Migraine causes many people not only physical but financial pain. Treatment costs money, of course. But the hidden price people with migraine pay often comes when they’re unable to work during an attack.

Work-related stress may trigger a migraine attack. This can lead to a greater financial burden from the condition, which in turn increases stress.

Fortunately, strategies exist that can help people with migraine and employers reduce the cost of migraine on productivity and income.

Migraine most commonly affects people who are 18 to 55 years old. This is also often the period of time when people have their most productive years of work. This can have a profound impact on your work productivity.

“People with migraine often try to work through an attack, resulting in underperformance,” says Paula Dumas, president of the World Health Education Foundation and chair of the steering committee for Migraine at Work, which helps employees and employers cope with workplace migraine issues.

According to the Migraine Research Foundation, 90 percent of people with migraine say they cannot function normally at work during an attack. In fact, migraine is the second most common cause of lost work days. The foundation estimates 157 million workdays are lost each year to migraine.

A 2018 report by the Integrated Benefits Institute compared employees who have migraine with those who don’t. It found that employees with migraine:

  • incurred on average $2,000 more in healthcare costs
  • took an average of 2.2 more sick days each year
  • lost nearly $600 in wages and benefits due to migraine

And a 2018 study estimated that people with migraine missed an average of 8.9 more days of work than people who don’t have migraine. Researchers concluded that for employees with migraine, employers paid $8,924 more per year in:

  • absenteeism
  • healthcare spending
  • short- and long-term disability

Because it impairs a person’s ability to work, migraine can also increase the risk of job loss. A 2013 study suggests that migraine is more common among people with lower incomes.

The economic impact of migraine is especially high among people who have chronic migraine rather than episodic migraine.

People who have chronic migraine have a 3.63 times greater rate of disability days per month than those with episodic migraine, according to a 2014 study.

The constellation of disabling symptoms that can occur during a migraine attack make it difficult and sometimes impossible or unsafe to work, says Dumas.

“Intense head pain and brain fog can make it difficult to concentrate,” she says. “Visual auras and dizziness make it dangerous to drive or operate machinery. Nausea and vomiting obviously take people away from their workstations.”

While workers with other illnesses can sometimes cope by working at home, many folks with migraine can’t sit in front of a screen during an episode.

“The lights from monitors, computers, and projectors are common migraine triggers,” Dumas explains.

Lower-income households tend to have higher rates of migraine, according to some 2013 research. Having migraine makes it harder to find and keep consistent work.

But the financial stress of having a lower income may also increase the likelihood of migraine. This creates a cycle where migraine makes it challenging to climb the financial ladder.

People who have migraine and work freelance can also be affected economically.

Heather Roberts owned a public relations firm and a magazine until she began having migraine attacks.

“I was incapacitated for weeks on end and over time neglecting the businesses had unfortunate repercussions,” Roberts explains. “I wasn’t able to keep at the production level needed to grow or even maintain the businesses, and as such [needed] to shut them down.”

Migraine episodes can occur without any trigger at all, even when you’re doing everything possible to prevent them.

However, many people do find their migraine attacks are linked to triggers such as:

  • stress
  • sleep deprivation
  • menstruation
  • certain foods
  • odors
  • loud noises

Among these triggers, stress is the most common, according to the American Migraine Foundation: Nearly 70 percent of people with migraine say that stress triggers migraine episodes. Between 50 and 70 percent say their daily stress levels and their migraine activity are linked.

It doesn’t help that 80 percent of U.S. workers say their job is stressful and that half say they need help learning to manage work stress, according to the American Institute of Stress. That’s a formula for stress-related migraine at work.

A 2017 study by the Brookings Institute found that 70 percent of U.S. jobs require medium to high levels of computer skills, with a growing amount of computer use among most employees in all types of jobs.

Another of the most common triggers for migraine is bright light, including the type of flickering light emitted by a computer monitor.

Experts recommend a number of techniques to manage workplace stress:

  • biofeedback
  • relaxation therapy
  • meditation
  • exercise
  • getting enough quality sleep

Some people with migraine may qualify for workplace accommodations under the Americans with Disabilities Act (ADA) to reduce migraine symptoms.

Even if your migraine doesn’t qualify as an ADA disability, your employer may still be open to making changes to reduce your migraine episodes and increase your productivity.

“Disease education and simple accommodations are far less expensive ways to boost productivity and reduce healthcare costs,” Dumas says.

Such accommodations could include:

  • lighting adjustments
  • noise reduction or quiet rooms
  • teleworking
  • flexible work schedules
  • light filters for overhead or desk lights
  • anti-glare filters for computer monitors
  • a white noise machine or headphones
  • air purification systems
  • a fragrance-free work policy (smell can be another migraine trigger)
  • a chair that supports good posture
  • a choice of workspace

If you feel comfortable doing so, disclosing your migraine history to co-workers may also encourage understanding and compassion about the condition and its symptoms.

Migraine can cost workers in terms of income and productivity. Migraine symptoms like pain, brain fog, dizziness, and nausea can make it difficult to work.

Work-related stress and hours of daily screen time can also trigger migraine episodes. Taking steps to reduce stress and screen time along with workplace accommodations can help minimize the cost of debilitating migraine episodes.