Migraine is not simply a bad headache. It is a complex neurological condition that can cause disabling symptoms and significantly affect everyday life and work. Around 10 million people aged 16 – 65 in the UK live with migraine, yet the condition is still widely misunderstood.
With understanding, appropriate treatment and practical workplace support, many people with migraine can remain in work and contribute effectively. This article explains what migraine can involve, how work may affect it, and how employees, managers and colleagues can respond constructively.
The scale of migraine
Migraine affects around one in seven people and is two to three times more common in women than in men. An estimated 190,000 migraine attacks occur in the UK each day, while around 100,000 people are absent from work or school because of migraine. It is also more common than diabetes, asthma and epilepsy combined.
These figures illustrate why migraine deserves attention as a workplace health issue. Its impact is not limited to sickness absence: symptoms before, during and after an attack can also affect concentration, communication, stamina and productivity.
Recognising the symptoms
Migraine symptoms vary considerably. A person may experience throbbing head pain, often on one side, but an attack can also involve nausea or vomiting, sensitivity to light and sound, dizziness, fatigue and difficulty concentrating. Some people experience migraine without head pain.
Symptoms can occur in stages. Early signs may begin hours or up to two days before the main attack and can include tiredness, yawning, thirst, food cravings, mood changes, a stiff neck or needing to urinate more often. Some people experience aura, such as flashing lights or zigzag patterns, tingling or numbness, dizziness or difficulty speaking. Not everyone with migraine has aura.
An attack typically lasts between four hours and three days, and recovery may continue after the headache has eased. Frequency also varies: some people have attacks several times a week, while others experience them much less often. This unpredictability can be particularly difficult at work.
Migraine and the workplace
Work does not necessarily cause migraine, and triggers differ from person to person. However, aspects of the working environment or job design may contribute to an attack. Commonly reported factors include stress, missed meals, dehydration, disrupted sleep or shifts, long periods at a screen, glare or bright or flickering light, noise, strong smells and insufficient breaks.
The most useful starting point is a private, supportive conversation. Managers should avoid assumptions and ask what the individual experiences, whether they recognise particular warning signs or workplace triggers, and what practical support could help. A migraine diary may help the employee identify patterns, although it should be their choice whether to share any of it.
What employees can do
People with migraine can consider discussing the condition with their line manager before a crisis occurs. A simple plan can cover early warning signs, medication or rest needs, how work will be handed over if an attack develops, who should be contacted and what support may help on return.
Helpful self-management may include regular meals, hydration, sleep routines, screen breaks and taking prescribed or recommended medication as directed. Anyone whose attacks are severe, worsening, difficult to control or occurring more than once a week should seek medical advice. New or unusual neurological symptoms, or a sudden extremely painful headache, require urgent assessment rather than being assumed to be migraine.
How colleagues can help
Migraine is often invisible, and a person may look well before or after an attack while still experiencing significant symptoms. Colleagues can help by taking the condition seriously, avoiding dismissive comments, respecting privacy and responding calmly if someone needs to stop work, move to a quieter space or go home.
Five-point checklist for employers
- Start with the individual: Arrange a confidential conversation and listen without making assumptions. Migraine affects people differently, so agree support around the employee’s symptoms, role and known workplace triggers.
- Reduce avoidable triggers: Review lighting, glare, screen set-up, noise, smells, temperature, hydration and access to regular breaks and meals. A display screen assessment can identify simple changes that reduce eye strain and fatigue.
- Agree a migraine attack plan: Record what should happen when warning signs or symptoms begin, for example, access to a quiet, dark space, time to take medication, temporary cover, safe travel home and who should be contacted.
- Consider flexible adjustments: Explore changes such as flexible start times, home working where suitable, altered shifts, additional breaks or a phased return after a severe attack. Review arrangements regularly and seek occupational health advice where helpful.
- Manage absence fairly and build awareness: Consider whether migraine-related absence should be handled separately from standard trigger points. Train managers, protect confidentiality and make clear that ridicule, disbelief or pressure to work through an attack is unacceptable.
A note on reasonable adjustments
Migraine is not automatically classed as a disability. However, it may meet the Equality Act 2010 definition if it has a substantial and long-term adverse effect on normal day-to-day activities. Where an employee is disabled, the employer has a legal duty to make reasonable adjustments if it knows, or could reasonably be expected to know, about the disability. In every case, focusing on practical support is better than debating labels.
Final thoughts
Migraine can be painful, disabling and unpredictable, but small workplace changes can make a substantial difference. The most effective approach combines individual self-management with informed, flexible support from employers and understanding from colleagues. By encouraging early conversations, reducing avoidable triggers and agreeing what to do when an attack occurs, organisations can help people with migraine stay well, remain productive and feel valued at work.
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Sources and further information
- NHS: Migraine – nhs.uk/conditions/migraine/
- The Migraine Trust: Managing migraine at work – https://migrainetrust.org/live-with-migraine/migraineandwork/managing-migraine-at-work/
- Acas: Reasonable adjustments at work – www.acas.org.uk/reasonable-adjustments
- HSE: Working safely with display screen equipment – https://www.hse.gov.uk/msd/dse/
Photo by Towfiqu barbhuiya on Unsplash
