Where to get help during the pandemic

Accessing migraine healthcare during the Covid-19 crisis

Migraine care has been greatly impacted by the Covid-19 pandemic.

Healthcare professionals are working hard to continue to provide care to people with migraine, adapting their practices and finding new ways to offer support. However, inevitably, they may be limited in what they can offer at the present time.

Access to services and how clinics are currently operating will vary from area to area, and for more information you should contact the service directly.

If you feel you need help or support with your migraine during the pandemic it’s important you contact those who can help.

GPs

For many people their GP is their main healthcare provider for help with their migraine. They may be able to diagnose migraine, provide information and prescribe acute and preventive treatments to help manage them. Some GPs specialise in headache and they are often known as a ‘GP with a special interest in headache’.

Some people find their GPs aren’t very supportive or they don’t understand migraine, if this is the case you may want to ask to see a different GP at the surgery or change GP surgeries.

However, sometimes people need more support than their GP can provide. For example, if you are not responding well to treatment, there is doubt over your diagnosis, or your symptoms are becoming more debilitating. In these cases your GP should refer you to a specialist such as a headache clinic.

How are GPs supporting people during Covid-19?

Many GPs have had to adapt how they work to support people during Covid-19. This includes offering more telephone and virtual consultations when there isn’t a need to physically assess someone. For more details on how your GP is operating you can visit their website or give them a call.

If you feel you need support from the GP do contact them as they are there to support people during the pandemic.

Pharmacies

Pharmacies can provide a range of services for people with migraine including fulfilling prescriptions and consultations about your symptoms so they can recommend appropriate treatments.

They can recommend painkillers such as paracetamol, NSAIDs (aspirin, ibuprofen and diclofenac) and combined analgesics containing paracetamol that can be used as first-line treatment to relieve pain from all headaches. There are also treatments that can be combined with paracetamol, such as buclizine and prochlorperazine to treat the nausea.

Sumatriptan can also be provided ‘over the counter’ to people with a migraine diagnosis. The pharmacist will ask about any cardiac risk or contraindications to taking sumatriptan before providing it.

How are pharmacies supporting people during Covid-19?

As with many other healthcare providers, pharmacies have had to adapt how they are working. How they have been affected will vary from pharmacy to pharmacy but may include only one person at the counter at a time and reduced opening hours. Some pharmacies may not be providing consultations for the time being.

Specialists

Many people with migraine need to be seen by a specialist to access specialist support and different treatment options. This is usually for people who have a complicated migraine presentation, unusual features, have not responded to preventive treatment offered by a GP or where a diagnosis is unclear. Who someone sees will depend on their local area, if possible it’s advisable to be seen by a headache specialist but people may also be seen in a general neurology department or a pain clinic.

A headache or migraine clinic specialises in the diagnosis and treatment of migraine and head pain. The clinics are often linked to a neurology department in a hospital and are directed by a consultant neurologist or doctor with a particular interest and expertise in migraine.

Each NHS migraine clinic will have its own referral criteria and people will need to be referred by a medical practitioner. This is most likely to be your GP but could be a hospital doctor or other healthcare professional within the NHS. You can find a list of specialist migraine and headache health services in the UK that are known to The Migraine Trust here.

Headache clinics have access to a wider range of treatments and have more expertise in managing migraine, and other headache conditions. Many will also have a nurse specialist to provide support, information and treatments to people with migraine.

How are specialists supporting people during Covid-19?

Unfortunately, many specialist appointments and treatments (such as Botox) have had to be cancelled due to Covid-19. This is to ensure the safety of staff and patients; and also (in some areas) due to staff being redeployed into other areas of the NHS.

Where they can, specialists are continuing to provide information, support and treatment via telephone and virtual consultations; and are working hard to ensure treatments can restart as soon as possible. Although there may be a delay in access for some people when clinics resume.

If you have had an appointment or treatment cancelled, or have an upcoming treatment you should contact your clinic to find out what options are available to you until your appointment or treatment resumes.

Support with wellbeing

Alongside trying to manage migraine in the current circumstances, many people are also experiencing a range of stresses and changes which are likely to have an impact on their wellbeing.

For more support around managing wellbeing during covid-19 the NHS Every Mind Matters website has a range of resources. Mind also have a range of resources and information on managing wellbeing during covid-19.

What to do if you need more support?

We know that many people with migraine experience low mood from time to time. The current coronavirus situation is likely to be making this more challenging, especially due to the increase in stress, appointments being cancelled and it not being clear when things will return to normal.

If you are feeling stressed, anxious or depressed it’s important to ask for help. You may feel that the situation isn’t serious enough, or that you don’t want to ‘bother’ your GP. However, it’s really important to seek help when you need it, and it’s important to persevere.

If you are feeling low or depressed you may benefit from speaking to someone – such as a friend or family member. If you don’t feel comfortable talking to someone you know, or don’t feel you have someone you can talk to – you can contact Samaritans (24/7) on 116 123.

If you are having thoughts about harming yourself you should contact your GP urgently (or 111 if out of hours). Most areas in the UK have a 24-hour support service for urgent psychological support you can be re-directed to.

For those with migraine, stress, anxiety and depression can act as a ‘double whammy’, as they usually make migraines worse or can trigger a migraine. They also make us less able to cope with the physical and emotional problems we have.

The Migraine Trust

We are here to support as many people affected by migraine as possible – whether you have a question related to Covid-19 or more information about migraine generally you can contact us at any time via our online contact form or by calling us on 0203 9510 150 between 10am and 4pm on Tuesdays and Thursdays.