By Nervous Doc — Jun 24, 2025

Decoding the Impact of Migraines with MIDAS: Unlocking a Clearer Picture of Your Pain

If you live with migraines, you know it's not just about the pain. It's about the days lost, the plans cancelled, the impact on your work, family, and life. It's a complex condition that can feel incredibly isolating, and often, the actual burden isn't fully understood by others, or even by yourself. How do you quantify something so personal and pervasive? This is where tools like the Migraine Disability Assessment (MIDAS) questionnaire come into play.

At Nervous Doc, we're dedicated to empowering you with the knowledge and resources to better understand and manage your neurological health. Today, we're diving deep into the MIDAS questionnaire—a simple yet powerful tool that helps decode the real-world impact of your migraines, giving you and your healthcare provider a clearer picture of your pain's burden.

The Invisible Burden: Why Measuring Disability Matters

Imagine trying to explain to your boss why you missed a crucial deadline, or to your family why you couldn't attend a special event. For someone who hasn't experienced a migraine, it can be hard to grasp the profound disability it can cause. They might just see a "headache," not the incapacitating pain, the debilitating nausea, the extreme light and sound sensitivity that forces you into a dark, quiet room.

This is why measuring migraine-related disability is so vital. It goes beyond just tracking the number of attacks or their severity. It quantifies:

Lost Productivity: How many days have you missed from work or school due to migraines? How many days have you been productive at less than 50% capacity?
Impact on Daily Activities: How much do migraines interfere with your household chores, social activities, or family obligations?
Treatment Effectiveness: By regularly assessing your MIDAS score, you can see if your current treatment plan is truly reducing the overall impact of your migraines, not just the pain.
Communication with Healthcare Providers: A MIDAS score provides objective data that can help your doctor understand your functional limitations, leading to more targeted and effective treatment strategies.
Advocacy and Awareness: For researchers and advocates, standardised disability measures like MIDAS help to highlight the significant public health burden of migraines, leading to increased funding for research and better access to care.

Introducing MIDAS: A Glimpse into Your Migraine's Reach

The Migraine Disability Assessment (MIDAS) questionnaire is a brief, self-administered tool that measures headache-related disability over the past three months. Developed by researchers at the University of North Carolina and GlaxoSmithKline, it's widely used in clinical practice and research to assess the impact of headaches on daily life (Stewart et al., 1999).

MIDAS consists of five core questions, plus two optional questions for additional information. The core questions focus on time lost due to migraines in the last three months, specifically in three key areas:

Work/School Productivity: How many days did you miss from work or school in the last 3 months because of your headaches?
Household Chores: How many days in the last three months have you not done household work because of your headaches?
Social/Family Activities: On how many days in the last 3 months did you miss family, social or leisure activities because of your headaches?
Work/School Productivity (Reduced): On how many days in the last 3 months was your usual work, school or household work at least half cut down because of your headaches?
Social/Family Activities (Reduced): On how many days in the last 3 months were your family, social or leisure activities at least half cut down because of your headaches?

For questions 1-5, you simply write in the number of days. The total MIDAS score is the sum of the days reported in questions 1-5.

There are also two additional questions (A and B) that ask about headache frequency and pain intensity:

On average, how much pain did you experience with your headaches on a scale of 0-10, where 0 is no pain and 10 is the worst pain imaginable?
On how many days in the last 3 months did you have a headache?

These questions are not included in the total MIDAS score but provide valuable context for your healthcare provider.

Decoding Your MIDAS Score: Understanding the Disability Grades

Once you sum the days from questions 1-5, your total MIDAS score will fall into one of four grades of disability:

Grade I (0-5 points): Little or no disability. Your headaches have minimal impact on your daily activities.
Grade II (6-10 points): Mild disability. Your headaches cause some disruption to your daily life, but you can generally manage.
Grade III (11-20 points): Moderate disability. Your headaches significantly interfere with your daily activities, leading to noticeable limitations.
Grade IV (21+ points): Severe disability. Your headaches cause a severe disruption to your life, leading to substantial time lost from work, school, and other activities.

It's important to note that a higher MIDAS score indicates a greater impact of migraines on your life. Your score can fluctuate depending on your migraine activity in the three months.

Using MIDAS for Empowerment and Better Management

Integrating the MIDAS questionnaire into your migraine management routine can be incredibly empowering. Here’s how you can make the most of this tool:

Regular Assessment: Consider completing the MIDAS questionnaire every three months, or before each of your neurology appointments. This regular assessment will help you track changes in your migraine burden over time and understand the effectiveness of your treatment plan.
Informed Discussions with Your Doctor: Bring your completed MIDAS questionnaire to your appointments. It provides objective data to help your doctor understand the full scope of your migraine's impact. This can lead to more targeted discussions about treatment adjustments, preventive strategies, and referrals to other specialists if needed.
Treatment Effectiveness Evaluation: If you start a new medication, lifestyle change, or therapy, using MIDAS before and after can help you objectively assess whether it reduces the disability caused by your migraines. A reduction in your MIDAS score is a strong indicator of successful treatment.
Self-Awareness and Advocacy: Regularly measuring your MIDAS score helps you better understand how migraines affect your life. This self-awareness can empower you to advocate for your needs, whether with your employer regarding accommodations or with your family regarding support.
Complementing Your Migraine Diary: While a migraine diary tracks frequency, intensity, and triggers, MIDAS focuses specifically on disability. Using both tools together provides a comprehensive picture of your migraine journey.

Beyond the Score: The Human Story

While MIDAS provides a valuable quantitative measure, it's important to remember that it doesn't capture the entire human experience of living with migraines. It doesn't quantify the emotional toll, the anxiety of anticipating the next attack, the feeling of letting others down, or the constant mental burden of managing a chronic condition.

However, the MIDAS score is an excellent starting point for deeper conversations. It validates your experience and provides a tangible measure of the disability you face, helping to bridge the gap between your subjective experience and objective data.

Take Control: Start Decoding Your Migraine Impact Today

Understanding the true impact of migraines is a crucial step toward effective management and improving quality of life. The MIDAS questionnaire offers a straightforward yet powerful way to achieve this clarity.

We encourage you to utilise the resources on NervousDoc.com, including a printable MIDAS questionnaire and further information on comprehensive migraine management. By actively tracking your condition and understanding its full burden, you can take a more informed and proactive role in your healthcare journey.

By Nervous Doc

References:

Stewart, W. F., Lipton, R. B., Kolodner, K. B., Sawyer, J., Lee, C., & International Headache Management Consortium. (1999). Validity of the Migraine Disability Assessment (MIDAS) score in a migraine population. Neurology, 53(7), 1438-1444.
Lipton, R. B., Stewart, W. F., & Von Korff, M. (2000). The Migraine Disability Assessment Scale (MIDAS): development and validation of a new tool for the assessment of headache-related disability. Headache: The Journal of Head and Face Pain, 40(1), 1-13.
Bigal, M. E., & Lipton, R. B. (2009). The MIDAS scale: a simple yet powerful tool for the assessment of migraine disability. Practical Neurology, 9(3), 162-167.