Giving migraine its place at work

An upcoming conference aims to highlight the difference between migraines and headaches, particularly in the workplace

THERE ARE few reasons for taking sick leave that arouse more suspicion than migraine which is synonymous in most people’s minds with having a headache.

A UK survey three years ago of more than 2,100 respondents confirmed what has always been suspected – that faking a migraine is the most common excuse for workers taking a “sickie” when they are well enough to work.

Migraine is easy to fake because they are ostensibly no external symptoms.

Such excuses make it hard for the people who genuinely have migraine to be believed.

The same survey, which was carried out by YouGov, found 28 per cent of those who genuinely had migraine worried that they would not be believed and 21 per cent felt colleagues would judge them as having made an excuse to take a day off.

Recognising the difference between genuine sufferers and those who are faking it will be the subject of the first national conference of migraine at work which will be hosted by the Migraine Association of Ireland (MAI) next week.

It will be open to employers, managers, occupational health staff, health and safety/disability and quality officers, trade union officials and employees.

Migraine is a huge problem in most developed countries. The MAI estimates that it affects 500,000 people a year in Ireland at various stages, but it is not well understood. Most people confuse the terms headache and migraine as if they were same, but they are different, in the same way that the common cold and influenza are different.

According to Esther Tomkins, a specialist nurse at Beaumont Hospital, there is a recognised diagnosis of migraine from the International Headache Society which extends to symptoms other than just a severe headache.

These include sensitivity to light, sound and smell, and vomiting along with severe headaches. Some patients get migraine with aura, which can have focal-neurological signs such as visual disturbance, numbness down one side of the body, in the face and the hands and the odd time in the legs.

“The patients who have migraine will fit into that diagnostic criteria. It is very easy to diagnose once the patient is telling you the symptoms,” Tomkins explains.

“It’s actually very easy. Some people say they have a migraine when they actually have a headache and they are completely different.”

The causes of migraine are myriad. The capacity for a brain to develop migraine is always there, but it is the trigger factor that turns them into an illness.

Those triggers include stress, bad diet, lack of exercise, lack of sleep, the hormone cycle, especially for women, and alcohol, caffeine and tobacco.

In a large number of cases there are genetic and/or physical factors which can be picked up by brain scanners. Migraine can morph from being an acute condition to a chronic illness.

“Usually the patient will identify with the triggers themselves. Very often it is a combination of triggers such as stress and lack of sleep,” she says.

MAI information officer Donna Ryan says there can be symptoms of migraine that are obvious which can help distinguish between those workers who really have it and those who are faking it.

These include sensitivity to light or sound and nausea. Migraine with aura can be distinguished with its sufferers having trouble articulating their words because of the pain.

“There can be obvious visual symptoms, but there are those who have severe headaches, who feel sick and unable to function and they have no way of telling and that is why it is used as an excuse,” she says.

The MAI says that migraine is not only an economic issue, but that poor management of the condition can also negatively impact on an employee’s mental wellbeing.

Since the recession, the association has seen an increase in calls from employees with migraine who feel vulnerable and stigmatised in their workplaces.

“The unseen nature of migraine means that the condition is often overlooked by employers and used as an excuse for taking a sick day by non-sufferers,” says Ryan.

“However, migraine is classified by the World Health Organisation as one of the top 20 leading causes of disability worldwide – ahead of conditions like psychosis, dementia and quadriplegia.”

The figures:The Migraine Association of Ireland estimates that migraine affects 500,000 people a year in Ireland at various stages, but it is not well understood

The conference will feature a line-up of key personnel in the area of workplace disability, including Esther Tomkins, a specialist nurse; Dr Tom Donnelly, occupational health physician with the civil service; and Dr Caoimhin MacMaolain, director of law research at Trinity College Dublin.

The event takes place at the Ashling Hotel, Dublin on Thursday, April 14th from 10am. Booking is essential, call 1850 200 378 or email info@migraine.ie