Migraine is one of the most common chronic conditions in the workplace, but it's often overlooked and undersupported. Here's how employers are starting to change that.
More than one in seven people experience migraine attacks, yet in most workplaces, this chronic condition is still invisible.
Migraine is not "just a headache"; it's a complex neurological disorder that can cause intense pain, nausea, and sensory sensitivity. It's also the second-leading cause of disability worldwide, and it's costing businesses more than they realize.
Migraine leads to reduced productivity, missed workdays, and excess health care costs due to ineffective treatment. Prevalence peaks during prime working years (ages 25-55), and people with migraine report, on average, being only 46% effective on the job during an attack.
Behind those numbers are real employees trying to push through the pain, often without the treatment or support they need.
That’s why the Health Action Alliance, with support from Pfizer, launched a free Migraine in the Workplace employer toolkit and hosted a live, interactive workshop to help employers take action — just in time for National Migraine and Headache Awareness Month in June.
The workshop, titled "Chronic Conditions at Work: Managing Migraine Head-On," presented new findings from Harvard and the de Beaumont Foundation about the hidden costs of chronic conditions like migraine, with insights from principal researcher Dr. Gillian SteelFisher. Then, Dr. Neil Parikh, Chief Medical Officer at Thirty Madison, shared strategies for designing a more supportive workplace.
More than 100 HR, benefits, and people leaders, representing companies like Disney, Northrop Grumman, Lockton, and Tegria joined the workshop.
The leaders weren't just there to listen; they participated in interactive activities to help them take action in their own workplaces. They were also invited to join the Migraine in the Workplace Challenge by committing to one of three steps: promoting self-screening, reviewing accommodations, or engaging brokers on benefits — all with support from resources in HAA’s new toolkit.
Before diving into solutions, Dr. Parikh and Dr. SteelFisher helped attendees better understand what it’s like to navigate the workplace with migraine and why it often goes unseen.
“Your employees and patients are suffering in silence,” Dr. Parikh told workshop attendees. “They’re having these symptoms that can stretch for days. All throughout, there are periods of time where they’re less productive. They’re less present. There’s increased absenteeism. They also just do not feel like themselves. They cannot bring their A-game to the workplace.”
Dr. SteelFisher also highlighted data from the Harvard and de Beaumont study, which revealed how chronic conditions take a toll on both workers and businesses.
"It really starts to impact work over and over in different ways because they're trying to manage around it, and work around it, and just accept it," she explained.
Stigma is one of the biggest barriers preventing people from getting the support they need.
Dr. SteelFisher noted that one-third of people with these conditions say they miss out on hours, projects, and promotions, or that they get negative feedback because of their condition.
"Many more worry that this could happen, even if it hasn’t,” she said. “The real challenge is that so many folks are afraid to talk about it, and that might mean they’re afraid to take the measures they need. … They’re afraid other people will think badly of them, that they’re not as productive. It closes off opportunities.”
Employers can combat that stigma by creating a culture where people feel safe to speak openly about chronic conditions like migraine, she said. One way to do that? Educating employees by sharing resources like HAA's sample letter or self-screening tool, "Migraine or Just a Headache? A Quick Test."
The self-assessment tool struck a chord with participants, many of whom planned to use it as a starting point for broader awareness and dialogue. In a live poll, 95% of attendees said they intended to share the tool within their organization, most commonly through internal channels like Slack or Teams, company newsletters, or during Migraine and Headache Awareness Month.
Stigma isn’t the only challenge. For many employees, the office environment itself can make migraine attacks worse, Dr. Parikh emphasized, pointing to triggers like bright lights, loud co-working spaces, and prolonged screen time.
Using HAA's "Migraine Accommodations Checklist," leaders at the workshop reflected on how their physical environments could either ease or intensify migraine attacks. A shared reality quickly emerged: Migraine triggers are everywhere, yet they are rarely addressed in accommodations planning or workplace design.
Fortunately, simple adjustments can make a big difference. In a whiteboarding exercise, leaders brainstormed solutions and shared plans to introduce new accommodations in their organizations.
Lighting adjustments — like installing dimmer switches, reducing overall light levels, introducing blinds or screen filters, and creating low-light or “zen” rooms — were among the most frequently cited changes. Many leaders also emphasized the need for quiet or sensory-friendly areas, including fragrance-free zones, designated rest spaces, and calming break rooms with tools like puzzles or massage chairs.
Beyond the physical environment, attendees discussed everyday practices that could help reduce stress and prevent migraine attacks, such as offering remote work options, allowing camera-off meetings, and normalizing conversations around health and time off.
These accommodations not only benefit those who ask for migraine-related adjustments, Dr. Parikh said, but also people who haven't yet been diagnosed or who may not feel comfortable disclosing their needs.
Many people with migraine disease spend years bouncing between primary care providers, neurologists, and other specialists before receiving an accurate diagnosis or effective treatment. And though there has been “significant progress” in migraine medicine over the last decade, Dr. Parikh said, those next-gen treatment options remain underused.
That’s where employers can play a meaningful role.
“It’s incumbent on us as an employer community to be able to connect patients to the types of resources and ultimately the type of care that will be able to get them on the right management pathway and keep them at work,” Dr. Parikh said. “Patients don't want to be having to search insurance networks to try to figure out where to be able to get the right type of care. We have data to show that when you actually connect people to the right type of care, … you give weeks back to patients to be able to come back to work. It’s very, very meaningful, and it certainly adds up very, very quickly.”
Workshop participants were encouraged to negotiate for health benefits that include the most effective treatments and make it easy for employees to access the care they need. HAA's conversation guide "Negotiating for Better Migraine Benefits" breaks down key considerations and provides prompts to help leaders start a conversation with their insurance providers or pharmacy benefits managers.
Some leaders were surprised to learn just how much opportunity exists in benefit design. In a live poll, 75% of attendees said they had never advocated for improved health care coverage for migraine disease. One participant commented, “I never knew I could negotiate this!”
Among those who had successfully pushed for better coverage, the most common strategy was partnering with a broker or working through union contract discussions. These conversations can be a powerful lever for change, opening access to more effective treatment and supporting employee well-being.
At the end of the workshop, attendees were invited to commit to one of three actions as part of the Migraine in the Workplace Challenge:
Nearly 40% of the workshop attendees formally accepted the challenge, signaling clear momentum for change.
After the workshop, several HR and people engagement leaders shared how these small steps have begun to shift their workplace culture.
One leader noted that circulating the self-assessment tool led to more open conversations about health. Others described a ripple effect; sharing migraine resources made it easier for employees to recognize symptoms, speak up about their needs, and ask for support without fear of judgment.
By providing resources, accommodations, and access to care, leaders are not only supporting employees with migraine, but also strengthening their entire organization.
“It makes people more productive, it makes people want to stay, and it’s ultimately good for the business,” Dr. SteelFisher said.
Ready to take action in your own workplace?
Explore the free Migraine in the Workplace Toolkit and join a growing movement of employers building more accommodating, supportive, and productive workplaces for people living with migraine.
In addition to the self-assessment tool, accommodations checklist, and benefits conversation guide, the toolkit includes a guide to help managers talk to their employees about migraine, tips for employees on championing their own care, an HR leader's cheat sheet to treatment options, and more helpful resources for employers.
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