Since late 2019, the COVID-19 pandemic has upended every part of our lives, isolating us from others, changing the way we live, work, and interact with people, and causing over 6 million deaths worldwide. While everyone has been impacted (some far more than others), it has affected people with migraine in unique ways—and not all of them are bad.
Many factors often trigger migraine, including stress and sensory stimulation, when people are out and about. "For many migraine patients who have a hard time dealing with all the physical triggers in life—being exposed to bright light, noise, traffic—being able to stay home and see their doctor on a video has actually been better," says Morris Levin, MD, a neurologist, and director of the UCSF Headache Center in San Francisco. Dr. Levin is on the Medical Board of the Mable team.
In addition, for people who have the option to work remotely, the COVID pandemic has brought an ability to have a more flexible schedule. "They don't have to show up at eight a.m. every single day, find parking, et cetera. You can be at home," Dr. Levin says.
Although telemedicine wasn't used nearly as often before the pandemic, its rise in popularity seems to be something that will continue as COVID-19 moves into the endemic stage and life becomes less restrictive. Now, headache specialists and other healthcare providers can make telemedicine appointments for routine visits and bring patients into their offices for treatment when needed, giving them the ability to treat people more efficiently. This is especially useful for migraine, making it challenging for people to travel to an office when they are experiencing an episode. Not having to travel is also very helpful for people who don't live near a headache specialist.
In 2021, the American Migraine Foundation surveyed over 1,000 people with migraine about their experience with telemedicine. More than half said they used telemedicine for migraine care during the pandemic year of 2020. Nearly 83 percent rated their telemedicine care as very good or good. In addition, 89 percent of respondents said they wanted telemedicine as an option for future migraine care.
"I used to criticize telemedicine; I thought doctors needed to see their patients in person. But I don't think that anymore," says Levin. "Access to care is actually better, and the quality of care is roughly the same."
While this decrease in barriers has been an unexpected benefit, the COVID-19 pandemic has also come with challenges for people with migraine. In 2021, the American Headache Society (AHS) and Medscape reported that many people with migraine had an increase in headache frequency over the previous year because of the challenges of the pandemic.
A September 2020 study published in The Journal of Headache and Pain found that in an online survey of how the pandemic had affected people with migraine, about 60 percent had an increase in migraine frequency. About 10 percent converted from episodic migraine (fewer than 15 headache days a month) to chronic migraine (15 or more headache days per month).
The AHS and Medscape editorial stated it attributed this increase to several factors:
For people with migraine who develop COVID, the effects can last long after they test negative for the virus.
According to the American Migraine Foundation (AMF), after contracting the virus, about half of people will develop a post-COVID headache — a persistent headache with symptoms that can last for weeks or even months after testing negative. Symptoms can include:
Although the intensity of post-COVID headaches can range from mild to severe, people with migraine are more likely to increase the frequency and intensity of migraine attacks. The headache generally clears within two months, although it can take longer.
Many people with migraine report that their post-COVID headache doesn't respond to their usual medications. Rather than reach for more medicine, it's essential to speak with your doctor to find an effective treatment for your pain.
The best way to avoid COVID and the potential complications, like the post-COVID headache, is by getting the COVID-19 vaccine.
People with migraine may be concerned about getting the vaccine because of the potential for flu-like side effects after receiving it. Headache occurred in about 38 percent of people after getting the Pfizer vaccine, 60 percent of those getting the Moderna vaccine, and 40 percent of those receiving the Johnson & Johnson vaccine, according to the AMF.
However, it's important to remember that the vaccine's side effects are short-lived—usually resolving within a few days, as opposed to the potential for months of symptoms after contracting COVID—which can also be fatal in some people.
Talk to your headache specialist or other healthcare providers about the migraine medications you're on and the COVID vaccine. After getting the vaccine, they can advise you on what to do if you develop a migraine.
It's essential to treat your migraine effectively, especially during stressful times like the pandemic. Are you ready to take control of your migraine symptoms and reduce the severity and frequency of your episodes? To get started, fill out Mable's online quiz.
1. Our World in Data, “Coronavirus Death Toll.” https://ourworldindata.org/explorers/coronavirus-data-explorer
2. Video interview with Dr. Morris Levin, director of the UCSF Headache Center and Medical Board member at Mable. https://www.ucsfhealth.org/providers/dr-morris-levin
3. American Migraine Foundation, “Telemedicine for Migraine and Headache Care.” https://americanmigrainefoundation.org/resource-library/telemedicine-for-migraine/
4. Medscape, “How Has COVID-19 Affected People With Migraine?” https://www.medscape.com/viewarticle/950452
5. Al-Hashel, J.Y., Ismail, I.I. Impact of coronavirus disease 2019 (COVID-19) pandemic on patients with migraine: a web-based survey study. J Headache Pain 21, 115 (2020). https://doi.org/10.1186/s10194-020-01183-6
6. American Migraine Foundation, “Migraine and Post-COVID Headache.” https://americanmigrainefoundation.org/resource-library/migraine-post-covid-headache/
7. American Migraine Foundation “Questions About the COVID-19 Vaccines for People Living with Migraine.” https://americanmigrainefoundation.org/resource-library/questions-about-the-covid-19-vaccines-for-people-living-with-migraine/