Are you mindful of migraine?

All about migraines and how the employer can help

Pleased to see that the Civil Service is joining in an awareness campaign as part of Migraine Awareness Week.

What's Migraine Awareness Week about?

The foci for 2019 are:

  • Tackling the isolation that migraine can often lead to and encouraging people with migraine to talk to their friends and family about it
  • Creating workplaces that are ‘Mindful of Migraine’. By mindful of migraine we mean for employers to be aware of the high numbers of people who get migraine and that it is a complex, varied, and often debilitating neurological condition. Employers can then make reasonable adjustments once they become aware that they have an employee who gets migraine. This is quite a simple message and one that all employers should integrate into their management of those working for them. It is also a win-win situation as mindful of migraine workplaces help employees who have migraine work better, which is good for them and the organisation. Duradiamond Healthcare can help with this - our occupational health team would be pleased to advise. Speak to us today.

What are migraines?

There are different types of migraine involving different symptoms so not everyone gets a “typical” migraine.

Migraine is an inherited tendency to have headaches with sensory disturbance. It’s an instability in the way the brain deals with incoming sensory information, and that instability can become influenced by physiological changes like sleep, exercise and hunger.

There are several types of migraine:

  • Migraine without aura: 70-90% of people with migraine experience this type
  • Migraine with aura: a common type of migraine featuring additional neurological symptoms. Aura is a term used to describe a neurological symptom of migraine, most commonly visual disturbances like flashes or blurring
  • Chronic migraine: If you experience headache on more than 15 days per month you may have chronic migraine.

There are a range of other types.

What are the symptoms of a migraine?

A typical migraine is one-sided and throbbing. In fact, headaches that are one-sided, headaches that throb and headaches that make you feel sick are more likely to be migraines than anything else.
Migraines are often severe enough to be disabling. Some people need to go to bed to sleep off their headache.

Migraine without aura: Attacks of migraine without aura last between four and 72 hours when untreated or unsuccessfully treated.
The headache is usually on one side of the head with a throbbing or pulsating pain that affects your normal daily life and worsens when you take everyday exercise such as walking or climbing stairs.
During this type of migraine, you are likely to feel sick and may vomit or have diarrhoea. You may also become sensitive to light and/or sound.

People who experience migraine with aura will have many or all the symptoms of a migraine without aura, with additional neurological symptoms which develop over a five to 20-minute period and last less than an hour. Visual disturbances can include:

  • Blind spots in the field of eyesight
  • Coloured spots
  • Sparkles or stars
  • Flashing lights before the eyes
  • Tunnel vision
  • Zig zag lines
  • Temporary blindness.

How is migraine diagnosed?

There's no specific test to diagnose migraines. For an accurate diagnosis to be made, your GP must identify a pattern of recurring headaches along with the associated symptoms.
Migraines can be unpredictable, sometimes occurring without the other symptoms. Obtaining an accurate diagnosis can sometimes take time.

What are the triggers for migraine?

  • There is some evidence that red wine may trigger a migraine because it contains tyramine, which has been linked to migraine.  This is why many people with migraine avoid red wine. Tyramine is also found in other food products such as soft cheeses like camembert/brie
  • Food-related triggers occur in about 10% of people with migraine.
  • Many people will crave sweet food such as chocolate before the pain of the migraine is experienced which leads them to conclude that eating sweet food is a cause
  • Missing meals or eating sugary snacks instead of a balanced meal can all contribute to a migraine attack. Insufficient food is probably one of the most important dietary triggers
  • Some food products contain chemicals or additives which may also be relevant to an attack. Those frequently mentioned by people with migraine are monosodium glutamate, nitrates and aspartame
  • Excessive consumption of caffeine (more than four to five cups) may contribute to the onset of a migraine
  • Some people find that changes in their routine can contribute to a migraine
  • Many people complain that they suffer migraines at the weekend. At the weekend you may have a change in many of your daily routines such as eating times, reduced caffeine consumption which is particularly noticeable if you have a rest after a busy week
  • Migraine and stress are strongly linked. Anxiety, excitement and any form of tension and shock may all lead to a migraine attack. Both too much and too little sleep can be implicated in a migraine starting
  • Migraine is closely associated with female hormones. Some women find their migraines start at puberty and are linked to their menstrual cycle. The menopause is often the most difficult time for women with migraine
  • There are certain trigger factors which can be related to environmental issues such as high altitude, weather changes, high humidity, loud noises, exposure to glare or flickering lights
  • Sitting in front of a computer at home or work for long periods of time can cause problems if you experience migraine. Taking regular breaks, sitting properly, using anti-glare screens and good lighting can help prevent this
  • Mild dehydration can have an impact on people who have migraine. It is recommended that you should drink at least 8 glasses of water per day. This is in addition to any other drinks you may have
  • Taking cocaine and withdrawal from cocaine can trigger an attack
  • Using cannabis can contribute to making your attacks more difficult to treat
  • Getting enough sleep is important. Shift work, changing routines or jet lag have been found to trigger migraines in some people
  • Like sleep, exercise can both help to prevent migraine and conversely can be a trigger factor for some people. Regular exercise which is built up gently can help to prevent migraine
  • The use of contraceptives which contain hormones such as the contraceptive pill can trigger migraine for some women
  • Some people grind their teeth during the night and find they wake with head pain. If this is the case it is worthwhile seeing a dentist
  • Physical conditions such as head injury and muscle tension can trigger migraines.

How can migraine be treated?

There is currently no cure for migraine but there are several treatments that may help:

  • Most people find that sleeping or lying in a darkened room is the best thing to do when having a migraine attack.
  • Others find that eating something helps, or they start to feel better once they've been sick.
  • Many people who have migraines find that over-the-counter painkillers, such as paracetamol, aspirin and ibuprofen can help to reduce their symptoms.
  • If ordinary painkillers aren't helping to relieve your migraine symptoms, you should make an appointment to see your GP. They may recommend taking painkillers in addition to a type of medication called a triptan and possibly anti-sickness medication
  • Acupuncture is also said to help.

Find out more about one woman’s experience with migraines.

Watch the BBC video