Migraine Overview

A migraine is a moderate or severe headache experienced on one side of the head. It is a throbbing pain and can be accompanied by nausea and a higher than normal sensitivity to light and sound. It is a common condition that affects up to 1 in 5 women and 1 in 15 men.

What are the signs and symptoms of migraines?

Migraines are characterised by a throbbing headache but they can be categorised into three main types:

  • Migraine with aura – a headache that is preceded by a warning symptom such as seeing flashing lights
  • Migraine without aura (any warning signs) – the most common type
  • Migraine aura without headache – flashing lights, for example, with no headache to follow.

Migraines range between multiple, successive migraines, or several in a week, to only occurring very occasionally.

Other symptoms include:

  • Increased sensitivity to light and sound
  • Nausea
  • Vomiting

How are migraines diagnosed and treated?

Migraines are difficult to diagnose because there is no specific test. A GP will look for patterns of headaches, combined with other typical migraine symptoms.

A person is likely to be diagnosed with migraines if the headaches are severe enough to stop them carrying out their daily activities as normal, as well as being aggravated, rather than alleviated, by light exercise.

Treatment for migraines can help make symptoms more manageable, but there is currently no cure for them altogether.

During an attack, some people find it best to sleep or rest in a darkened room. Others find they feel better after eating or vomiting.

It may also be possible to avoid the onset of an attack by refraining from certain triggers such stressful situations, long-haul flights and consumption of alcohol or caffeine.

Common painkillers used to treat migraines are over-the-counter paracetamol, ibuprofen or aspirin. GPs can also provide stronger painkillers if necessary, such as triptans.

Some people with migraines may also benefit from anti-sickness medication (anti-emetics).

There are a few ways to confirm what sort of reasonable adjustments should be made for an employee with migraines:

An employee may not disclose their migraines upfront, but if they do, questions regarding the nature of an employee’s migraines and what extra support they may need can be broached sensitively. For example:

  • Have they required adjustments in the past? For example, avoiding certain high-stress work situations to prevent the onset of a migraine attack, or avoiding night shifts if disrupted sleep is a trigger.
  • Encouraging the employee to express their strengths and interests and which tasks they might enjoy doing is a positive way of adapting to their needs and empowering them, in spite of their migraines.
  • Even if the employee does not wish to disclose their migraines – or they have not even received a precise diagnosis – an employer can focus on making reasonable adjustments, rather than seeking to determine the precise disability their employee has.

What reasonable adjustments are possible for employees with migraines?

Employers have a legal duty to make reasonable adjustments for employees with migraines if they know, are aware of, or could ‘reasonably be expected to know’ that the employee has migraines. Most employees will tell their employer what reasonable adjustments they need. They often involve simple changes in the way an employer might usually do things.

If the employee does not disclose a health issue or disability which may affect their performance upfront, an employer should broach the subject sensitively if they suspect that there may be a disability behind the employee’s reduced performance. Reasonable adjustments can then be made in accordance with the employee’s needs, including, in the case of migraines:

  • Flexible working hours to accommodate medical appointments and periods of increased absence or decreased productivity following a flare-up in symptoms.
  • Additional breaks if the person’s pain medication causes their concentration to lapse or makes them drowsy shortly following taking it.
  • Adjustments to duties depending on the severity of their symptoms, which may be variable and improve or deteriorate from one week to the next. This may also be dependent on when they take their medication if they are required to operate machinery, for example.
  • Raising awareness so that colleagues understand the employee’s migraines and can help ensure the employee feels comfortable at work, for example, when taking additional breaks.
  • Adapted overhead lighting and computer screens to reduce exposure to bright lights. Anti-glare screens are available for computers.
  • Access to drinking water so that the employee can stay hydrated and avoid an attack brought on by dehydration.

Migraine Signposting

Migraine Trust – the UK’s largest research and support charity for migraines campaigning for better understanding among health professionals and providing a community in which people with migraines can support each other (0203 9510 150).

National Migraine Centre – organisation offering treatment and support for migraines without the requirement of a GP referral (020 7251 3322/ 020 7251 7800).

The Brain Charity – non-migraine-specific charity offering help and emotional support to anyone with a neurological condition, including migraines, with a focus on tackling stigma attached to the conditions in question (0151 298 2999).

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