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How can I stop migraines at work? By Professor Paul Booton

02 September 2018

It is Friday, it is 5 o’clock, but it is not Crackerjack, it is a cracking headache. Sadly, this is often the result of a week at work. In this article, we will look at how you can keep a healthier head and help prevent migraine headaches.

This is important for your employer too: 43 million workdays are lost due to migraine every year, which costs around £2.8 billion pounds to the economy. But equally important for you as an individual losing days off work, may be losing pay and in the long run may be losing your job altogether.

What are the triggers?
The major triggers for migraine are dehydration, low blood sugar, inadequate or erratic sleep and lack of exercise. These are often problems in a busy workplace, where you do not drink enough, skip or delay meals, being over tired or wound up from the day affects your sleep and you do not find time for exercise. Shift work is one of the worst offenders. Shift working means your body never catches up properly on sleep, overheated workplaces risk worsening dehydration, and relentless workload means skipped meals. By the end of the day the last thing you want to do is go to the gym. Another common trigger, particularly in large offices are bright overhead strip lights and computer screens, which are powerful triggers for some people.

So what can you do?
Keep a regular routine as far as possible: go to bed and get up at the same time every day including weekends (especially at weekends attacks are a problem). For some shift workers moving to a fixed shift is the solution.

Always carry a bottle of water with you and make sure you drink plenty. Take your meals regularly, or where this is impossible have a healthy snack of some sort (a banana, a brunch bar) that you can eats to keep you going.

Build some sort of exercise into your daily routine: I cycle to work as it means I get 45 minutes worth of exercise each way which I would certainly never get as a busy doctor otherwise. But it needs to be something which works for you.

If screens and lighting is a problem try to arrange to have your desk near a window so that you get more natural light and artificial light. Turning down screen brightness or using screen filters may be helpful or even wearing sunglasses in the office may help.

The weekend is a particularly difficult time for many people: after a hard week of work you want to relax but that relaxation can trigger an attack. The best advice is to try to continue a fixed routine, keep regular bedtime hours (no late-night Friday), be modest with alcohol and coffee, do not have a Saturday morning lie in.

Migraine is recognised as one of the leading causes of disability worldwide (7th according to the WHO). From a work point of view, if you are needing frequent time off work because of migraines it should be regarded as a disability and the laws relating to disability should apply. At their simplest this means the employer should make ‘reasonable adjustments’ to your workplace to allow you to take part the same as an unaffected individual. Such changes need to be made for each individual – there is no one size fits all.

What can you do as an employer?
Firstly, believe your employee who cannot attend work, or who has to leave because of migraine. It is not just a bad head, it is not being work shy and it is not a low pain threshold.

Allow flexible working: if an employee has a migraine attack they may be able to get it under control in a couple of hours with a quiet space and the right medication. Forcing them to sit in a busy office rather than rest at home guarantees they will stay unwell. Have a healthy work environment: excessive screen time and huge offices without natural light are powerful triggers for some migraine sufferers. A quiet working space with natural light and work away from the computer screen can make all the difference between retain in a valuable employee and losing them to illness.

Ensure your workers can take regular meal breaks and have access to drinks. Shift working may be especially difficult for migraine sufferers who need a regular routine of sleep in particular: allowing a fixed shift can be vital. Take special note all you managers of shift workers, where staff work erratic shifts, have high stress levels from inadequate resources, are forced to skip meals to get the job done and work in superheated workplaces where staff dehydration is an everyday problem!

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