How to manage migraines at work

How to manage migraines at work

Imagine that you arrive at work, ready to begin a productive day. As you sit down at your desk, you feel a painful twinge behind your left eye and realize with dread that another excruciating migraine is on the way. What should you do first? Can you stop the attack? Should you stay at work or head home?

What to do when a migraine strikes at work

Steps you can take when a migraine strikes at work are:

  1. Take your medication as soon as possible so long as it is safe to do so

    Take your medication as soon as you sense the start of a migraine or it may not be as effective. Keep extra doses of your acute medication as well as a bottle of over the counter pain reliever in your work bag at all times.

    Safety Tip: It’s best not to take any new or sedating medications while at work.

  2. Find a quiet, dark place to sit

    If you are sensitive to light and/or sound, seek out a quiet, dark place to sit, such as a breakroom or vacant office, until the medication has had a chance to take effect.

  3. Assess your symptoms

    If your medication doesn’t stop the migraine attack, assess your symptoms. Here are some important questions to consider:

    • Are you experiencing cognitive symptoms? Many migraine sufferers not only experience painful headaches, but also symptoms such as trouble speaking, difficulty concentrating, or confusion. During a migraine, sufferers can have trouble coming up with words and understanding what people are saying.
    • Are you able to drive? If you are not able to drive home, and the attack is severe, consider asking a coworker or friend for a ride or using a ride service. Driving during a migraine attack can be dangerous.

    Safety Tip: Go to a trusted coworker or call a family member. Someone who knows you well can usually tell you whether you are cognitively compromised, even when you are not able to recognize it yourself.

  4. If you are able to tough it out, take action

    These are steps you can take to help make the rest of your work day less excruciating:

    • Turn off or dim the lights. Keep a lamp with a dimmer on your desk at work for use when you need to turn off the overhead lights.
    • Wear sunglasses or other light-filtering glasses, especially if you are working at a computer. Staring at the screen can make your symptoms worse. If you don’t have glasses available, try dimming the brightness of your monitor or working on a project that doesn’t involve a screen.
    • Know your triggers and migraine-helpers. For some people, caffeine is a migraine trigger. For others, caffeine actually improves their symptoms. If caffeine helps you, have an extra cup or two of coffee to curb an attack.
    • Lie down and rest when you get home. Migraines can last for days, so taking proper care of yourself is critical to give yourself the best chance for a faster recovery. Get some sleep, try ice packs, a warm shower, or meditation – whatever is helpful for you.

    Safety Tip: As most migraine sufferers know, it’s very important to know what does and does not work for you. Work is not a good place to experiment, so stick with the tried and true.

Migraine prevention at work

Steps you can take at work to help prevent a migraine are:

  1. Always have your migraine medications with you

    You never know when an attack may strike and taking your acute medication at the start of an attack is crucial.

  2. Reduce stress as much as possible

    Stress is one of the most common migraine triggers. Do what you can to minimize work stress by taking regular breaks, completing one task at a time, and taking a moment or two during the day to focus on your breathing.

  3. Assess your work environment

    Make your desk and work area as comfortable as possible.

    • Ergonomics – check your desk setup, including the height of your computer monitor. Eyestrain can trigger a migraine and something as small as the level of your monitor can make a difference.
    • Environment – If lighting, smells, noises or other environmental factors trigger migraine attacks, discuss possible solutions with your manager or human resource department.

Migraine prevention at home

Steps you can take at home to help prevent a migraine are:

  1. See a specialist

    To get the best treatment for your condition, see a specialist. Find a neurologist who focuses on treating patients with migraines and headaches, as he or she will be familiar with the latest treatment options. A specialist will also recognize that migraine is a neurological condition and should be treated as such.

    Safety tip: The suggestions in this article are not intended as medical advice. A neurologist can help devise an individual treatment plan for you.

  2. Know and avoid your triggers if possible

    Common triggers include hormonal changes in women, certain foods and food additives, stress, changes in sleep habits, and changes in the weather.Tracking your migraine attacks, associated symptoms, and other relevant data can help identify triggers, and even help prevent attacks in the future.

  3. Get enough quality sleep

    Studies indicate that poor quality sleep, not enough sleep, or too much sleep is a migraine trigger. It’s important to go to bed and wake up at the same time each day, even on weekends.

  4. Stay hydrated

    Dehydration is a common migraine trigger. Make sure you’re getting enough fluids by regularly sipping from a water bottle. If you don’t like plain water, try adding slices of fruit or cucumber, or enjoy juice, sports drinks, or flavored water instead. Foods such as fruit, soup, and smoothies will also boost your body’s hydration.


Deciding whether to let your boss and/or coworkers know about your condition can be a tough decision. On one hand, you are disclosing personal medical information. On the other, not disclosing your condition could hurt your career.

A former supervisor expressed her concern at the number of times I had been absent during a particularly stressful few months, most due to migraine attacks. When I did disclose that I suffer from chronic migraines, she was sympathetic and asked me to let her know about future attacks.

If you suspect your boss may not be so sympathetic, it may help to have your doctor write a letter confirming your diagnosis.

Educate yourself and others in your company about migraines. Here are a few facts to jumpstart the conversation:

  • Migraines are a neurological condition involving an array of symptoms. The underlying cause of migraine is still unknown, but current research suggests that nerve pathways and brain chemicals may be to blame.
  • Migraines affect approximately 14.7% of the population (about 1 in 7 people).
  • In the United States, the cost of migraine, factoring in both healthcare costs and lost productivity, has been estimated at around $36 billion per year and the medical cost of treating migraines in 2015 was more than $5.4 billion.

Finally, know your rights under the Americans with Disabilities Act, check your company’s policies on attendance and medical leave, and check with your Employee Assistance Program (EAP) if your company has one for additional services and assistance.

Living (and working) with chronic migraines is tough, but with some prevention, a plan, and good communication, you can lessen the impact of migraines on your job and your life.

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