Does Migraine Cause Disability? 2024
In medical school I always heard that the three most disabling medical conditions were: a kidney stone, childbirth labor, and Migraine. And later when I had an office and would be called to the emergency room, I found that the most common reason for the call was a patient with a severe migraine headache.
Read my eBook on Migraine. Click here.
This is an article by Britt Talley Daniel MD, retired member of the American Academy of Neurology, Migraine textbook author, Podcaster, YouTube video producer, and Blogger.
Migraine is present in 12% of the general population and is a common, usually lifelong, neurological disorder which causes significant disability. Only about 48% of migraine patients have been diagnosed by a physician. The condition is most prevalent between the ages of 30 and 49 years old. Migraine is disabling, underdiagnosed, and undertreated.
Migraine brings remarkable short-term disability with 50% to 95% having trouble functioning during an attack. About 80% of patients experience disability or the need to go to bed during an attack. In general migraine severely impacts work, relationships, home life, and the ability to shop and get out.
School children with migraine lose time from school each year. The estimate of lost workdays is 2-4 days/year and of decreased work effectiveness due to migraine is 4-9 days/year.
In addition to lost work productivity migraine is expensive when considering the economic impact of the expense of doctors’ fees, blood work and scans, and acute and preventive medication costs. Migraine results in increased utilization of healthcare costs.
Migraine affects persons at the time of their most productive years and is more common than osteoarthritis (present in 7% of the population), Diabetes (present in 6%), asthma (present in 7%), and rheumatoid arthritis (present in 1%).
Poor Migraine treatment
Nearly half (57%) of migraineurs use over–the-counter medications while 12% use a medication specifically indicated for migraine like a triptan. Preventive therapy is offered more to women, to migraineurs with increased age, and those with increased severity of headache (elevated MIDAS scores.)
About 25% of migraineurs could benefit from preventive therapy but most of these don’t get it. Fifty percent of migraine suffers get frontal sinus, forehead, and/or nose located pressure pain, nasal congestion, tearing, and expression of clear fluid from the nose which provokes them into thinking they have a sinus condition, the media calls “Sinus Headache.”
Age of disability
The peak age of involvement for women is 42 years old, while in men it is 38. The duration of individual migraines is shorter in men than in women, probably because of the long length of menstrual migraine in women. Men and women have no difference in number of attacks or in intensity.
The diagnosis of migraine is not made in men as often as in women, perhaps related to the fact that their headaches are bilateral more than one sided. The burden of headache is highest in females 18-44, where the 3-month prevalence of migraine or severe headache is 26.1%. The prevalence of migraine relates inversely to household income. The worldwide prevalence of migraine is relatively stable.
Migraine severity
The severity and frequency of migraine may vary a lot among sufferers while the attacks can range from mild pain to terrible agony and inability to function. However, a large proportion of migraineurs are moderately or severely disabled. Frequency can range from one attack a year to two or three a week.
Loss of productivity
In the US annual lost productivity due to migraine costs around 14 billion dollars, while direct costs are thought to be 2.5 billion dollars. The National Ambulatory Medical Care Survey showed that head pain was the fifth leading cause of emergency room visits overall in the US and accounted for 1.2% of outpatient visits.
Further Statements
Migraine pain is severe Migraine is disabling chiefly because of the sheer intensity of the headache pain so that the affected person has to stop their current activity and yield to it. According to the International Classification of Headache Disorders v. 3 Migraine pain is “moderate to severe.”
In my office when I asked patients to give a range of pain using a scale of 1 to 10, they often did not stay within the limit of 10 and answered, “a thousand.”
Migraine and nausea and vomiting Eighty percent of migraineurs have nausea and vomiting with the headache part. Nausea and vomiting are very disabling. Imagine being in an office situation and experiencing nausea and wondering if it would be so bad that one would vomit at their desk or on the way to the toilet, a very nerve racking and embarrassing situation.
Migraine and sensitivity to light. Photophobia which means “fear of light” is also a very distressing symptom. Again, consider this while being in an office with flickering fluorescent lights which especially seem to drive migraineurs crazy or driving into the western sun on the way back home with a bright light in your face.
Light sensitivity is a disturbing, interruptive problem so that one doesn’t want to open one’s eyes at all as the light seems to hurt in the eye and make the migraine pain worse. Many migraines are started by glancing light, like off a medallion on the front of a car or flickering sunlight viewed through trees while driving.
I have often written a prescription for light sensitive migraineurs to use at their office to deter florescent light bulbs or any other aggravating light condition affecting their work ability.
Read my article on “How Does Migraine Aggravate Photophobia” on my website, www.doctormigraine.com.
Migraine and dysosmia, sensitivity to smell. This has been a special migraine problem for my office while I have run a headache clinic and migraine persons do not want to smell any offensive odors in their doctor’s office. My nurse put up signs all over the office warning patients to be careful of offending odors for other migraine persons.
Once checking into a hotel with my wife who is particularly sensitive to smells and who has migraine, we made three steps inside of a supposedly “smoke free room” when my wife informed me that she could smell cigarettes. I went straight to the phone and called the front desk for a room transfer.
Migraine and movement Consider how nice it is to finally lie down in bed at night after a long, stressful day, to stretch out your legs and relax. Migraine patients feel worse when they are up and standing aggravates their headache. They need to lie down whenever an attack occurs because it makes them feel so much better.
Migraine patients want to lie down in a quiet, dark room.
Consider that during an attack of migraine persons with migraine have:
Severe headache
Nausea and vomiting
Light sensitivity
Smell sensitivity
The need to be down
And you will learn how migraine is very disabling.
Read my big book on Migraine. Click here.
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Although this site provides information about various medical conditions, the reader is directed to his own treating physician for medical treatment.
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All the best.
Britt Talley Daniel MD