Supporting employees with migraines

Information and guidance for employers on supporting employees who have migraines including legal obligations

Migraine is a common health condition with 1 in 5 women and around 1 in 15 men affected, usually beginning in early adulthood.

Migraine is more than just a headache. It is a condition with a wide variety of symptoms with the main feature being a painful, throbbing headache. Other symptoms may include​:

  • disturbed vision
  • sensitivity to light, noise and smell
  • feeling sick and vomiting
  • lack of energy

The symptoms vary from person to person, some experiencing migraine several times a week and others only occasionally. Sometimes there can be years between attacks. Therefore, when implementing support in the workplace, an understanding of the condition and the possible symptoms is useful.

There are different types of migraine, but the 3 main types are:

  • migraine with aura – where there are specific warning signs just before the migraine happens such as seeing flashing lights
  • migraine without aura – the most common type where the migraine happens without the specific warning signs
  • migraine aura without the headache – where you have specific warning signs but no headache

Migraine with aura is the rarer form and can also present with additional symptoms such as loss of balance, double vision and fainting.

The exact cause of migraines is unknown. It may be due to inflammation in the brain, or it may have a genetic link, as half of all people who experience migraines also have a close relative with the condition.

For those susceptible to migraine, there are certain triggers which are common. These include:

  • stress
  • delayed or irregular meals, dehydration, or specific foods
  • alcohol
  • caffeine
  • hormonal changes in females
  • tiredness, lack of sleep
  • surroundings, for example bright lights or flickering screens on computers

Treating migraines

There's no cure for migraines, but a number of treatments are available to help reduce the symptoms. These may include:

  • painkillers – including over-the-counter medicines
  • triptans – medicines that can help reverse the changes in the brain that may cause migraines
  • anti-emetics – medicines often used to help relieve people's feeling of sickness (nausea) or being sick
  • during an attack, many people find that sleeping or lying in a darkened room can also help

Preventing migraines

If your employee could have a specific trigger which is causing the migraines, such as stress or a certain type of food, avoiding this trigger may help reduce the risk of experiencing migraines.

It may also help to maintain a generally healthy lifestyle, including regular exercise, sleep and meals, as well as ensuring you stay well hydrated, and limiting your intake of caffeine and alcohol.

The GP may refer them to a migraine clinic and ask them to keep a diary of their symptoms and what they were doing prior to the migraine onset. This is to try and pinpoint specific triggers which would allow them to manage them. They may also use some anti-seizure medication which may also help reduce, or even prevent, the symptoms or occurrence of migraine.

How to support employees in the workplace

You may find employees with a diagnosis of migraine may have increased levels of sickness absence, or they may need to attend the hospital, their GP or their specialist more frequently than those without the health condition.

Authorised absence, outwith the normal organisation sickness absence triggers, should be considered an appropriate adjustment under the Equality Act 2010. This would be identified within your Supporting Staff Attendance policy.

If you feel your policy doesn’t include this, you can get support from our Supporting staff attendance pages.

Other areas that you can consider when supporting an employee with migraine may include:

  • if their work pattern exacerbates the health condition, such as shift work, early starts or full-time hours
  • does their medication have side effects that you need to consider when looking at their job role and their work rotas
  • does their working day allow them to eat regularly and hydrate regularly
  • if they have any triggers which the workplace setting may make worse
  • the nature of the work they do
    • is it physically demanding for them
    • is it psychologically demanding
    • can they be redeployed or their duties amended to allow them to continue to work
  • do they drive as part of their job role? If so, do they need to inform the DVLA and insurance company of their diagnosis?
  • consider a Display Screen Equipment (DSE) risk assessment if your employee uses a computer for their work. This would include if they use computerised tills or other work equipment that might cause flickering
  • consider if your employee became unwell during his working day and how it would affect them and their colleagues
  • encourage the employee to discuss possible signs, symptoms and emergency treatment with work colleagues and first aiders

Key sources of support

Key sources of support for both the employer and employee include:

Healthy Working Lives can help you to develop supportive and inclusive workplace policies and offer support both online and on the telephone. You can contact the free and confidential advice line on 0800 019 2211 for more advice.

COVID-19

Due to Coronavirus (COVID-19), there may be further support required for your employee who has a health condition due to migraine.

They may be in the category identified by the Scottish Government at very high risk of severe illness from COVID-19. To protect themselves, they have been issued with a letter informing them of shielding (external site) and what this means for them.

Within this shielding letter, there is lots of information on support for them. They can also use this to provide evidence to you as their employer that they cannot work outside their own home.

If they have not received a letter requesting them to follow shielding protocol, you may find that they still fall into a category of higher risk. This can be identified by the fact they get offered the flu vaccine by their GP. They do not need to accept this offer, but they need to have been classified by their GP as needing it because of their health condition.