A migraine is a severe headache which can be complicated by other symptoms such as nausea, vomiting, visual or other sensory disturbances (aura) and hypersensitivity to light and sound. They are thought to involve a temporary disturbance to the nerve signals, blood vessels and chemistry of the brain. The exact causes of migraines are unclear but they are believed to have a genetic element and can be passed on through genes.
Health experts estimate that some 6 million people in the UK (one in seven people) suffer from migraine, and two thirds of sufferers are women. Migraines may affect people as infrequently as once a year or as often as a few times a week. When migraines do strike, they can be debilitating, and sufferers are often unable to carry out normal day-to-day tasks or work productively.
Migraines are most common among the 30-50 age groups when workers are at their most economically productive. Government estimates the cost to the NHS of treating migraine at £150 million a year but the annual cost to the economy, through sick days or reduced productivity in work, is far greater (£2.25 billion). This makes migraine a serious issue for employers as well as their staff.
Types of migraine and symptoms
Experience of migraine tends to vary among individuals but can generally be described as:
- migraine without aura: migraines tend to be associated with visual or other sensory disturbances (aura) but most people (70-90 percent of sufferers) do not experience aura. The headache is characteristically on one side of the head and is likely to be accompanied by feelings of nausea, vomiting and hypersensitivity to light and sound;
- migraine with aura: this will usually involve a one-sided headache and visual disturbances, that may include coloured spots or sparkles, zig zag lines, tunnel vision or temporary blind spots. These can be troubling, especially when experienced for the first time. These migraines may also be accompanied by numbness or tingling in arms and legs and dizziness and may be mistaken for a stroke;
- aura without migraine: some people suffer with visual disturbances without the severe headache.
There is no cure for migraine so doctors emphasise the importance of identifying the triggers (an event, a physical change or stimulus that occurs 6-8 hours before the onset of a migraine) that may cause the problem. Triggers will be particular to an individual.
There are a number of known and common triggers:
- Hormones – Many women develop migraine linked to their menstrual cycle and this can be exacerbated by the menopause. This may explain why so many more women than men suffer from migraine.
- Change – Changes to routines (e.g. weekends, holidays or long journeys) can upset sleep patterns and trigger a migraine.
- Food and drink – Food-related issues trigger about 10 per cent of migraines and common causes include:
- missing meals or replacing meals with sugary snacks;
- consumption of alcohol, cheese and caffeine;
- some additives in food.
Chocolate has long been thought of as a trigger for migraine but doctors now think it is a symptom rather than cause as sufferers may experience a craving for sweet treats before the onset of a migraine.
- Stress – There is a strong link between migraine and stress. Anxiety, excitement or any form of increased tension can act as a trigger.
- Computer screens – Sitting for long periods at a computer is linked to migraines for some people. It is important to take regular breaks from the screen, use anti-glare screens if troublesome glare cannot be eliminated, ensure that lighting is flicker-free, and adopt a comfortable sitting position that minimises back and shoulder tension, which can trigger migraine.
- Environment – High altitude, weather changes, high humidity, loud noises, exposure to glare or flickering lights are all possible triggers.
Some 50 per cent of migraine sufferers don’t go to the doctor for help, but self-medicate with painkillers and time out in a darkened room. If painkillers don’t work, the doctor can prescribe specific medicines, which reverse the widening of the blood vessels in the brain, which is believed to cause migraine. Anti-sickness drugs are also available. Doctors generally advise patients to keep a migraine and food diary in an effort to identify triggers and then avoid behaviour that may lead to a migraine.
Working with migraine
If you suffer with migraine the chances are it will affect your working life and you may need to take time off. These steps could help you manage your condition successfully at work.
- Inform your employer – Try to be open about your condition and its possible impact on your ability to work. Managers cannot support you if they don’t know about the issues you are facing.
- Research your company’s sickness policy – Migraine episodes may mean needing to take time off work, so it’s important to be clear on your organisation’s sickness absence policy.
- Reduce workplace stress – Try to manage your stress. Set realistic expectations, communicate with your manager and look after yourself with regular breaks and nutritious lunches.
- Address workplace triggers – Try to ensure that your workplace surroundings are not triggering your migraines and speak to your manager about making changes to the environment, if necessary.
- Stay hydrated: Dehydration is a common trigger for migraines so it’s important to drink plenty of water.
For more help with work-related health issues, visit the Fit For Work website. For specific advice, you can call our free telephone advice line on 0800 032 6235 (English) or 0800 032 6233 (Welsh). There is a separate service running in Scotland – call 0800 019 2211.
Supporting staff who experience migraine
An estimated 25 million work days are lost in the UK due to migraine. Taking steps to support staff and tackle potential migraine triggers in the workplace (e.g. ensuring that employees have DSE assessments, encouraging good posture, reducing ‘nuisance’ noise where possible, ensuring that lighting is effective, and encouraging staff to take regular breaks from long periods of screen-based work) will help organisations reduce staff sickness and improve morale and staff retention.
For more information about looking after the health and wellbeing of staff, visit the Fit For Work website or call the free telephone advice line on 0800 032 6235 (English) or 0800 032 6233 (Welsh). There is a separate service running in Scotland – call 0800 019 2211.