While migraine is a complex neurological condition that can significantly impact patients’ quality of life and ability to work, it’s also poorly understood and often accompanied by the weight of stigma, said Elizabeth Leroux, faculty lecturer at McGill University, during a session sponsored by Lundbeck at Benefits Canada’s 2024 Healthy Outcomes Conference.

One in 10 Canadians — and up to a quarter of women — live with migraine. The World Health Organization recognizes it as the most prevalent neurological disorder worldwide and the leading cause of disability in adults younger than 50 years old.

Most people suffering from migraine have fewer than four attacks per month, a smaller subset of patients has frequent episodic migraines and roughly one in 10 live with chronic migraines that impact them at least 15 times per month. Symptoms can include nausea and vomiting, neck pain and brain fog.

Read: Migraines an underestimated, disabling and treatable condition, says medical expert

In addition, migraine is also associated with numerous other conditions, including anxiety disorders and depression, hypertension, chronic pain, arthritis, allergies, sleep apnea and more.

According to a Canadian study of 287 migraine sufferers, 61 per cent missed work due to their condition and experienced lower productivity, 15 per cent were unemployed, 13 per cent had gone on short-term disability and 16 per cent on long-term disability. The study put the mean annual direct and indirect cost of migraines per person at between $15,651 and $25,669 depending on migraine frequency.

There isn’t one specific cause for the condition. More than 40 genes are associated with migraine and people who experience them are more sensitive to sensory inputs such as bright lights, scents and loud noises, as well as other triggers such as stress, poor sleep, alcohol and weather changes.

Despite how common it is, migraine is often incorrectly perceived as a mere headache that someone should be able to work through or get over quickly, said Leroux.

Migraine patients overwhelmingly feel their co-workers don’t understand what they’re going through, according to a Migraine Canada survey. And the more severe a patient’s migraine, the less likely they were to feel understood.

Read: How employers can better address migraines

Many adjustments can be made within the workplace to support migraine sufferers, such as no-scent policies, screen filters, noise protection, lighting changes, access to a room for rest and the ability to make workstation adaptations. Aside from physical workspace changes, schedule flexibility and telework options are important, noted Leroux.

In Japan, Fujitsu worked with the Japanese Headache Society to survey employees, finding 17 per cent had migraines and many were not getting the appropriate care. The company launched an education campaign and began offering medical consultations for people with migraine.

While lifestyle adjustments are part of migraine management, they’re “not the whole game,” said Leroux, noting patients often also need some form of drug, such as an injectable medication, nasal spray or oral medication, to treat individual attacks.

CGRP inhibitors, a class of migraine drugs that have only become available in the last five years, are helping to reduce the number of migraines people experience and lessen their severity. Sharing a real-life example, Leroux said one of her patients who was put on a CGRP inhibitor went from having 15 to 23 migraines per month, many of them severe, to just two to seven per month.

Read more coverage of the 2024 Healthy Outcomes Conference.