Migraines, Work Productivity and Education Programmes

work

When you have a migraine, doing even small tasks like having a shower can be a seemingly insurmountable challenge, let alone getting any work done.

For those who suffer with migraines personally, and also those who employ people who suffer with them, the issue of how best to manage migraine attacks is a knotty one. You want to be boosting productivity, but also making sure that you’re looking after migraine sufferer(s) and doing all you can to help them.

There are ways both of these aims – of caring and of boosting productivity – can be done.

It’s been found that putting in place migraine education programmes can be hugely beneficial. One study found that by organising educational events such as lunch conferences and webinars, sending out email newsletters, and making available online materials covering topics like ‘communicating with your colleagues about migraine’ and ‘lifestyle changes that can mitigate symptoms’, resulted in an increase in productivity of between 29-36%. This was thanks to fewer days missed because of migraine attacks, fewer days worked with migraine attacks, and increased effectiveness on days which employees worked with migraine attacks. 

Naturally these education programs can be useful for employees and employers who are directly affected by migraines, but they can also help by working to dispel the myth that migraines are “just a bad headache” and in so doing dispel the stigma around migraines. This certainly needs doing as, according to one survey which involved almost 200,000 U.S. workers, only 22% thought that migraine is a serious enough condition to warrant staying home from work.

How to Relieve Migraine Nausea Without Medication

migraine nausea

Not everyone is able to, or happy to, take prescription medications or over-the-counter pharmaceutical remedies for migraine nausea. Some migraine sufferers also find that while it may take the edge off, the medications they have to relieve their migraine nausea isn’t effective enough on its own.

If this sounds relatable then the following nausea remedies may be of use.

Ginger

Doubtless you’ve heard of this one, but with good reason. Ginger has been used by people to help digestion and calm the stomach for hundreds of years.

It can be taken as supplements if you don’t like the taste, or else eaten or drunk in a variety of ways such as ginger tea or ginger beer (though when you’re feeling sick carbonated drinks aren’t so great), or eaten in biscuits. Dry ginger biscuits can be good to nibble on while you’re feeling queasy because they’re quite plain and they’ll help ensure that your blood sugar levels don’t drop too low thereby making your migraine attack worse.

Peppermint (or menthol)

Peppermint is another good one. Peppermint tea, whether hot or cold, could be good to sip throughout your bout of nausea. Alternatively, you might find that peppermint oil applied to the temples and forehead could help, or inhaling peppermint oil via an oil diffuser is another option.

Acupressure or acupuncture

Acupressure uses the same principles of acupuncture – stimulating key points across the body to bring pain relief – only without the needles and using pressure instead, which could make it more tempting if you’re not a fan of needles.

One small study involving 40 patients showed that those who received acupressure had notably less nausea with their migraines and less of a need for migraine anti-nausea medications than those who didn’t have the treatment.

All three of these treatments could be worth exploring if you suffer from migraine nausea because they have few to no side effects and can be used in conjunction with other medications. 

Spring, Hay Fever, and Migraines

hay fever and migraine

The coming of spring is much needed after the chill and dark days of winter, but despite the warmer weather and brighter days, for migraine sufferers it’s not all good news.

The arrival of spring can mean the coming of more migraine attacks. This is especially the case for migraine sufferers who suffer from pollen allergies. People who suffer from allergies are more likely to suffer from migraine attacks, and to experience them more frequently, than those who don’t have allergies.

Hay fever season starts in spring, and runs from late March through to September. Tree pollen is the first type released – from late March to mid-May, then grass – from mid-May through to July, and finally weed pollen – from the end of June through to September.

If you suffer from migraines and have an allergy to one of these types of pollen, you may well find your attacks are more intense and/or frequent during these peak times. Although how bad and how long the pollen season and ensuing migraines triggered by it are will be dependent on average temperature and rainfall. For example, a drier season reduces the amount of pollen produced. 

Doctors aren’t sure why allergy sufferers are more susceptible to migraines, but they do know that the nervous system, hormonal system, and immune system all play a part. One part of the problem may be that when you’re exposed to allergens and your immune system is triggered, certain chemicals are released which can fuel inflammation throughout the body, and in doing so trigger a migraine attack.

With this in mind, now is the time to make sure that you have enough of your anti-histamine hay fever medication ready to use. While anti-histamines won’t help with reducing migraine pain or symptoms, they can help by easing your allergy symptoms and so reduce the migraine-triggering impact of hay fever.

Migraine and Alice In Wonderland Syndrome

alice in wonderland syndrome

Alice in Wonderland syndrome (AIWS for short) is where objects, and even parts of the body, can appear to be much smaller or much bigger than they really are. These impressions of distorted size can last for many minutes, and sometimes longer. This is much as Alice found herself to be in Lewis Carroll’s books – hence the name. In fact, based on his diary entries, it has been hypothesized that Carroll himself suffered from migraines and may have experienced the sensory distortions which characterise the syndrome.

Although not actually a migraine syndrome, it’s worth talking about Alice in Wonderland syndrome here because so many of its symptoms are like those of a migraine aura. AIWS can also accompany migraines as one part of a migraine aura, or it can happen during the headache phase of a migraine attack, or even both. In a situation where no head pain is experienced, but other migraine symptoms and AIWS are, it may be part of what is commonly referred to as a “silent” migraine.

Although it was first described in 1952, and named in 1955 by the English psychiatrist John Todd, not that much is known about what causes AIWS, but it may stem from disruption to the parieto-occipital part of the brain. The parietal part of the brain is what deals with perception of space and the body, while the occipital area is what deals with vision.

This would tie in with why migraine auras might involve AIWS – since cortical spreading depression (CSD), which has been thought to cause migraine aura symptoms, moves through the brain during a migraine aura and disrupts different senses in turn and so resulting in symptoms such as seeing flashing lights and having difficulty speaking.

Migraines, Magnesium, and Pregnancy

magnesium and pregnancy

Pregnancies are rarely an easy walk-in-the-park kind of an affair whoever you may be, but when you suffer from migraines being pregnant can get even more complicated. Many of the migraine medications you normally take may suddenly become off limits as they’re not recommended for use during pregnancy. This is where things start to get complicated.

Well the good news is that many migraine sufferers find that their migraines decrease in frequency and intensity during pregnancy. Research has shown that between 50%-80% of women who had migraines before they were pregnant noticed a reduction in their migraine attacks during pregnancy, and especially so during the second and third trimesters.

That’s not all migraine sufferers though, and if you are one of the unlucky few who doesn’t see a positive change; or not enough of a reduction; or (please no!) a worsening of their migraines during pregnancy, what do you do? What can you do to manage your migraines without causing potential harm to your baby?

As well as discussing with your doctor which medications are suitable to take during pregnancy (paracetamol and, for the first 24 weeks of pregnancy, ibuprofen are common recommendations), you might find taking magnesium supplements to be beneficial.

There has been lots of research which has shown that people with migraines often have lower levels of magnesium than those who don’t have migraines and, linked to this, one study found that giving participants a regular intake of magnesium reduced the frequency of migraine attacks by an average of 41.6%.

Aside from migraine-related benefits, in terms of pregnancy-related benefits, research suggests that magnesium supplements may reduce some risk of additional complications such as foetal growth restriction.

It may not eliminate your migraine attacks completely, but even so given the research results, magnesium supplements could be beneficial for both mother and baby.

How to Find Migraine Triggers With An Elimination Diet

elimination diet

We all know the saying you are what you eat. Well, while it might not be quite that simple (thankfully!), there is an element of truth to it.

This link between your diet and your health is one which some migraine sufferers know only too well. Certain foods such as chocolate, cured meats, and caffeinated drinks are all commonly cited as migraine triggers, but it can be even more complicated than that.

As all migraine sufferers are different, so are their triggers, and identifying what could be helping to trigger a migraine attack is not easy for this reason. It’s an important thing to do however, as prevention in the case of migraines is far better than trying to relieve the pain of a migraine once one has struck.

Perhaps the most effective way to identify which food(s) may be triggering your attacks is to do an elimination diet. This is where you remove any foods which you suspect may be triggering your attacks or worsening your symptoms, and then reintroduce these foods at a later date, one food group at a time, to see if your attacks are worse following the introduction. If they are, it’s a fair assumption that the food you reintroduced is a trigger.

The first part of an elimination diet is the 2-3 weeks during which you cut out all possible trigger foods. If your migraine symptoms improve, it’s a safe assumption to make that one or more of those foods was helping to trigger your migraines.

The next phase is to reintroduce a food or food group (citrus fruits may be an example of a food group which is reintroduced as opposed to an individual food). This reintroduction should be done over 2-3 days, and any attacks or symptoms which are experienced during this time carefully recorded. If reintroducing a food doesn’t trigger an attack, it’s likely that that food will be safe for you to eat. If it triggers an attack, you may need to cut it out of your diet.

Normally an elimination diet lasts a total of between 5 and 6 weeks, and should only be done under the supervision of a health professional such as a doctor or dietitian – since such diets increase the risk of a nutritional deficiency if the diet is not followed correctly.

Motion Sickness and Migraine Nausea

motion sickness

Nausea and vomiting are both common symptoms of migraine. In fact, between 50% to 60% of migraine sufferers vomit during an attack, and between 60% and 95% of migraine sufferers experience nausea. Although this statistic does vary depending on which study you read, it is certainly generally accepted that nausea and vomiting are common migraine symptoms, and a symptom which you are more likely to suffer from if you also experience motion sickness.

Motion sickness happens when messages from the inner ear and from the eyes are in conflict with one another. If the inner ear detects one degree of motion, and the eyes detect an even slightly different degree of motion, then motion sickness can occur. Often this happens when travelling on a boat, in a car, or while in other forms of transport. However, it can also occur when there is motion in your visual surroundings while you’re stood still.

Scientists aren’t clear exactly why there is a link between suffering from migraines and from motion sickness, but there is a theory.

Many drugs which are used to treat motion sickness work by increasing levels of the hormone serotonin in the brain. Research has also suggested that having low levels of serotonin may make you more likely to suffer from migraines. Perhaps this low level of serotonin is one reason why migraine sufferers often suffer with nausea.

If you find that you suffer from motion sickness, from migraines, and also from nausea during migraine attacks, then that combination will make a difference to what kind of medication you might want to take in order to treat the nausea. Motion sickness medications are generally more effective for treating migraine nausea than over-the-counter treatments which are used for gastrointestinal issues.

Migraines and Dizziness

Although head pain is typically what people think of when they think of migraines, it’s certainly not the only migraine symptom.

dizziness

Another common migraine symptom which many sufferers experience is dizziness or vertigo. In cases where dizziness or balance problems are the main migraine symptom the migraines are called vestibular migraine or migrainous vertigo.

Vestibular migraine sufferers may experience dizziness, imbalance, vertigo (feeling as though the world is moving), and sensitivity to movement – not only just before or during the migraine attack, but for some the dizziness and balance issues can be experienced during headache-free periods.

In terms of triggers, as is the case with other types of migraine, vestibular migraines can be triggered or made worse by certain types of food, by stress, and by certain activities such as intense exercise.

Treatment varies for vestibular migraines, but in general drugs to relieve and/or to prevent the symptoms of headache, nausea, dizziness or vertigo may be prescribed, but another treatment option for vestibular migraine sufferers is physiotherapy.

For some vestibular migraine sufferers, physiotherapy exercises can help to relieve balance symptoms – although if the migraines are very frequent these exercises can make the symptoms worse so timing of the physiotherapy exercise is key. 

A diagnosis of vestibular migraines is made via reporting of symptoms as there is no test which can be conducted to confirm migraines. However, your doctor may ask for some tests to be conducted in order to rule out other potential causes of the head pain and dizziness.

Lockdown, Screen Time and Migraines – How To Limit The Impact

In the current situation with people being advised to work from home where possible and socialising mainly taking place via the likes of Zoom, time away from the screen is getting less and less – which is a problem if you suffer from migraines.

screen time

Too much screen time can strain your eyes, raise your stress levels, but most importantly, help to trigger a migraine attack. But what can you do? Most work that people are doing is now via a computer screen, and unless you want to become completely cut off from the outside world, chances are you’re going to be spending some time on Zoom staying in contact with friends and family.  

There are things you can do to limit the effect which all this extra screen time is having on you and your migraines though.

Screen filters

If you haven’t already, try and get hold of a screen filter that you can put on your computer screen which will block the blue wavelengths. Blue light can mess with your circadian rhythm and aggravate light sensitivity, even in migraine patients who are blind. So blocking out these blue wavelengths should help you. Alternatively, or additionally, software called F.lux is a blue light exposure protection app which is available as a free download for Windows.

Space out your screen time

Or, at least, try and spread it out if you can. If you’re part-time, talk to your boss about spacing out your time with flexible hours, perhaps across a greater number of days, so that you don’t have to be online for such a long uninterrupted period. Taking breaks will help so take them if you can.

Turn off your video

When you’re on a Zoom call, use the option to be audio only and turn away from the screen. Maybe not always (you’ll want to see the faces of your friends and family from time to time!). 

Find screen-free fun

Netflix is tempting, but if you’ve spent all day on a screen, finding something to do that you enjoy that doesn’t involve a screen will help. Audiobooks are one suggestion, or colouring (which some people find relaxing – so could help reduce the migraine trigger of stress), or puzzle books – essentially something which won’t strain your eyes any further and will help you to wind down.   

Be honest and look after yourself Tell people why you can’t make every Zoom meeting they plan (yes, even when you’re stuck at home with no prior engagements) and don’t just try and battle through it. Explain to them that it’s important for your health not to go over a certain number of hours of screen time in a day. Your health has to come first. 

Is It A Covid Headache Or A Migraine?

It would be an understatement to say that we’re all a bit on edge about coronavirus. Any slight tickle at the back of the throat can leave us wondering if it might be the first sign of an infection. What with headache being a potential symptom of COVID-19, is it any surprise that every migraine attack leaves us stressed and questioning if we’ve caught it.

covid

The symptoms of a headache caused by COVID-19:

  • Is moderate to severe in intensity
  • Has a pulsing or pressing pain
  • Is felt on both sides of the head (rather than migraine which is often (but not always) felt on one side)
  • Is difficult to alleviate with over-the-counter medications like ibruprofen
  • Generally happens early on in the infection (probably not a comfort but worth noting)

Better news is that people with a history of migraines have reported differences between COVID-19 headaches and their usual migraine attacks.

Most notably perhaps, a COVID-19 headache does not occur alongside other typical migraine symptoms such as nausea, vomiting, or sensitivity to light and sound. Similarly, COVID-19 headaches have not yet been reported to be preceded by aura – unlike migraines. So if you have visual disturbances, feelings of vertigo, and other aura symptoms, you can be pretty sure that it’s probably nothing to do with COVID-19.

A COVID-19 headache is also not likely to response to medications which are used to treat acute migraine pain. Essentially, if it feels like your normal migraine, and it reacts to your medication as your normal migraine would, it’s probably not COVID-19 related.

If you do contract COVID-19, it has been recommended that if you are in the midst of an active infection then you should be wary of using aspirin, ibuprofen, naproxen and other NSAIDS. Paracetamol, triptan medications, and usual preventative medications have been deemed to be safe however.

Some final good news to do with migraines and coronavirus: suffering from migraines does not increase your likelihood of contracting COVID-19, so that’s something.