Chronic daily headaches
DEFINITION
Most people have headaches from time to time. But if you have a headache more days than not, you may be experiencing chronic daily headaches.
The incessant nature of chronic daily headaches makes them among the most disabling headaches. Aggressive initial treatment and steady, long-term management may reduce pain and lead to fewer headaches.
CAUSES
The causes of many chronic daily headaches aren’t well-understood. True (primary) chronic daily headaches don’t have an identifiable underlying cause.
Conditions that may cause non-primary chronic daily headaches include:
- Inflammation or other problems with the blood vessels in and around the brain, including stroke
- Infections, such as meningitis
- Intracranial pressure that’s either too high or too low
- Brain tumor
- Traumatic brain injury
- Medication overuse headache
- This type of headache usually develops in people who have an episodic headache disorder, usually migraine or tension-type, and take too much pain medication. If you’re taking pain medications — even over-the-counter analgesics — more than two days a week (or nine days a month), you’re at risk of developing rebound headaches
SYMPTOMS
By definition, chronic daily headaches occur 15 days or more a month, for at least three months. True (primary) chronic daily headaches aren’t caused by another condition.
There are short-lasting and long-lasting chronic daily headaches. Long-lasting last more than four hours. They include:
Chronic migraine
- Chronic tension-type headache
- New daily persistent headache
- Hemicrania continua
Chronic migraine
This type typically occurs in people with a history of episodic migraines. On eight or more days a month for at least three months, migraines tend to have the following features:
- Affect one side or both sides of your head
- Have a pulsating, throbbing sensation
- Cause moderate to severe pain
- Are aggravated by routine physical activity
And they cause at least one of the following:
- Nausea, vomiting or both
- Sensitivity to light and sound
Chronic tension-type headache
These headaches tend to have the following features:
- Affects both sides of your head
- Cause mild to moderate pain
- Cause pain that feels pressing or tightening, but not pulsating
- Aren’t aggravated by routine physical activity
- Some people may have skull tenderness.
New daily persistent headache
These headaches come on suddenly, usually in people without a headache history. They become constant within three days of your first headache. They have at least two of the following characteristics:
- Usually affects both sides of your head
- Cause pain that feels like pressing or tightening, but not pulsating
- Cause mild to moderate pain
- Aren’t aggravated by routine physical activity
Hemicrania continua
These headaches:
- Affect only one side of your head
- Are daily and continuous with no pain-free periods
- Cause moderate pain with spikes of severe pain
- Respond to the prescription pain reliever indomethacin (Indocin)
- May sometimes become severe with development of migraine-like symptoms
In addition, hemicrania continua headaches are associated with at least one of the following:
- Tearing or redness of the eye on the affected side
- Nasal congestion or runny nose
- Drooping eyelid or pupil narrowing
- Sensation of restlessness
When to see a doctor
Occasional headaches are common, and usually require no medical attention. However, consult your doctor if:
- You usually have two or more headaches a week
- You take a pain reliever for your headaches most days
- You need more than the recommended dose of over-the-counter pain remedies to relieve your headaches
- Your headache pattern changes or your headaches worsen
- Your headaches are disabling
Seek prompt medical care if your headache:
- Is sudden and severe
- Accompanies a fever, stiff neck, confusion, seizure, double vision, weakness, numbness or difficulty speaking
- Follows a head injury
- Gets worse despite rest and pain medication
