Researchers at the University of Copenhagen, in Denmark, are looking into how migraines and tension headaches are impacting our ability to do productive work. The findings raise some interesting questions regarding how we think about and treat such conditions, and also point out that both workers and employers stand to benefit from better management of employees suffering from frequent headaches.

Both migraines and tension headaches can be debilitating experiences. People suffering from either become hyper-sensitive to outside stimuli, from a door slamming to a curtain being drawn. And, quite understandably, such situations make it near impossible for them to be productive, and virtually guarantees that the quality of their work will drop.

A migraine attack can last for up to 72 hours if untreated, and tension headaches can draw out for up to a week. Needless to say, overall, such events represent a huge drain on the overall productiveness of a workforce. In Denmark alone (with a population of 5.8 million), the authors explain, roughly 770,000 people suffer from migraine or frequent tension headaches. Their study is the first to focus on the effect these conditions have upon our ability to work.

A head full of trouble

“Migraine is the leading cause of functional impairment among people under the age of 50. And headaches have negative effects on sick leave and productivity. So, it would benefit workplaces to open their eyes to the untapped potential that you find here. Indeed, we cannot afford not to take it seriously,” says corresponding author of the study, Kirsten Nabe-Nielsen.

“It is especially the ability to remember, make quick decisions and do hard physical work that cause difficulties for people with these headache disorders.”

Migraines are bouts of moderate to severe, pulsating headaches, often accompanied by nausea, vomiting, and sensitivity to light and sound. Tension headache is characterized by mild to severe pain, on both sides of the head, but usually without nausea. Both are considered ‘chronic’ if they occur for more than 14 days a month.

Roughly 24% of women and 10% of the men in the Danish working population suffer from migraines or frequent tension headaches. How well these men and women can adapt to their tasks during headaches depends, largely, on their type of employment;

Those in academic positions will often have the luxury of going home a little earlier, working remotely, or postponing tasks that demand the most focus. Others, especially those working physical jobs such as cleaning or nursing staff, don’t often have this option. Instead, workers in these fields of employment may have to call in sick due to migraines or headaches. There is some evidence that headaches are the second-most common cause of sick leave, she explains, second only to infectious disease.

Managers and workers can however collaborate to find solutions that work for both parties and don’t force an ailing employee to give up an entire day of work. For example, the work schedule can be shifted around to allow the employee to postpone more difficult tasks for some that can be solved at a leisurely pace or in a quiet space until the pain has subsided.

She also believes that there are still many unknowns in the general public regarding the importance of headache disorders. For example, she explains that taking too many painkillers can actually lead to more headaches.

“Most people have experienced headaches. Therefore, it may be difficult to understand how debilitating migraine and frequent headaches may be for a colleague, friend or family member. People still have the notion that it will be sufficient to swallow a pill.”

For the study, the team used information about migraines and frequent headaches from literature and tracked the painkiller usage of over 5,000 Danish participants with different educational backgrounds. Participants also provided information about their health, depressive symptoms and pain in muscles and joints. They were also asked about their “ability to cope with seven different, specific requirements at work” to give researchers an accurate idea of their ability to perform professionally.

One of the key findings of the study was that depressive symptoms and pain in muscles or joints are associated with headache disorders and their ill effect on our ability to work. Handling these depressive symptoms and pain may therefore help reduce the symptoms of people with headache disorders and improve their ability to perform. These findings align with previous research that found a link between headaches, muscle and joint pain, and depressive symptoms.

These findings mean that feeling neck pain may be a warning sign of a migraine attack, just as frequent headache attacks may affect the mood negatively. Mood changes may also be indicative of an upcoming headache, the team adds.

The two groups in the study whose ability to work was most affected by migraines were participants who took no painkillers at all, and those who used them daily. This suggests that the two groups are under- and over-treated, respectively. The first is feeling the full debilitating effect of the pain, while the other is likely not receiving the correct medication and may even be suffering the symptoms of medication overuse.

“On the other hand, when you look at the group who does not take medication at all, it seems to indicate that they are undermedicated. And maybe it has to do with the fact that they do not consider their illness to be severe enough to seek medical attention — but that is just our guess,” says Kirsten Nabe-Nielsen.

Based on these findings, the team makes three recommendations. The first is that people take their headaches seriously and visit their doctor for advice and medical treatment, if needed. Secondly, employers should consider steps to adapt work during an employee’s headache attacks, which will reduce absenteeism. Thirdly, people with headache disorders should take steps to handle other types of pain disorders (such as neck-shoulder pain) and protect their mental health, to help prevent headaches as much as possible and protect their quality of life.

The paper “Demand-specific work ability among employees with migraine or frequent headache” has been published in the International Journal of Industrial Ergonomics.