alfred Brain, Alfred Health, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faraidoon","family":"Haghdoost","sequence":"additional","affiliation":[{"name":"The George Institute for Global Health, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1637-9700","authenticated-orcid":false,"given":"Richard James","family":"Stark","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, School of Translational Medicine, Monash University, Melbourne, Victoria, Australia"},{"name":"Department of Neurology, Alfred Brain, Alfred Health, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,7,27]]},"reference":[{"key":"2026072703050790000_pn-2025-004957v1.1","doi-asserted-by":"publisher","DOI":"10.1016\/s1474-4422(24)00038-3"},{"key":"2026072703050790000_pn-2025-004957v1.2","doi-asserted-by":"crossref","first-page":"3331024251321500","DOI":"10.1177\/03331024251321500","article-title":"Evidence-based guidelines for the pharmacological treatment of migraine, summary version","volume":"45","author":"Ornello","year":"2025","journal-title":"Cephalalgia"},{"key":"2026072703050790000_pn-2025-004957v1.3","doi-asserted-by":"crossref","first-page":"915","DOI":"10.31128\/AJGP-01-21-5807","article-title":"The state of migraine: An update on current and emerging treatments","volume":"50","author":"Ray","year":"2021","journal-title":"Aust J Gen Pract"},{"key":"2026072703050790000_pn-2025-004957v1.4","unstructured":"Hippocrates AF . 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