Diagnostics and treatment of primary headaches in occupational medicine

Abstract

A vast majority of all people suffer from headache during their lifetime. The socioeconomic burden caused by primary headaches is significant. Presenteeism is ten times more costly than absenteeism. Avoiding migraine triggers and making amendments for the workplace to be more headache-friendly leads to increased productivity. More recognition is needed on the factors associated with workplace productivity.

When early treatment is applied for primary headache, productivity loss and therefore economic loss of primary headache is less. Early treatment needs early diagnosis, so education about diagnostics and treatment is needed. Periodic employee examinations should focus more on headache.

Diagnosis of primary headache is clinical. No imaging or laboratory tests are needed in most cases. As there are no laboratory tests, imaging, or validated headache screening tools to guide in making of primary headache diagnosis, the diagnostics should be based on thorough history taking, exclusion of headache red flags and guidelines made by International Headache Society.

Various methods of pharmacologic treatment of primary headaches are available and well-studied. Many of the medications cause adverse effects and the pain relief can be inadequate. Different pharmacologic groups and combinations should be experimented. Combining pharmacologic and nonpharmacologic methods in treatment of primary headaches is recommendable. Multiple nonpharmacologic treatment methods demonstrate promising results in treatment of primary headaches, although scientific evidence of the efficacy of most of them is still limited and needs more scientific research.