Migraine at work: practical tips for employees

Migraine at work is common: about 10 million people in the UK live with migraine, many of them of working age. Whether you can keep working during an attack depends on how severe it is, how well your medication works and what your job involves. Open communication, reasonable adjustments and fast-acting treatment can make a real difference.

Can you work with a migraine?

Working through a migraine attack is often hard and not always possible. With milder attacks and medication that works well, you may be able to carry on, but this differs from attack to attack and from person to person. In more severe attacks, where more areas of the brain are involved, carrying on is often much harder. Effective acute medication can help, but much depends on the work you do.

Some tasks, such as driving or operating dangerous machinery, are not advisable during an attack. With many other tasks you are more likely to make mistakes, so it is reasonable to step back until the attack has passed.

Should you tell your employer about your migraine?

You do not have to, but it often helps. Letting your employer know that you have migraine gives you the chance to discuss what you need and which changes would help you work well, both during and between attacks. If your workplace has an occupational health service, you can ask for a referral. Occupational health can advise you and your employer on adjustments that suit your role.

What reasonable adjustments can you ask for?

Under the Equality Act 2010, migraine can count as a disability if it has a substantial and long-term effect on your ability to carry out normal day-to-day activities. If it does, your employer has a duty to make reasonable adjustments. Even if it does not, many employers are willing to help. Adjustments people with migraine often find useful include:

• flexible working hours, or starting later after a bad night
• the option to work from home on difficult days
• a quieter workspace, away from strong smells and noise
• changes to lighting, such as avoiding flickering lights, or an anti-glare screen
• regular screen breaks
• a quiet place to rest when an attack starts
• time off for medical appointments

Do you need a fit note for migraine?

If you are off sick for 7 days or fewer, you can usually self-certify. If you are off for more than 7 days in a row, your employer can ask for a fit note, which your GP can provide. A fit note can also say that you may be fit for work with some changes, such as altered hours or duties, which can support a conversation about adjustments.

What should you do when a migraine attack starts at work?

1. Take your acute medication early. Fast-acting triptans work best when taken as soon as the headache starts, while the pain is still mild.
2. Find a quiet place to rest. Light and noise can make the pain worse, so reduce them where you can.
3. Let your manager or colleagues know. When they understand your situation, they can give you the space you need.
4. Do not drive while you have symptoms. Arrange another way home if you need to leave.

Can breaks and relaxation help?

Some people find that regular breaks help to reduce tension in the body during a busy working day. Relaxation exercises, a short walk or simply stepping away from the screen can also help. Migraine is not your fault, and these steps are tools rather than duties: what works differs from person to person.

How can The Migraine Clinic help?

We believe a personal approach is the key to effective migraine treatment. Our migraine specialists see you by video, so you do not have to take time off to travel to an appointment. Together you look at the right acute medication and, if you have frequent attacks, preventive treatment to reduce how often they happen.

Want to know whether your headaches are migraine? Take our migraine test, read about our treatment, or see how to start.