Does your employer understand what migraine is? Here are a few informations that could be worth sharing. 

1. Migraine is more than a headache 

Migraine is not only a headache. It is accompanied by other symptoms like

  • Sensitivity to light, sounds, smells and movement. 
  • Nausea and vomiting 
  • Brain fog, dizziness, neck pain 
  • Auras that may impair vision, speech, sensation and even movement

2. Migraine is a chemical and electrical phenomenon in the brain

  • The predisposition for migraine is genetic, but from a combination of genes. That probably explains why migraine is so variable. 
  • Even in between attacks, the migraine brain is hypersensitive to sensations, and it processes serotonin differently. 
  • During an attack, different zones of the brain get activated. A cascade of events leads to the release of inflammatory molecules near the sensitive nerves inside the skull. 

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3. Migraine is VERY common

  • 12% of the world’s population has migraine, women more than men (3/1). 
  • 1 to 2% have chronic migraine (a severe form). 
  • The World Health Organization recognizes migraine as the third most common disease in the world (just after dental cavities and… tension headache). 

4. Migraine can be disabling

  • According to the World Health Organization, a migraine attack is classified with the most disabling health events (along with quadriplegia and schizophrenia). 
  • Because it affects so many people during their productive years, migraine is ranked as the second cause of years lived with disability (YLD), way above other health conditions. 

5. Migraine is a leading cause of absenteeism (missed workdays)

Migraine should be a top priority for employers and disability insurance companies. It is a significant cause of lost productivity in the workplace.

  • According to a study done in Canada on 28 000 employees on 16 health conditions, migraine came third for cost related to missed days at work after back pain and mood disorders. Migraine was more costly than asthma, diabetes, cancer and arthritis. (Zhang)
  • Among Canadian employees, 56% had taken sick days, 23% were on short term disability, and 18% were on long term disability.
  • A Migraine Canada survey found that only 20% of people with migraine (all severity) did not miss days of work. 36% missed between 4 and 16 days per year. 25% reported being disabled

6. Migraine is a leading cause of presenteeism (being at work but not able to function)

  • A study done in the US on presenteeism showed that migraine was more costly than 20 other conditions including depression, back pain, diabetes and asthma.
  • Many people with migraine will come to work even with severe pain and symptoms. 

7. A good collaboration between the employer, the employee and a physician can boost productivity

  • It’s extremely important for people with migraine to be able to discuss health issues with their employers and colleagues. 
  • The treating physician can get involved to optimize treatment but also provide suggestions for reasonable accommodations. 
  • Choosing insurance plans that cover migraine treatments can allow employees with migraine to function better

8. Accommodations in the workplace can make a positive difference 

A few examples include

  • Migraine Awareness program for employees and HR staff 
  • No scents policy to avoid odor triggers
  • Adaptation of the lighting
  • Optimization of the workstation for posture 
  • Access to water
  • Coverage of allied health services (physiotherapy, occupational therapy etc)

9. Migraine is a good example of temporary disability 

A person with migraine might spend two days throwing up and treating with prescription medications, then come back to work in a good state. The concept of temporary disability applies to other neurological conditions such as epilepsy and multiple sclerosis. Elements that should be taken into consideration by employers include: 

  • Flexibility of the schedule 
  • Avoiding irregular shifts
  • Possibility to work part-time 
  • Not asking a doctor’s note for every disabling migraine attack

10. Refractory chronic migraine should be recognized as a cause of disability 

  • Even with optimal care, people with chronic migraine may be disabled at work and in their personal lives.
  • According to a canadian survey, people with chronic migraine report an average of 40 days of presenteeism per year. 
  • In a Migraine Canada survey, 19% of people with chronic migraine were disabled but able to live independently and 26% were disabled and at least partially dependent on someone else to perform daily activities. 

In summary, raising awareness about migraine in the workplace could significantly improve the productivity of Canadian businesses and the quality of life of numerous Canadians. 

To read more: https://migraineatwork.org/

REFERENCES

  • Young WB, Park JE, Tian IX, Kempner J. The stigma of migraine. PLoS One. 2013;8(1):e54074.
  • Global, regional, and national burden of neurological disorders, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2019;18(5):459-80.
  • Steiner TJ, Stovner LJ, Vos T, Jensen R, Katsarava Z. Migraine is first cause of disability in under 50s: will health politicians now take notice? J Headache Pain. 2018;19(1):17.

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