For an active migraine: forward extensions and head support
When a migraine is active, the priority is to calm the nervous system and reduce vascular pressure in the head. Forward extensions with the head supported — on a bolster, a block, or a chair seat — are the most effective poses. The key action is that the skin of the forehead flows toward the heart, and the center of the forehead can spread out and release. This is not a passive resting position; it is a specific therapeutic action that requires the forehead to make contact with a firm, supportive surface.
A therapeutic head wrap — a long bandage wrapped evenly around the forehead and temples — applies gentle, consistent pressure that can reduce the vascular component of a migraine. Combined with a supported forward extension in Adho Mukha Virasana (Child's Pose) or Paschimottanasana with the head on a bolster, this is one of the most effective immediate interventions for an active migraine.
"Inversions and forward extensions are the primary therapeutic tools for conditions affecting the head and nervous system." — B.K.S. Iyengar, Yoga: The Path to Holistic Health
Releasing the upper neck and shoulder girdle
Chronic headaches are often driven by tension in the trapezius, the upper neck, and the shoulder girdle. In therapeutic Iyengar yoga, we work to release this tension through supported inversions, chest-opening poses, and specific neck work. The relationship between the cervical spine and the shoulder girdle is central — when the shoulders are chronically elevated and the neck is compressed, the conditions for headache are constantly present.
Sarvangasana (Shoulderstand) with appropriate support is one of the most powerful tools for releasing neck and shoulder tension. The pose requires the student to broaden the shoulders and lengthen the neck, which directly addresses the postural pattern that drives many chronic headaches.
Supported inversions in the early stages
For headaches that are just beginning — before the full migraine has established — supported inversions are appropriate and effective. Viparita Karani (Legs Up the Wall) with a bolster under the sacrum, or Sarvangasana with a chair, can interrupt the vascular cascade before it becomes a full migraine. These are not used during an active migraine, but they are valuable preventive and early-intervention tools.