What is a migraine?
What is a migraine?
A migraine is a specific type of headache disorder characterised by intense, debilitating headaches lasting from a few hours to several days. Unlike regular headaches, migraines are often accompanied by other symptoms, such as nausea, vomiting, sensitivity to light and sound, tingling of the hands or face, hearing strange sounds, and visual disturbances such as flashing lights, zigzag patterns, or blind spots. These symptoms are known as auras. Migraines can vary greatly in severity, frequency, and duration, affecting each individual differently. While the exact cause of migraines is not fully understood, they are believed to result from abnormal brain activity that affects nerve signals, chemicals, and blood vessels in the brain.
Triggers for migraines can include a range of factors such as stress, hormonal changes, certain foods and drinks (like caffeine, alcohol, and aged cheeses), strong odours, changes in sleep patterns, bright lights, loud noises, and weather changes. Understanding these triggers can be key to managing and preventing migraines, though triggers can vary widely from person to person.
Migraines can disrupt day-to-day living by:
- Physical Limitations and Pain
The most immediate and obvious impact of a migraine is the intense pain, usually throbbing or pulsing, often on one side of the head. This pain can be so severe that it disrupts normal activities, making it nearly impossible to concentrate on work, household chores, or even basic tasks like walking or talking. The pain is often aggravated by movement, making getting out of bed and participating in life activities a significant challenge.
- Cognitive Impairments
Migraines can also cause cognitive symptoms, sometimes referred to as “brain fog” or “migraine hangover.” Even after the pain has subsided, many people experience lingering effects like difficulty concentrating, memory lapses, slowed thinking, and trouble finding the right words. These cognitive difficulties can be especially problematic for those whose work involves high levels of concentration, such as professionals, students, or those in creative fields. It can be hard to keep up with tasks, meet deadlines, or participate in meetings or classes when one’s brain feels foggy and unresponsive.
- Emotional and Psychological Impact
The unpredictable nature of migraines can also take a significant emotional toll. The fear of an impending attack can lead to anxiety and stress, which can trigger migraines, creating a vicious cycle. Many individuals with chronic migraines also experience depression, as the constant battle with pain and its impact on daily life can feel overwhelming.
The social isolation that often accompanies migraines can further exacerbate these feelings. Missing out on social events, family gatherings, or even simple interactions with friends can lead to loneliness and sadness. This can strain relationships, as loved ones may not fully understand the debilitating nature of migraines and the need for withdrawal during an attack.
- Impact on Sleep and Daily Routine
Sleep disturbances are both a trigger and a consequence of migraines. Many migraine sufferers report difficulty falling asleep or staying asleep, particularly if the pain strikes at night. Conversely, a lack of quality sleep can also trigger migraines, creating a challenging feedback loop. This disrupted sleep can lead to daytime fatigue, irritability, and decreased motivation, making it hard to maintain a consistent daily routine.
How can an Occupational Therapist help a person who experiences Migraines?
Occupational therapists (OTs) can help individuals manage migraines and their impact on daily life. While migraines are often managed through medications and lifestyle changes, OTs offer a holistic approach focussing on improving function, reducing triggers, and enhancing quality of life. Here are some ways an occupational therapist can assist someone suffering from migraines:
- Identifying and Managing Triggers
OTs work closely with individuals to identify specific triggers, such as poor posture, environmental factors, stress, and ergonomic issues. By analysing daily routines and environments, OTs can help modify these factors to reduce the likelihood of triggering a migraine. For example, they may recommend changes in lighting, noise levels, or screen time in workspaces and homes to create a more migraine-friendly environment.
- Developing Personalised Coping Strategies
OTs help individuals develop personalised strategies to cope with migraines during an attack and in daily life. This may include teaching relaxation techniques, such as deep breathing, mindfulness, and progressive muscle relaxation, which can help manage stress—one of the most common migraine triggers. OTs can also guide individuals in creating a quiet, comfortable retreat space at home or work where they can manage migraine symptoms more effectively.
- Improving Sleep Hygiene and Routine Management
OTs can assist in developing better sleep hygiene practices to improve sleep quality and consistency. They can help with creating a calming bedtime routine, managing screen time before bed, and setting up an ideal sleep environment. They can also help establish routines that promote regular sleep and wake times, which can be crucial for those who experience migraines related to irregular sleep patterns.
- Posture and Ergonomic Modifications
Poor posture, particularly during work or screen use, can contribute significantly to migraines. OTs assess and modify an individual’s posture and work environment to reduce strain on the neck and shoulders, which can help prevent migraines. This might include ergonomic adjustments such as proper chair positioning, computer screen height, and body mechanics during daily tasks.
- Activity Pacing and Energy Conservation
Managing energy levels is crucial for those with migraines, as overexertion can often trigger an attack. OTs help individuals learn to pace their activities, balance high- and low-energy tasks, and incorporate rest periods throughout the day to prevent overexertion. This approach assists individuals in maintaining productivity and engagement in daily activities without overwhelming their system, reducing the frequency and severity of migraine attacks.
- Cognitive and Sensory Strategies
OTs can also provide cognitive and sensory strategies to help manage the impact of migraines on concentration and sensory sensitivities. They may introduce techniques for controlling light and sound sensitivities, such as using tinted glasses, noise-cancelling headphones, or setting up designated quiet spaces. Additionally, they can offer strategies for managing “brain fog” through cognitive exercises, organisational tools, and memory aids to improve focus and task performance.
- Support with Stress and Emotional Regulation
Given the emotional toll migraines can take, OTs can assist with stress management and emotional regulation techniques. They help identify stressors, teach effective time management skills, and develop routines that minimise stress. OTs may also guide individuals through goal-setting and problem-solving techniques, empowering them to take control of their condition and reduce the anxiety associated with unpredictable migraine attacks.
Conclusion
Occupational therapists provide valuable support to those living with migraines by addressing the condition’s impact on daily functioning. Through individualised interventions and by focussing on practical, everyday strategies tailored to each person’s needs, OTs empower migraine sufferers to regain control, participate more fully in their daily activities, and live more comfortably despite the challenges posed by this condition.