Everyday headache causes. Understanding Chronic Daily Headaches: Causes, Types, and Treatment Options
What are the main causes of chronic daily headaches. How can you identify different types of persistent headaches. What treatment options are available for managing frequent headaches. When should you seek medical attention for recurring headaches.
The Nature of Chronic Daily Headaches
Chronic daily headaches are a persistent and often debilitating condition that affects millions of people worldwide. These headaches occur 15 or more days per month, for at least three months, and can significantly impact an individual’s quality of life. While the exact causes of most headaches remain unknown, understanding the nature of chronic daily headaches is crucial for proper management and treatment.
Defining Chronic Daily Headaches
Chronic daily headaches are not a specific type of headache but rather a classification that encompasses various headache disorders. These headaches can be primary, meaning they are not caused by an underlying condition, or secondary, resulting from another medical issue. Primary headaches are more common and include tension-type headaches, migraines, and cluster headaches.
Prevalence and Impact
Chronic daily headaches affect approximately 4-5% of the general population. The impact of these persistent headaches extends beyond physical discomfort, often leading to decreased productivity, social isolation, and emotional distress. Understanding the prevalence and impact of chronic daily headaches is essential for developing effective treatment strategies and support systems.
Common Triggers and Contributing Factors
While the exact causes of most headaches remain elusive, several factors can contribute to the development and persistence of chronic daily headaches. Identifying these triggers is crucial for managing and preventing headache episodes.
- Alcohol consumption
- Caffeine intake or withdrawal
- Dehydration
- Hunger or skipping meals
- Lack of sleep or irregular sleep patterns
- Sensory stimuli (bright lights, loud noises, strong odors)
- Stress and anxiety
- Hormonal changes
- Certain medications
- Changes in weather or barometric pressure
Understanding these triggers can help individuals make lifestyle adjustments to reduce the frequency and severity of their headaches. Keeping a headache diary, as recommended by the National Headache Foundation, can be an effective tool for identifying personal triggers and patterns.
Types of Chronic Daily Headaches
Chronic daily headaches can manifest in various forms, each with distinct characteristics and treatment approaches. Recognizing the different types of chronic headaches is essential for accurate diagnosis and effective management.
Tension-Type Headaches
Tension-type headaches are the most common form of chronic daily headaches. They typically present as a constant, dull ache on both sides of the head, often described as a tight band or pressure. These headaches can last from 30 minutes to several days and may be accompanied by neck and shoulder muscle tension.
Chronic Migraines
Chronic migraines are defined as headaches occurring on 15 or more days per month, with at least eight of those days meeting the criteria for migraine headaches. Migraines are characterized by intense, throbbing pain, often on one side of the head, and may be accompanied by nausea, vomiting, and sensitivity to light and sound.
Cluster Headaches
Cluster headaches are less common but extremely severe. They occur in cyclical patterns or clusters, with intense pain typically centered around one eye. These headaches are more prevalent in men and can be accompanied by eye tearing, nasal congestion, and restlessness.
New Daily Persistent Headache (NDPH)
NDPH is a rare type of chronic daily headache that develops suddenly in individuals with no prior history of frequent headaches. The onset is often abrupt, and patients can usually recall the exact date their headaches began. NDPH symptoms can mimic tension-type headaches or migraines but require specialized evaluation and treatment.
Diagnosing Chronic Daily Headaches
Accurate diagnosis of chronic daily headaches is crucial for developing an effective treatment plan. The diagnostic process typically involves a comprehensive evaluation of the patient’s medical history, symptoms, and potential contributing factors.
Medical History and Symptom Assessment
A detailed medical history, including the frequency, duration, and characteristics of headaches, is essential for diagnosis. Physicians may inquire about family history, lifestyle factors, and any recent changes or stressors that could be contributing to the headaches.
Physical and Neurological Examination
A thorough physical and neurological examination helps rule out underlying conditions that may be causing secondary headaches. This may include checking vital signs, assessing cranial nerve function, and evaluating muscle strength and coordination.
Diagnostic Tests
In some cases, additional diagnostic tests may be necessary to rule out secondary causes of headaches or to provide more detailed information about the condition. These tests may include:
- Imaging studies (MRI or CT scans)
- Blood tests
- Lumbar puncture (spinal tap)
- Electroencephalogram (EEG)
It’s important to note that most chronic daily headaches are primary headaches and may not require extensive testing. However, certain red flags or atypical symptoms may warrant further investigation.
Treatment Approaches for Chronic Daily Headaches
Managing chronic daily headaches often requires a multifaceted approach, combining pharmacological interventions with lifestyle modifications and complementary therapies. The goal of treatment is to reduce the frequency and severity of headaches while improving overall quality of life.
Pharmacological Interventions
Medications play a crucial role in managing chronic daily headaches. Treatment strategies may include:
- Acute pain relievers: Over-the-counter medications like ibuprofen or acetaminophen for occasional relief
- Preventive medications: Daily medications to reduce the frequency and severity of headaches
- Migraine-specific medications: Triptans or gepants for migraine attacks
- Botulinum toxin injections: For chronic migraine prevention
It’s important to use medications under the guidance of a healthcare professional to avoid medication overuse headaches, which can occur with frequent use of pain relievers.
Lifestyle Modifications
Implementing lifestyle changes can significantly impact the frequency and severity of chronic daily headaches. Some effective strategies include:
- Maintaining a regular sleep schedule
- Staying hydrated
- Eating regular, balanced meals
- Exercising regularly
- Managing stress through relaxation techniques or mindfulness practices
- Avoiding known triggers
Complementary and Alternative Therapies
Many individuals find relief from chronic daily headaches through complementary and alternative therapies. These may include:
- Acupuncture
- Biofeedback
- Massage therapy
- Cognitive-behavioral therapy
- Herbal supplements (under medical supervision)
- Yoga or tai chi
While these therapies may not work for everyone, they can be valuable additions to a comprehensive treatment plan for some individuals.
When to Seek Medical Attention
While most headaches are not life-threatening, certain symptoms or patterns may indicate a more serious underlying condition. Knowing when to seek medical attention is crucial for proper diagnosis and treatment of chronic daily headaches.
Red Flags for Immediate Medical Evaluation
Certain headache symptoms require immediate medical attention. These include:
- Sudden, severe headache often described as a “thunderclap”
- Headache accompanied by fever, stiff neck, or rash
- Headache following a head injury
- Headache with neurological symptoms (confusion, seizures, vision changes)
- New onset of headaches after age 50
- Headaches that worsen with coughing, exertion, or sudden movement
If you experience any of these symptoms, seek immediate medical care or go to the nearest emergency room.
When to Consult a Headache Specialist
Consider consulting a headache specialist or neurologist if:
- Your headaches are becoming more frequent or severe
- Over-the-counter medications are no longer effective
- Headaches are interfering with your daily activities or quality of life
- You’re experiencing side effects from headache medications
- You have a history of migraines and your pattern changes
A specialist can provide a comprehensive evaluation and develop a tailored treatment plan to manage your chronic daily headaches more effectively.
Living with Chronic Daily Headaches: Coping Strategies and Support
Dealing with chronic daily headaches can be challenging, but there are numerous strategies and support systems available to help individuals manage their condition and improve their quality of life.
Developing a Headache Management Plan
Working with your healthcare provider to develop a comprehensive headache management plan is crucial. This plan may include:
- A medication regimen for prevention and acute treatment
- Lifestyle modifications to avoid triggers
- Stress management techniques
- Regular exercise and relaxation practices
- A schedule for follow-up appointments and treatment adjustments
Building a Support Network
Living with chronic daily headaches can be isolating, but building a strong support network can make a significant difference. Consider:
- Joining a headache support group (in-person or online)
- Educating friends and family about your condition
- Seeking counseling or therapy to address emotional challenges
- Connecting with others who have similar experiences through online forums or social media
Exploring Workplace Accommodations
Chronic daily headaches can impact work performance. Explore potential workplace accommodations such as:
- Flexible work hours
- Ability to work from home when needed
- Adjustments to lighting or noise levels in your workspace
- Regular breaks for relaxation or medication
Open communication with your employer about your condition can help create a more supportive work environment.
Practicing Self-Care and Mindfulness
Incorporating self-care and mindfulness practices into your daily routine can help manage stress and improve overall well-being. Consider:
- Regular meditation or deep breathing exercises
- Engaging in hobbies or activities you enjoy
- Prioritizing sleep and relaxation
- Maintaining a balanced diet and staying hydrated
- Practicing gratitude and positive thinking
Remember that managing chronic daily headaches is a journey, and it may take time to find the right combination of treatments and coping strategies that work best for you. Stay patient and persistent in your efforts to improve your quality of life.
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.
Why Am I Getting Frequent Headaches?
To say, “I have a headache,” is one thing. To say, “I always have headaches,” is another. The latter is often more concerning.
Most people get headaches from time to time. They usually go away with or without any treatment. Frequent headaches are much less common and much more serious. They can disrupt your work or personal life. They can also be a sign of an illness or injury.
“Unfortunately, many people don’t seek help because they think they can cope on their own,” says Christy Jackson, MD, a neurologist and director of the Donald J. Dalessio Headache Center at Scripps Clinic. “They may rely on over-the-counter pain relievers instead of getting medical help. In some cases, headaches are not properly diagnosed. ”
Consult with your primary care doctor if your headache symptoms get worse or occur more often despite treatment at home. Your doctor may refer you to a headache specialist.
“No one should go through life suffering from chronic headaches,” Dr. Jackson says. “Not when they are treatable.”
Headache specialists at Scripps help people who suffer from recurring, chronic headaches through a combination of traditional and complementary care with a focus on prevention and lifestyle changes.
“We evaluate your symptoms and design a treatment plan that targets the underlying physical, psychological and environmental causes of your headaches,” Dr. Jackson says.
“There are many effective treatments to relieve symptoms and prevent future attacks,” adds Robert Bonakdar, MD, a pain specialist at the Scripps Center for Integrative Medicine. Treatments may include medication, biofeedback and other therapies.
Dr. Bonakdar stresses the importance of clear and open communication between doctor and patient. “Correct diagnosis depends largely on the information you share with your health care provider.”
It’s important to understand your diagnosis as much as possible, including what type of headache you have and what is causing it. There are many types of headaches, levels of frequency and severity.
Headache pain can range from mild to disabling. Headaches can be episodic or chronic. Episodic headaches occur occasionally. Chronic headaches are more consistent. They can strike for 15 days or more in a month.
Headaches are divided into two main types: primary and secondary. Primary headaches are those not caused by another medical condition. Migraine and tension headaches are the most common.
Secondary headaches are symptoms of another health problem, such as a fever, infection, stress or a head injury.
Tension headaches, which are the most common type of headache, cause mild to moderate pain. They often present as a dull, constant pain felt on both sides of the head, and have no other symptoms.
These type of headaches are caused by tightening or tension in the muscles in the head, neck and scalp. They can be brought on by stress, noise, fumes and even long periods of watching TV or computer screens. They’re easier to handle than other types of headaches because they usually just come and go. Chronic tension headaches are much less common.
Migraine is the most disruptive type of primary headache. It is often marked by a throbbing pain that is moderate to severe. It can last four to 72 hours and happen one to four times a month.
Migraines often include other symptoms. Someone with a migraine may be sensitive to light and sound. They may prefer to be in a dark, quiet space. They may also experience nausea and vomiting and visual disturbances (aura).
Women are more likely than men to get migraines. Migraine attacks may also run in a family and begin at an early age.
Certain environmental factors are common triggers, such as sleep disruption, dehydration, skipped meals, some foods, hormone fluctuations and exposure to chemicals.
“The goal is to treat migraine symptoms right away and to prevent symptoms by avoiding or changing triggers,” Dr. Jackson says.
Cluster headaches are more severe but less common. They often begin on one side of the head and recur for days or weeks. Attacks can last between 15 minutes to three hours and occur every day.
They tend to affect men between the ages of 20 and 50, and smokers. People who experience these types of headaches are often restless, agitated and sweat profusely. Alcohol can trigger an attack.
Also known as rebound headaches, they are caused by an overuse of pain medications, such as aspirin, acetaminophen and ibuprofen. Women are affected more often than men.
When over-the-counter medicine fails to work and headaches become more frequent, medication and other therapies may be prescribed.
Medications to prevent frequent migraines include antidepressants and Botox injections and newer medications.
In 2018, the Food and Drug Administration (FDA) approved a new class of medications that modulate a neuropeptide known as calcitonin gene-related peptide (CGRP) that is believed to play a key role in migraine. Neuropeptides are small protein-like molecules used by neurons to communicate with each other.
For treatment of migraines as they occur, your doctor may prescribe triptans for relief.
Medication for frequent headaches may be combined with non-medication options, such as biofeedback, relaxation, bio stimulation and diet therapy.
Biofeedback uses electronic monitoring to help teach individuals how to control certain physical responses, such as muscle tension.
Many different relaxation therapies are available and can be individualized.
“Manual and massage therapy can be especially helpful for those with significant muscle tension or neck stiffness related to headache,” Dr. Bonakdar says.
For those who may have significant stress and sleep issues, one of the most powerful techniques is mindfulness. “This technique helps individuals increase awareness to manage triggers and automatic responses that often lead to the next headache.”
Mindfulness is typically offered at Scripps as an 8-week stress reduction course.
Biostimulation is a broad term that encompasses therapies such as acupuncture, which involves the use of needles to stimulate specific points of the body to alleviate pain.
“With a treatment course, acupuncture has been found to be as helpful as medication in the prevention of migraines,” Dr. Bonakdar says.
Electrical stimulation and other techniques can also be used. The most recent is the Nerivio wearable device, which was one of Time magazine’s Best Inventions of 2019.
Many headache sufferers often report a diet-related trigger. “When this is the case, the solution may be as simple as identifying and avoiding these triggers or finding a diet or supplement regimen that can fill gaps created by long-term headaches,” Dr. Bonakdar says.
While many foods can cause headaches, some are more common than others. Dr. Bonakdar works closely with the center’s dietician to help patients identify and avoid individualized triggers, which typically fall into a few categories:
- Allergenic foods which may take testing to confirm, such as peanuts and foods made with gluten
- Additives, such as those found in pre-packaged and processed foods
- Artificial sweeteners, such as those found in diet foods to reduce calorie content
- Aged foods, including wine, cheese, sauerkraut and cured meats.
“Diet is just one component of headache management,” he adds. “It’s important to look at the whole person to develop a treatment plan that includes a healthy lifestyle, integrative therapies — and when appropriate — medication.”
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 .