Are chronic daily headaches normal. What are the main types of chronic daily headaches. What causes chronic headaches. When should you see a doctor for headaches. How can chronic headaches be prevented or managed.

Understanding Chronic Daily Headaches

Chronic daily headaches are a debilitating condition affecting many individuals worldwide. These headaches occur 15 days or more a month for at least three months, significantly impacting quality of life. While occasional headaches are common, experiencing them almost daily is not normal and requires medical attention.

The Four Main Types of Chronic Daily Headaches

Chronic daily headaches can manifest in various forms, each with distinct characteristics. Understanding these types can help in proper diagnosis and treatment.

1. Chronic Migraine Headaches

Chronic migraines are characterized by:

• Throbbing pain affecting one or both sides of the head
• Moderate to severe intensity
• Nausea and/or vomiting
• Sensitivity to light and sound

2. Chronic Tension Headaches

These headaches typically involve:

• Pain on both sides of the head
• Mild to moderate intensity
• A pressing or tightening sensation (not throbbing)

3. New Daily Persistent Headaches

This type of headache:

• Occurs suddenly, often in people without a history of headaches
• Affects both sides of the head
• Causes mild to moderate pain with a pressing or tightening sensation

4. Hemicrania Continua

Hemicrania continua is characterized by:

• Continuous pain on one side of the head
• Spikes of severe pain
• Response to the prescription drug Indocin
• Associated symptoms like tearing or redness of the eye, nasal congestion, drooping eyelid, or restlessness

Potential Causes of Chronic Headaches

The exact causes of chronic daily headaches remain unclear, but several factors may contribute to their development:

• Blood vessel problems in and around the brain
• Strokes
• Infections (e.g., meningitis)
• Abnormal intracranial pressure
• Brain tumors
• Traumatic brain injury
• Overuse of pain medication

Can chronic headaches be a sign of a serious underlying condition? While most chronic headaches are not life-threatening, they can sometimes indicate more severe health issues. This is why it’s crucial to consult a healthcare professional for proper diagnosis and treatment.

Prevention and Management Strategies

While the underlying cause of chronic daily headaches may be unclear, several strategies can help prevent or reduce their frequency and intensity:

Identify and Avoid Triggers

Keeping a headache diary can help you track potential triggers such as:

• Certain foods or beverages
• Environmental factors
• Specific activities

Medication Management

How can overusing medication contribute to chronic headaches? Paradoxically, using headache medications more than twice a week can increase the frequency and severity of headaches, a condition known as medication overuse headache. If you’ve been taking pain relievers regularly, consult your doctor about safely reducing your intake.

Lifestyle Modifications

Several lifestyle changes can help manage chronic headaches:

1. Maintain a consistent sleep schedule, aiming for 7-8 hours per night
2. Eat regular, balanced meals
3. Engage in regular physical exercise (with your doctor’s approval)
4. Practice stress reduction techniques like yoga or meditation
5. Reduce caffeine intake

When to Seek Medical Attention

While occasional headaches usually don’t require special medical attention, certain situations warrant a doctor’s consultation:

• Experiencing two or more headaches per week consistently
• Needing pain relievers for headaches most days
• Requiring more than the recommended dose of over-the-counter pain medication
• Changes in headache patterns or worsening pain
• Headaches that significantly impact daily activities

Are there any headache symptoms that require immediate medical care? Yes, certain headache symptoms can indicate a medical emergency. Seek immediate medical attention if your headache:

• Is sudden and severe
• Comes with fever, stiff neck, confusion, seizure, double vision, weakness, numbness, or difficulty speaking
• Occurs after a head injury
• Worsens despite rest and pain medication

The Role of Healthcare Providers in Managing Chronic Headaches

Healthcare providers play a crucial role in diagnosing and managing chronic daily headaches. They can:

• Perform a thorough medical history and physical examination
• Order necessary diagnostic tests to rule out underlying conditions
• Develop a personalized treatment plan
• Prescribe appropriate medications
• Recommend lifestyle modifications and non-pharmacological interventions
• Monitor progress and adjust treatment as needed

How do doctors diagnose chronic daily headaches? Diagnosis typically involves a combination of patient history, physical examination, and sometimes imaging studies or other tests to rule out secondary causes. Keeping a headache diary can be extremely helpful in this process.

Advanced Treatment Options for Chronic Headaches

When conventional treatments fail to provide relief, several advanced options may be considered:

1. Botox Injections

How can Botox help with chronic migraines? Botulinum toxin injections can help prevent migraines in some patients by blocking pain signals and relaxing muscles in the head and neck. This treatment is typically administered every 12 weeks.

2. Nerve Blocks

Nerve blocks involve injecting medication around specific nerves to reduce pain transmission. These can be particularly effective for certain types of headaches, such as occipital neuralgia.

3. Neurostimulation

This technique uses electrical or magnetic stimulation to modulate pain signals. Devices can be external (like transcutaneous electrical nerve stimulation or TENS units) or implanted.

4. Cognitive Behavioral Therapy (CBT)

CBT can help patients manage stress and develop coping strategies for dealing with chronic pain. It’s often used in conjunction with other treatments for better overall outcomes.

5. Acupuncture

Some patients find relief through acupuncture, an ancient Chinese practice involving the insertion of thin needles into specific points on the body. While scientific evidence is mixed, many people report benefits for headache management.

The Impact of Chronic Headaches on Quality of Life

Chronic daily headaches can significantly affect various aspects of a person’s life, including:

• Work productivity and absenteeism
• Social relationships and activities
• Mental health, potentially leading to anxiety or depression
• Sleep quality
• Overall physical health

How can individuals cope with the psychological impact of chronic headaches? Developing a support network, practicing mindfulness techniques, and seeking professional mental health support when needed can all be beneficial. Support groups for chronic pain sufferers can also provide valuable emotional support and practical tips.

Research and Future Directions in Chronic Headache Management

The field of headache medicine is continuously evolving, with ongoing research into new treatment modalities and a better understanding of headache mechanisms. Some promising areas of research include:

• CGRP (Calcitonin Gene-Related Peptide) antagonists for migraine prevention
• Neuromodulation techniques
• Genetic studies to identify susceptibility to certain headache types
• Novel drug delivery systems for more effective pain relief
• Artificial intelligence in headache diagnosis and treatment planning

What role might personalized medicine play in the future of headache treatment? As our understanding of the genetic and molecular basis of headaches improves, treatments may be tailored more precisely to individual patients based on their specific headache type, genetics, and other personal factors.

Nutrition and Chronic Headaches: The Diet Connection

Diet can play a significant role in triggering or preventing headaches for many individuals. While dietary triggers can vary widely between people, some common culprits include:

• Alcohol, especially red wine
• Caffeine (both excess consumption and withdrawal)
• Chocolate
• Aged cheeses
• Processed meats containing nitrates
• Monosodium glutamate (MSG)
• Artificial sweeteners

Can certain diets help prevent chronic headaches? Some evidence suggests that anti-inflammatory diets, such as the Mediterranean diet, may help reduce headache frequency and severity. Additionally, maintaining proper hydration is crucial for headache prevention.

The Ketogenic Diet and Migraines

Recent research has shown promising results for the ketogenic diet in reducing migraine frequency and intensity. This high-fat, low-carbohydrate diet induces a state of ketosis, which may have neuroprotective effects. However, it’s important to consult with a healthcare provider before starting any new diet regimen, especially one as restrictive as the ketogenic diet.

The Role of Sleep in Chronic Headache Management

Sleep and headaches have a complex, bidirectional relationship. Poor sleep can trigger headaches, while headaches can disrupt sleep, creating a vicious cycle. Improving sleep hygiene can be a crucial component of headache management:

• Maintain a consistent sleep schedule, even on weekends
• Create a relaxing bedtime routine
• Ensure your sleeping environment is dark, quiet, and cool
• Limit screen time before bed
• Avoid caffeine, alcohol, and large meals close to bedtime

How can sleep disorders affect chronic headaches? Conditions like sleep apnea, insomnia, and restless leg syndrome can all contribute to chronic headaches. Treating these underlying sleep disorders can often lead to significant improvements in headache frequency and severity.

Exercise and Physical Therapy for Chronic Headache Relief

Regular physical activity can play a crucial role in managing chronic headaches. Exercise can help by:

• Reducing stress and tension
• Improving sleep quality
• Releasing endorphins, the body’s natural pain relievers
• Enhancing overall physical health and well-being

What types of exercises are best for headache sufferers? Low-impact aerobic exercises like walking, swimming, or cycling are often well-tolerated. Yoga and tai chi can be particularly beneficial due to their combination of physical activity, breathing exercises, and mindfulness.

The Benefits of Physical Therapy

Physical therapy can be an effective treatment for certain types of headaches, particularly those related to muscle tension or poor posture. A physical therapist can:

• Teach exercises to strengthen neck and shoulder muscles
• Provide manual therapy to relieve muscle tension
• Offer postural correction techniques
• Teach relaxation and stress management strategies

The Importance of a Multidisciplinary Approach

Given the complex nature of chronic daily headaches, a multidisciplinary approach to treatment often yields the best results. This may involve coordination between various healthcare providers, including:

• Primary care physicians
• Neurologists or headache specialists
• Pain management specialists
• Physical therapists
• Psychologists or psychiatrists
• Nutritionists
• Complementary and alternative medicine practitioners

How can patients effectively navigate a multidisciplinary treatment plan? Open communication between all healthcare providers is crucial. Patients should keep a comprehensive record of their treatments, medications, and responses to share with all members of their healthcare team.

Coping Strategies for Living with Chronic Headaches

Living with chronic headaches can be challenging, but there are several strategies that can help improve quality of life:

1. Educate yourself about your condition
2. Develop a support network of family, friends, and fellow headache sufferers
3. Practice stress management techniques like deep breathing or progressive muscle relaxation
4. Use distraction techniques during headache episodes
5. Plan activities and work responsibilities around your headache patterns when possible
6. Be open with employers or educators about your condition and necessary accommodations
7. Explore complementary therapies like acupuncture or massage

How can mindfulness meditation help with chronic pain management? Mindfulness meditation can help reduce the emotional distress associated with chronic pain, improve pain coping skills, and potentially even alter pain perception. Regular practice can lead to improved quality of life for many chronic headache sufferers.

Chronic daily headaches represent a significant health challenge, impacting millions of people worldwide. While they can be debilitating, a combination of medical treatment, lifestyle modifications, and coping strategies can help many individuals manage their symptoms effectively. It’s crucial for those experiencing frequent headaches to seek medical attention for proper diagnosis and treatment. With ongoing research and advancements in headache medicine, the future holds promise for even better management strategies and potential cures for chronic headache conditions.

Is It Normal To Get Headaches Everyday?

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May 16, 2022

No, it’s NOT normal to get headaches everyday

Most people have headaches from time to time. But if you have a headache more days than not, you might have chronic daily headaches, which come in many forms – most of them pretty disabling.

You may be suffering from chronic daily headaches if the headaches occur 15 days or more a month and you have experienced them for at least three months.

In general, there are four kinds of chronic daily headaches. They include:

• Chronic migraine headaches. These can affect one side or both sides of your head, have a throbbing sensation, and cause moderate-to-severe pain. They can also cause nausea, vomiting, or both. People tend to be sensitive to light and sound during these headaches.
• Chronic tension headaches. These tend to affect both sides of your head, cause mild-to-moderate pain, and produce a pain that feels like pressing or tightening but not throbbing.
• New daily persistent headaches. These occur suddenly, usually in people without a history of headaches. They often affect both sides of the head, cause pain that feels like pressing or tightening and produce mild-to-moderate pain.
• Hemicrania continua. These affect only one side of the head, are continuous with no pain-free periods, produce spikes of severe pain, respond to the prescription nonsteroidal anti-inflammatory drug Indocin, and are associated with one or more of the following:
  • Tearing or redness of the eye on the affected side of the head.
  • Nasal congestion or a runny nose.
  • Drooping eyelid or narrowing pupil.
  • The sensation of restlessness.

What Causes Chronic Headaches?

No one really knows why some people suffer from this debilitating condition. Conditions that may cause it include:

• Inflammation or other problems with the blood vessels in and around the brain.
• Strokes, in which blood vessels in the brain a blocked, reducing blood flow to the brain.
• Infections, including meningitis.
• High or low intracranial pressure.
• Brain tumors.
• Traumatic brain injury.
• Overuse of pain medication.

While the cause of these headaches is unclear, research suggests that you can do some things to help prevent them – or at least reduce their intensity:

• Avoid headache triggers. Keep track of things that appear to result in headaches, including foods you eat, activities you are doing, and the environment in which the headaches occur. If you can identify your headache triggers, you can try to avoid them.
• Do not overuse medication. Using headache medications more than twice a week can increase the frequency and severity of headaches. If you have been taking medication for a long time, consult a doctor about weaning yourself off. Some medicines cannot be stopped cold turkey.
• Get a good night’s sleep. Most adults need seven to eight hours of sleep a night. It’s best to go to bed and wake up at the same time every day. If you have trouble sleeping, see a doctor.
• Don’t skip meals. Eat healthy meals and avoid food or beverages that seem to trigger headaches. Lose weight if you’re obese.
• Get regular exercise. Physical activity can improve your physical and mental well-being and reduce stress. With your doctor’s OK, choose activities you enjoy, like walking or cycling.
• Reduce stress. Stress is a common trigger of chronic headaches. Try stress-reduction techniques, like yoga, tai chi, or meditation.
• Cut back on caffeine. Some headache medications include caffeine because they can help to reduce headache pain. But it can also aggravate headaches. Try reducing or eliminating caffeine.

When Should You See A Doctor?

Occasional headaches usually require no special medical attention. However, you should consult a doctor if you:

• Consistently have two or more headaches a week.
• Take pain reliever for your headaches on most days.
• Need more than the recommended dose of over-the-counter medicines to relieve headache pain.
• Experience changes in the pattern of your headaches, or they get worse.
• Find the headaches are disabling.

Seek immediate medical care if your headache:

• Is sudden and severe.
• Is accompanied by a fever, stiff neck, confusion, seizure, double vision, weakness, numbness, or difficulty speaking.
• Occurs after a head injury.
• Gets worse after you rest and take pain medication.

Get The Care You Need 

If your chronic headache is sudden and severe and associated with one of the symptoms above, you should call 911 and seek immediate medical attention. If you suffer from more common chronic headaches, visit your doctor for advice. If you do not have a doctor, Grady can help. If you need a primary care physician, call us at (404) 616-1000 or make an appointment online. We’ll arrange an appointment at a Primary Care Center near you. Doctors there can treat most conditions and provide access to Grady’s unparalleled medical specialty expertise.

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Are Your Daily Headaches a Sign of Something More Serious?

Don’t fret just yet. The pounding pain in your head may be annoying, but it doesn’t necessarily indicate a bigger problem.

There it is again — the throbbing in your dome. If you’re bothered by frequent headaches, you may be concerned that you have a more serious condition, such as a brain tumor or an aneurysm. And while those and other dangerous conditions can be marked by headaches, it’s likely that your pain is primary. In other words: It’s probably not the result of another condition.

Unfortunately, doctors don’t know what causes most headaches. According to some estimates, only 10% of headaches have a known cause. But there are contributing factors that can trigger chronic headaches, such as:

• Alcohol
• Caffeine
• Dehydration
• Hunger
• Lack of sleep
• Sensory triggers such as bright lights, loud noises and pungent smells
• Stress

Chronic headaches can also be linked to other disorders, including depression, anxiety, sinus infections, allergies and temporomandibular joint dysfunction, also known as TMJ. In order to figure out your headache pattern and identify your triggers, you may want to keep a headache diary to share with your doctor. The National Headache Foundation provides a handy template.

Here are a few common types of chronic headaches:

Tension headache

This is the most common type of headache and it’s likely that you’ve had more than one of these in your life. But for some people, they occur almost every day. Tension headaches affect both sides of your head with a pressing, moderate pain. Over-the-counter medications like ibuprofen (Advil) or acetaminophen (Tylenol) often help, but taking them for long periods of time can lead to headaches called “medication overuse” or “rebound” headaches. Instead, you may want to try meditation, relaxation techniques or heat therapy.

Migraine

Migraines, although less common, are more severe. The pain is intense, may pulsate and can be accompanied by nausea, sensitivity to light or sound, vomiting or visual disturbances called “auras.” Often, migraines only affect one side of the head, although they can affect both. They also affect women more often than men. Prescription medications are available to treat migraines, but you also may benefit from simply resting in a quiet, dark room and using hot or cold compresses. Progressive symptoms of more severe or frequent headaches, or any headache that is also associated with other neurological symptoms, should be evaluated by a physician

Cluster headache

Men are more likely to have these more sudden headaches, which are often marked by pain on one side of the head, behind the eye. They tend to happen in clustered periods of time, even multiple times a day, then disappear for a while. Eyes tend to water, and a restless feeling is common. These headaches usually require prescription medicines.

New daily persistent headache (NDPH)

If you suddenly get frequent headaches, you may have NDPH. The symptoms of NDPH can mimic tension headaches or migraines, but NDPH occurs in people who don’t have a history of headaches. Often, people with NDPH can remember exactly when the onset happened. Your doctor may need to run tests to make sure these headaches aren’t secondary — that is, a symptom of a serious underlying condition.

Although daily headaches might not be the result of a dangerous problem, they can affect your quality of life and shouldn’t be considered “normal.”

“Progressive symptoms of more severe or frequent headaches, or any headache that is also associated with other neurological symptoms, should be evaluated by a physician,” says Jonathan J. Russin, MD, a neurosurgeon at Keck Medicine of USC and assistant professor of clinical neurological surgery at the Keck School of Medicine of USC. “Even using these criteria, the majority of headaches will not represent an underlying problem. An exception is a ‘thunderclap’ headache, which refers to the sudden onset of the worst headache of your life. This type of headache should always be evaluated by a physician whether it is associated with other symptoms or not.”

Topics

cluster headache

Dr. Jonathan J. Russin

headaches

migraine

tension headache

Tina Donvito

Tina Donvito is a freelance writer covering health, culture, travel and parenting.

HEADACHE – Hadassah Medical Moscow

Traditional migraine therapy consists of behavioral therapy, relief of an already developed attack and preventive treatment aimed at preventing attacks. Behavioral therapy, a necessary step in effective patient management, is carried out during a conversation with the patient and includes: explaining the benign nature of migraine, dissuading the presence of an organic disease, discussing the role of attack triggers and the need to avoid them, risk factors for migraine chronicity (taking a large number of painkillers, stress , psycho-emotional states), as well as the rationale for treatment tactics (mechanisms of action of prescribed drugs).

Treatment of a migraine attack is prescribed depending on its intensity and the degree of maladaptation of the patient. With infrequent attacks of mild or moderate intensity, simple or combined analgesics are indicated; with severe nausea and vomiting – antiemetics. With a high intensity of pain and significant maladaptation, triptans are prescribed.

New drug groups have been approved worldwide for the treatment of migraine attacks. This, in turn, enables doctors to treat their patients more effectively, and for patients to reduce the number of days with a headache, improve quality of life, sleep, mood and performance.

Lasmiditan is a selective serotonin 1F receptor agonist that does not have vasoconstrictive activity. The role of lasmiditan in clinical practice has not yet been determined, but it is probably best suited for patients with relative contraindications to triptans due to cardiovascular risk factors.

In October 2019, the US Food and Drug Administration (FDA) approved lasmiditan oral tablets for the treatment of acute migraine in adults. The drug is currently not registered in the Russian Federation.

CGRP antagonists (Rimegepant and Ubrogepant) Monoclonal antibodies directed against the CGRP receptor or ligand. These are oral options available for the acute treatment of migraine in patients with insufficient response or contraindications (eg coronary artery disease) to triptan treatment.

Ubrogepant received US Food and Drug Administration (FDA) approval for the treatment of acute migraine in adults in December 2019year, and rimegepant received a similar FDA approval in February 2020. This group of drugs is not registered in the territory of the Russian Federation.

Preventive therapy is aimed at reducing the frequency, duration, intensity of attacks, the number of doses of painkillers and improving the quality of life of patients.

The main indications for course treatment: the frequency of days with GB > 4 per month, the lack of effectiveness of drugs for the relief of migraine attacks, the presence of risk factors for migraine chronicity (abuses, depression), prolonged aura (> 60 min). The duration of the course of treatment is from 3 to 12 months (an average of 4-6 months for episodic, 8-12 months for chronic migraine), then an attempt is made to gradually withdraw the drug (s) or reduce their dosage.

CGRP antagonists is a human monoclonal antibody that binds to and inhibits the calcitonin gene-related CGRP receptor (CGRP) and is a therapeutic target in migraine due to its putative role in mediating the transmission of trigeminovascular pain and the vasodilator component of neurogenic inflammation

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Large molecules in the form of monoclonal antibodies directed against the CGRP receptor or ligand are injected to prevent migraine. The US Food and Drug Administration (FDA) approved the CGRP antagonist monoclonal antibodies erenumab, fremanezumab, and galcanezumab in 2018 and eptinezumab in 2020 for the preventive treatment of migraine. In 2020, two drugs (erenumab, fremanezumab) were registered in the Russian Federation.

All about headaches – causes, diagnosis and treatment

It is extremely rare to meet people who have not experienced a headache at least once in their lives. A complaint of headache or cephalalgia is one of the most common complaints at a neurologist’s appointment. More than 13% of the population suffers from chronic headaches.

Types of headaches

Headache forms are various: migraine; tension headache; post-traumatic headache; headache caused by an increase or decrease in intracranial pressure; headache with prolonged use of drugs; headache caused by infections, etc.

• Vascular headache occurs due to spasm of arteries or vein dilation, insufficiency of their tone, slowing of blood flow.
• Muscle tension headache caused by muscle tension during prolonged non-physiological position (e.g. non-compliance with the principles of physiological seating by schoolchildren, drivers, programmers, etc.)
• Neuralgic headache is caused by nerve involvement.
• Psychic headache is associated with disturbances in the exchange of mediators of the central nervous system.
• Mixed headache is characterized by a combination of the above factors that develop sequentially or almost simultaneously.

It is necessary to mention extremely rare cephalalgias: cluster headache, chronic paroxysmal hemicrania, temporal arteritis, etc.

What is a headache?

Any headache should be a reason to contact a neurologist, so as not to miss the pathology of the nervous system or internal organs, signaling itself with a headache. This can be hypertension, diseases of the upper respiratory tract, kidneys, gastrointestinal tract, infectious, dental diseases, etc.

Headache diagnostics

The causes of the headache are established after undergoing a comprehensive neurological examination: Echo-encephalography, electroencephalography, ultrasound dopplerography of the vessels of the head and neck, rheoencephalography, P-graphy of the skull, magnetic resonance and computed tomography of the brain, examination of the fundus, consultations of the necessary specialists, laboratory research methods.

Treatment recommendations

Self-medication, prolonged uncontrolled use of painkillers to relieve headache symptoms should not be dealt with. In such a case, by drowning out the pain, the patient does not in any way affect its cause, which can be very serious. Moreover, the daily abuse of analgesics leads to the opposite effect – an overuse headache occurs. Daily uncontrolled intake of analgesics leads to drug disease, which is observed in 20% of the population of developed countries.

An integrated approach to treatment is needed, depending on the pathogenetic mechanisms of headache development identified during the examination. In each case, the treatment is selected individually and includes both relief of headache attacks and treatment in the period between attacks. The doctor’s arsenal includes medication methods, acupuncture, psychotherapy, autogenic training, post-isometric relaxation, manual therapy (especially for relieving muscle tension with tension headaches), biofeedback, massage, physiotherapy, physiotherapy, millimeter resonance therapy, laser therapy, homeopathic approaches .