Chronic migraine, adapting your work environment

Feb 18, 2023

Classified as the 2 nd most disabling global disease by the WHO and the 1 st for the population aged 18-50, migraine represents a major socio-economic impact both for the individuals affected and for companies. However, adjustments are still possible to limit these various repercussions.

Understanding Chronic Migraine

Migraine is a neurological disease that affects 15 to 20% of the world population (INSERM) and more frequently women (3 women for 1 man) . Causing sometimes extreme pain, migraine is a chronic disease characterized by repeated attacks of headaches, induced by increased neuronal excitability - due to genetic and/or environmental factors. Migraine is considered a chronic disease when attacks occur frequently, that is to say more than 15 days per month for at least 3 months and after exclusion of all other pathologies by the medical profession. To date, there is no cure for migraine. The management of the disease is based on the treatment of the attacks , associated or not with a background treatment, with relief activities, but also with the eviction of the modifiable triggering factors.

Modern work environment: a source of triggering factors

People with migraine suffer from hypersensitivity to internal and/or external variations. These can be emotional, environmental, hormonal, climatic, sensory variations, etc. We talk about "triggering factors" of migraine attacks. These vary between individuals and over the course of their lives. Open space, artificial light, screen work, ambient noise, stress, air freshener, excessive heating, etc. evoke modern work environments, but also many triggering factors for migraine sufferers. Companies cannot discriminate against an employee because of his illness. To do this, they must – as far as possible – support employees suffering from chronic migraines to promote a better balance between their illness and their professional life. This approach requires the establishment of structured exchanges between the employee and the management of the company. From this communication may emerge solutions for adapting the work environment, etc. for better management of the disease and its symptoms – for the benefit of both parties.

Strategies for improving working conditions

All migraine attacks begin with triggers , some of which can be "controlled" or at least be limited. Because working conditions can play a role in the occurrence of crises, the company – depending on the position occupied – can put in place reasonable and specific arrangements to exclude a certain number of these factors and thus promote the reduction of crises. These arrangements may vary depending on the people affected, hence the importance of constructive communication between employee and management. These arrangements are numerous, but do not necessarily require costly investments for the employer. Some examples of simple actions / possible arrangements (non-exhaustive list):

- Heat reasonably and ventilate often

Overheated and unventilated space are common triggers. Also, for everyone's well-being, do not neglect to maintain a reasonable and constant temperature in the offices and their regular ventilation.

- Limit sources of noise and odors

Favor a somewhat isolated office for the employee as far as possible or, in the context of an open-space, install noise-reducing panels and/or provide noise-reducing headphones. Also limit room fragrances and, in general, strong odors.

- Promote natural lighting and limit the brightness of screens

Artificial light is very aggressive for migraine sufferers and is a factor favoring the onset of attacks. For this, it is recommended to work with natural light, to favor deferred lighting, to install a filter on the work screens (anti-reflective and anti-blue light) and to prefer the dark themes of the different applications used.

- Allow regular and appropriate breaks

Regular breaks will allow the employee to rest, have a snack and/or get some fresh air in order to better manage his symptoms. In general, it is recommended to stop every hour or 2 hours and to associate it with an ocular pause (by looking 1 min in the distance and then, 1 min by pressing on his eyes).

- Think about the ergonomics of equipment

Muscle tension is also a factor favoring the onset of migraines. To reduce tension in the neck and trapezius muscles, do not neglect the ergonomics of the workstation: a seat with armrest and headrest is preferable, the position of the screen must limit the rotation of the head as much as possible as well as flexion or extension of the neck. The mouse arm must be able to be released. Also, a support to raise the feet can be useful to limit tension in the pelvis and lumbar spine.

- Facilitate the organization of working time

Teleworking or flexible working hours will allow the employee to better plan his working days and offer better conditions for managing his symptoms and his professional objectives while avoiding stressful situations as much as possible.

- Set up a rest room

This room must be dark and quiet to allow the employee to rest if necessary or to isolate themselves in the event of a crisis and/or while their treatments are taking effect.

An understanding of the professional environment to be developed

Beyond the real physical suffering of people with migraine, they also suffer from frequent skepticism on the part of their colleagues, which affects professional relations while accentuating the patient's distress. Although migraine was identified as early as the 19th century, this neurological disease is subject to major societal ignorance. For Esther Lardreau, associate professor of philosophy (“Migraine, biography of a disease”), this disease is conceived as a pretext since it does not put life in danger. However, migraine goes beyond a simple headache. Chronic, it has a lasting impact on the life of the patient and pushes some to deep depressive disorders (and not the reverse). To support migraine sufferers and limit tensions within teams, awareness-raising actions are possible, even essential. Organizing information sessions on migraine, encouraging people with migraines to testify, to talk about their illness… in short, communication remains essential to limit misunderstandings and promote optimal working conditions for everyone. Support its employees in the management of their pathology, work to improve work environments, etc. has a direct impact on the image and health of the company. Do not neglect them.

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