Businesses must handle headache of migraine’s impact on workplace productivity
Lifestyle changes and suitable medication can help migraine sufferers manage symptoms and regain control of their lives
Migraine is recognised as one of the world’s most prevalent diseases and, according to the Global Burden of Disease study in 2019, ranks second among causes of disability around the globe.
Sufferers of this neurological disorder experience headaches that cause intense, throbbing pain, often on one side of the head, which can be accompanied by fatigue, nausea, vomiting, and sensitivity to light and sound. These symptoms, which can last for hours or even days, have an impact on people’s lives, jobs – even the wider economy.
However, many sufferers are slow to seek medical advice or remain unaware of the different available treatments, and may think they are simply prone to “bad headaches” or feeling the side effects of some other physical ailment.
For that reason, a major initiative has been launched in Hong Kong to increase awareness of migraine and ways to mitigate its impact. It aims to encourage greater understanding and action to help sufferers prevent the start of a migraine or lessen the frequency through having appropriate medication when needed and making changes in their lifestyle, diet and daily routine.
“Migraine is a complex headache disorder which affects blood vessels and pain pathways in the brain,” Dr Yannie Soo, a specialist in neurology in Hong Kong, says. “The exact cause is not known, but there is a genetic component to it. There are usually some stimulants which start a cascade of abnormal signals.
“It can be an internal or environmental stimulus that first causes some blood vessels in the brain to dilate. That causes the release of chemicals that give rise to pain signals in the head, and sometimes around the eyes as well.”
About one-third of patients suffer warning symptoms hours or minutes in advance, such as the appearance of flashing lights in their eyes, blind spots and difficulty speaking. For those with chronic migraine, the headaches can recur many times a month or almost daily.
“This disabling disease typically affects people of working age from 20 to 50, but children and teenagers can be affected as well,” Soo says. “It can occur anytime and anywhere, which presents a challenge for careers and interferes with daily social life.
“Many people think they just have a headache which can be cured with rest or over-the-counter painkillers, but that is a misconception. This is a neurological disorder with a high tendency to recur, and there are effective interventions and lifestyle modifications which can prevent these painful episodes and let sufferers gain control of their lives.”
Research shows stress is often a trigger, with one in five women of working age susceptible to migraine, as opposed to one in 15 men, Soo says, something generally linked to hormonal differences and a woman’s menstrual cycle. Lack of sleep has been identified as an important factor in more than 60 per cent of cases.
However, timely diagnosis of the condition and individualised decisions about treatment, diet, exercise and self-management can lessen the frequency and mitigate the severity.
“We usually start with simple analgesics, but can move on to other pharmacological therapies,” Soo says. “We also aim to identify specific triggers, which vary among individuals, including cheese, chocolate, coffee or MSG [flavour enhancer monosodium glutamate], menstrual cycle, prolonged sun exposure, loud noise and the pattern of attacks, so patients can take preventive action and have pain-relieving drugs on hand.”
Jolene Watt, a Hong Kong-based business owner, writer and mother of two, first experienced migraine as a 19-year-old student in Canada. Ever since, she has conscientiously followed medical advice and made recommended modifications to her lifestyle and daily routine.
Initially she assumed her chronic headaches were linked to poor eyesight.
“I went home one weekend and had to lie down,” Watt says. “I could hear the sound of water trickling through the pipes and it drove me nuts. Then my mother came in and flicked on the TV; the light from it made me want to throw up. Later, I went to see a doctor, listed the symptoms and he diagnosed migraine and suggested tablets.”
Watt then began to make changes. One was to be alert to the warning signs – tense shoulders, stress around exam times and the pressure of work deadlines – and to realise if an attack came, that day was a write-off.
She made more time for yoga, meditation, mindfulness and self-care each week and watched her diet very closely, and started taking vitamin B. She also committed to regular exercise including tennis, boot camp sessions, and controlled breathing to help the body’s parasympathetic nervous system, responsible for stimulation of “rest and digest” activities, work better.
“I learned to slow down and relax more, and make sure tablets are in my bag all the time,” Watt says. “I’m more inclined to know my limits, and I’ve found that working from home with flexible hours really helps.”
She also suggests employers should be more aware of the causes of migraine and how it affects individuals, and offer regular talks about symptoms, prevention, treatment and stress management, with extra “wellness days” granted for those who need them.
Several studies have highlighted the need to raise awareness of migraines. One multinational study, led by a doctor at Norway’s Sandvika Neurologic Service, examined the impact of migraine on the work, family and leisure activities of 1,810 young women aged 18 to 35. The 2004 research found that, over a six-month period, 46 per cent missed a day of work or school owing to migraines, with 74 per cent unable to fully function because of an attack.
Another study, carried out in Taiwan in 2008, which looked at the migraine-related economic impact on job productivity of 3,377 Taipei workers over the previous 12 months, found sufferers missed an average of two workdays a year. The report, published by the Neurological Institute at Taipei Veterans General Hospital, estimated that across Taiwan there were 1.7 million migraine sufferers, which equated to 3.7 million missed workdays at a cost of NT$4.6 billion (US$145 million) a year.
A comparative calculation for Hong Kong showed such an annual loss through missed workdays could exceed HK$4 billion (US$515 million).
Other international studies have found similar impacts of migraine on people’s lives and work, highlighting the need for understanding and awareness in today’s fast-paced workplaces.
The latest initiative in Hong Kong is a welcome move, which will help to reinforce the message that migraine is manageable. By consulting medical professionals on proper treatments and making a few careful changes to their lifestyle and daily routines, millions of people around the world who are prone to attacks can go a long way to preventing the onset and regaining control of their lives.
PP-UNP-HKG-0252 SEP 2024