Migraine Awareness Week, from 1st-7th September, is run by the charity The Migraine Trust to raise awareness of the health condition and to help reduce stigma.
With the Trust estimating that as many as 25 million working days are lost each year to migraine, and research suggesting this is only going to get worse as our working population ages, it is an important health and wellbeing conversation for employers to be embracing.
A new report published by the Migraine Trust reveals the legacy of pain and damaged lives caused by the UK’s broken migraine healthcare system. The report exposes a broken healthcare system which migraine patients struggle to navigate.
This is leading to the worsening of people’s migraine, limiting their ability to carry out their lives with a huge impact on personal relationships, work and mental health. The Trust is calling for an urgent review of migraine healthcare.
The week itself involves a range of events, including encouraging workplaces to become more “mindful of migraine”. More details of how to get involved can be found here.
Migraine
Migraine is a common health condition, affecting around one in every five women and around one in every 15 men. They usually begin in early adulthood.
Migraine is usually a moderate or severe headache felt as a throbbing pain on one side of the head.
Many people also have symptoms such as feeling sick, being sick and increased sensitivity to light or sound.
There are several types of migraine, including:
- Migraine with aura – where there are specific warning signs just before the migraine begins, such as seeing flashing lights
- Migraine without aura – the most common type, where the migraine happens without the specific warning signs
- Migraine aura without headache, also known as silent migraine – where an aura or other migraine symptoms are experienced, but a headache does not develop
Some people have migraines frequently, up to several times a week. Other people only have a migraine occasionally. It is possible for years to pass between migraine attacks.
You should see a GP if you have frequent or severe migraine symptoms.
Simple painkillers, such as paracetamol or ibuprofen, can be effective for migraine.
You should try not to use the maximum dosage of painkillers on a regular or frequent basis as this could make it harder to treat headaches over time.
You should also make an appointment to see a GP if you have frequent migraines (on more than five days a month), even if they can be controlled with medicines, as you may benefit from preventative treatment.
You should call 999 for an ambulance immediately if you or someone you’re with experiences:
- Paralysis or weakness in 1 or both arms or 1 side of the face
- Slurred or garbled speech
- A sudden agonising headache resulting in a severe pain unlike anything experienced before
- Headache along with a high temperature (fever), stiff neck, mental confusion, seizures, double vision and a rash
These symptoms may be a sign of a more serious condition, such as a stroke or meningitis, and should be assessed by a doctor as soon as possible.
Causes of migraines
The exact cause of migraines is unknown, although they’re thought to be the result of temporary changes in the chemicals, nerves and blood vessels in the brain.
Around half of all people who experience migraines also have a close relative with the condition, suggesting that genes may play a role.
Some people find migraine attacks are associated with certain triggers, which can include:
- Starting their period
- Stress
- Tiredness
- Certain foods or drinks
Treating migrainesThere’s no cure for migraines, but a number of treatments are available to help reduce the symptoms. These include painkillers including over-the-counter medicines like paracetamol and ibuprofen, triptans, medicines that can help reverse the changes in the brain that may cause migraines, and anti-emetics, medicines often used to help relieve people’s feeling of sickness (nausea) or being sick. During an attack, many people find that sleeping or lying in a darkened room can also help.
Preventing migraines
If you suspect a specific trigger is causing your migraines, such as stress or a certain type of food, avoiding this trigger may help reduce your risk of experiencing migraines.
It may also help to maintain a generally healthy lifestyle, including regular exercise, sleep and meals, as well as ensuring you stay well hydrated and limiting your intake of caffeine and alcohol.
If your migraines are severe or you have tried avoiding possible triggers and are still experiencing symptoms, a GP may prescribe medicines to help prevent further attacks.
Medicines used to prevent migraines include the anti-seizure medicine topiramate and a medicine called propranolol that’s usually used to treat high blood pressure.
It may take several weeks before your migraine symptoms begin to improve.
Outlook
Migraines can severely affect your quality of life and stop you carrying out your normal daily activities. Some people find they need to stay in bed for days at a time. But a number of effective treatments are available to reduce the symptoms and prevent further attacks.
Migraine attacks can sometimes get worse over time, but they tend to gradually improve over many years for most people.
More widely, there is growing recognition of the health and wellbeing impact of neurological conditions such as migraine, but also Alzheimer’s disease and multiple sclerosis, in the workplace, especially as our working population ages.
For example, a report over the summer by The Economist and Novartis argued that employers will need to become more aware of the needs of staff with these conditions as our working population gets older.
Organisations, it suggested, will need to develop or strengthen existing policies to better support staff suffering from these conditions. They will need to educate colleagues around their capabilities to remove negative perceptions. And they will need to consider introducing workplace adjustments that will enable workers to stay in work longer.
Alongside the ageing workforce factor, the fact work increasingly involves the use of screens, laptops and computers – all of which can put strain on the eyes – makes being aware of the potential causes and consequences of both headaches and migraine that much more important.
The Migraine Trust has set out in the report a range of proposals to be considered in order to address these issues, which includes:
- Everyone attending primary care for head pain should be assessed for migraine, with the outcome of the assessment recorded as a positive or negative diagnosis of migraine.
- Support GPs to make an accurate and rapid diagnosis by making migraine treatment and care a core part of junior doctor and GP training.
- Everyone diagnosed with migraine should receive an individualised care plan, developed closely with them. Regardless of whether medication is prescribed, the individual should have their care plan regularly reviewed at an interval decided with their doctor.
- Each nation’s department of health should support the recruitment of additional headache specialists and consultant neurologists to bring the UK in line with other European countries.
As Optima Health Chief Medical Officer Dr Lucy Wright argues, this can mean thinking quite widely about your organisational culture and working environment.
“Whether it’s the physical environment – lighting, glare, types of workstation or seating – or the culture – long hours staring at screens, demands or pressure – it is beholden on employers to be recognising and managing potential factors that can be an issue in terms of causing migraine and headaches.
“We often assume a headache is just part and parcel of daily life – and, to an extent, it is – but headaches and migraines, especially if they become severe and regular, can be debilitating and lead to significant absence as well as have an impact on performance and productivity.
“The Migraine Trust is a good starting point in terms of advice and resources, as will be your occupational health provider. But awareness raising weeks such Migraine Awareness Week are also a great opportunity to kickstart conversations, run health promotion activities and simply reflect on and revisit how you are doing as an organisation in terms of being supportive, of being, as the trust suggests, ‘mindful’ of this condition,” she adds.
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