Overlooked: Millions suffer tension, migraine headaches at work

 

NIH/Migraines at work overlooked, understudied.

Millions suffer tension, migraine headaches at work, in silence

Date:

February 9, 2022

Source:

University of Copenhagen - The Faculty of Health and Medical Sciences

Summary:

A new study shows that people with migraine or frequent tension headaches have a reduced work ability in particularly three areas. The researchers hope that the new knowledge may help workplaces become better at accommodating those suffering from headaches.

    

FULL STORY

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Imagine your head pounding. And when you try to move, a door slams, or curtains are drawn it gets much worse. Ideally, you would like to crawl under your blanket in a dark and quiet room.

 

This is how it may feel for people suffering from migraine or frequent tension headaches. Untreated, a migraine attack may last for 4-72 hours, and tension headaches may potentially last for a week. In Denmark, it is estimated that approximately 770,000 people suffer from migraine or frequent tension headaches.

 

Now, for the first time, a new study from the University of Copenhagen shows specifically how migraine or frequent tension headaches affect the ability to work.

 

"It is especially the ability to remember, make quick decisions and do hard physical work that cause difficulties for people with these headache disorders," says Project Manager and author of the study Kirsten Nabe-Nielsen.

 

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She hopes that the study will help to focus on the consequences which headaches may have for working life.

 

"Migraine is the leading cause of functional impairment among people under the age of 50. And headaches have negative effects on sick leave and productivity. So, it would benefit workplaces to open their eyes to the untapped potential that you find here," says Kirsten Nabe-Nielsen, adding:

 

"Indeed, we cannot afford not to take it seriously."

 

If you ask the Danish working population, 24 per cent of women and 10 per cent of men suffer from migraines or frequent tension headaches.

The possibilities of adapting the work during headache attacks depend on the type of work you have, says Kirsten Nabe-Nielsen, stressing:

 

"So also in this context, there is a significant inequality in health."

While people with academic jobs will often be able to go home a little earlier, work from home or choose to postpone the tasks that demand the highest concentration, other people, such as cleaning staff or nursing staff in old people's homes, do not have the same opportunities to adjust the working hours or postpone the tasks to be solved. Instead, they may have to call in sick.

 

According to Kirsten Nabe-Nielsen, it takes creativity on the part of the manager and the employees to find out which solutions may be helpful:

 

"It is about having a good overview of the tasks that need to be solved, and then having a talk as to the best way to arrange a work day. For example, there may be tasks that can be performed later in the day, or that can be solved at a leisurely pace or in a quiet space until the pain has gone."

 

"I am going to lay down"

Kirsten Nabe-Nielsen believes that headache disorders such as migraine and frequent headaches are an overlooked epidemic.

 

"We are stuck with the idea of the character Maude from the Danish TV series Matador saying 'I am going to lay down' whenever she is a bit stressed," she says, explaining:

 

"Most people have experienced headaches. Therefore, it may be difficult to understand how debilitating migraine and frequent headaches may be for a colleague, friend or family member. People still have the notion that it will be sufficient to swallow a pill."

 

Kirsten Nabe-Nielsen believes that there is a lack of knowledge in the general population about the importance of headache disorders. The same applies to the fact that taking too many painkillers to soothe the headache may actually lead to more headaches.

 

"Some studies show that headaches are the second-most common cause of sick leave -- surpassed only by infectious diseases. Therefore, headache disorders carry large personal and socio-economic costs," says Kirsten Nabe-Nielsen.

 

Associated with depressive symptoms and muscular pain

The researchers have used self-reported information from more than 5,000 active Danes with different educational backgrounds -- from people with long academic educations to unskilled workers.

 

"It is new that we combine information about migraine and frequent headaches with the participants' use of painkillers and with their description of the ability to cope with seven different, specific requirements at work," says Kirsten Nabe-Nielsen.

 

The participants also answered questions about their health, depressive symptoms and pain in muscles and joints.

 

Here, the researchers found that depressive symptoms and pain in muscles and joints play an important role for the context between headache disorders and the ability to work.

 

"Our results indicate that the handling of depressive symptoms and pain in the musculoskeletal system may be an important factor in improving the ability to work among people with headache disorders," says Kirsten Nabe-Nielsen.

Previous studies support the finding that headaches, muscle and joint pain coincide with depressive symptoms.

 

Among other things, you may see mood changes, and neck pain may be a warning sign of a migraine attack, just as frequent headache attacks may affect the mood negatively.

 

Under- and overmedication

The researchers find the lowest ability to work in the group of headache sufferers who do not use painkillers at all and the group who use painkillers on a daily basis.

 

"This raises the question whether these two groups are undertreated and overtreated, respectively," says Kirsten Nabe-Nielsen.

 

According to Kirsten Nabe-Nielsen, it seems to indicate that the group taking painkillers on a daily basis may not receive a treatment that works as intended -- and they might even suffer from medication overuse headaches.

 

"On the other hand, when you look at the group who does not take medication at all, it seems to indicate that they are undermedicated. And maybe it has to do with the fact that they do not consider their illness to be severe enough to seek medical attention -- but that is just our guess," says Kirsten Nabe-Nielsen.

 

 

Facts: What are migraines and frequent headaches?

The two most common forms of headaches are migraine and tension headache.

 

Migraine is characterised by bouts of moderate or severe pulsating headache accompanied by nausea, vomiting and sensitivity to light and sound. Chronic migraine occurs more than 14 days a month.

 

Tension headache is characterised by mild to severe pain on both sides of the head. Nausea and vomiting are usually absent. Chronic headache occurs more than 14 days a month.

 

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Facts: Recommendations

Based on the study, and seen in the light of other research, the researchers are making two recommendations:

 

People with headaches should see their doctor for advice and possible medical treatment.

 

Managers and employees should discuss the possibilities for adapting work during attacks, in order to reduce absenteeism, such as the opportunity to work in a room with less noise or outdoors, the opportunity to perform less physically demanding tasks or the opportunity to perform tasks that are not emotionally or cognitively demanding.

 

We need to think about the handling of other pain disorders (e.g., neck-shoulder pain) and mental health in order to improve the overall health-related quality of life among people with headache disorders.

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Story Source:

Materials provided by University of Copenhagen - The Faculty of Health and Medical Sciences. Note: Content may be edited for style and length.

Relief for Migraines

Effective help is available for migraine sufferers

Summary:

Although it’s the third most prevalent illness in the world, migraine is widely misunderstood and frequently undiagnosed. Until quite recently a common “remedy” for migraine was to lie in a dark room and wait for the pain to pass. But today there are treatments that work – and new medications formulated specifically for migraine are in the pipeline.

The World Health Organization lists migraine -- the condition that produces recurring, severe, often-incapacitating headaches and other debilitating symptoms lasting from a few hours to a few days -- as the third most prevalent illness in the world, behind only tooth decay and tension-type headaches. More than 38 million Americans suffer from migraine, including approximately 28 million women, who are afflicted at a rate three times that of men. The nonprofit Migraine Research Foundation says health care and lost-productivity costs associated with migraine are estimated to be as high as $36 billion annually in this country.

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Despite those (and many other) daunting statistics, migraine is still widely misunderstood and frequently undiagnosed. And until quite recently the most commonly prescribed "remedy" for migraine was to lie in a dark room and wait for the pain to pass.

"It used to be that people with migraine were largely ignored and had to sequester themselves off someplace for hours or even days," said Juline Bryson, M.D., a neurologist and headache specialist at Wake Forest Baptist Medical Center. "But people who have migraine don't have to suffer. We have treatments that work, and even better ones are in the pipeline."

The first thing to realize about migraine, Bryson said, is that it's not just a bad headache. Rather, migraine is a complex neurological disorder that is genetic in nature.

"It's a strong hereditary trait," she said. "If one of your parents has migraine, there's a 50 percent chance you will, too. If both parents have it, there's a 75 percent chance."

In people who have this genetic predisposition to migraine the brain is abnormally sensitive to certain stimuli.

"When the brain is irritated it slows everything down, which is why people can't see clearly, feel clumsy, can't think straight, can't speak well, feel nauseous," Bryson explained. "Blood vessels get super-sensitive with increased blood flow, which causes throbbing pain.

"And the trigeminal nerve [the large nerve on both sides of the head that supplies sensations to the head and face and controls the muscles used in biting and chewing] flips out and sends all sorts of pain signals."

Not all migraine attacks are the same -- some, for example, are preceded by visual disturbances called aura -- nor are the triggers that initiate them.

And because migraine doesn't produce a visible sign like a bruise or rash and can't be detected by an X-ray or other imaging technique, doctors have to depend on patients' accounts of their episodes to know exactly what they're dealing with.

"We do rely on what patients tell us," Bryson said. "But people don't have very good recollections of their migraines. Some people think they have more headaches than they actually do, some fewer. So we tell a lot of patients to do a headache diary. When they keep a record of their migraines, when they occur, how bad they are, how often they last, what they did or consumed before they happened, we can get a much better idea of how to proceed."

Some of the factors than can trigger migraines or make them worse are common to most patients. These include fluctuations in estrogen levels in women, a drop in barometric pressure (as when a storm is approaching), anything that causes inflammation (such as a cold or any type of infection) and the overuse of over-the-counter medications and prescription opiates. Physical conditions such as obesity and sleep apnea also can contribute, as can lifestyle choices like smoking, drinking alcohol and eating foods high in preservatives and artificial sweeteners. But by no means does the list stop there.

"I could talk for hours about migraine triggers. There are probably as many triggers as there are patients," Bryson said, adding that some people have no clear triggers.

The prescription medications currently used to prevent migraine were all developed for other purposes. These blood pressure medicines, anti-seizure drugs and antidepressants have proven effective in reducing migraine. There's also onabotulinum toxin type A (Botox), which is approved as a preventive measure for people who have attacks more than 15 days a month. Medicines in a group called triptans can be taken at the onset of migraine attacks to lessen their effects.

"There are some good medications, but not everybody responds to them," Bryson said. "Fortunately, we have a whole new class of medications formulated specifically for migraine that are probably going to be released in the next year or two, which should change the face of migraine treatment strategies as we know them."

Those treatment strategies are not limited to drugs. Bryson and her colleagues in the headache program at Wake Forest Baptist take an integrative approach that can include sleep studies, psychological counseling, relaxation techniques, physical therapy, exercise and lifestyle changes.

Another member of the Wake Forest Baptist team, Rebecca Wells, M.D., is currently conducting a clinical study of stress reduction as a treatment for migraine.

"We don't just give somebody pills and send them on their way," Bryson said. "We look at a variety of factors and try to address them. It's my job to educate patients, to help them learn how to control their headaches, but they have to do their part."

However, no treatment program can totally eliminate migraine.

"Patients can do everything perfectly -- take their meds, lose weight, get enough sleep, stop drinking coffee, whatever -- and still get migraine, because it's genetic," Bryson said. "We'll never completely stop migraine headaches, but we can reduce them so people can be in control of their pain instead of their pain controlling them.

"Even if somebody has only one or two migraines a month, those hours with pain are lost to them, their families, their work, the enjoyment of their lives. Anyone who has migraine should see a doctor as soon as it interferes with their life. Period."

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Story Source:

Materials provided by Wake Forest Baptist Medical Center.