It’s common for most people to experience a headache occasionally. However, if headaches become a frequent occurrence, happening more often than not, you might be experiencing chronic daily headaches. This condition, rather than being a specific type of headache, encompasses a spectrum of headache subtypes, characterized by their frequency and persistence.
The relentless nature of chronic daily headaches positions them as one of the most disabling headache disorders. Effective early intervention and consistent, long-term management are crucial steps toward alleviating pain and reducing the frequency of these headaches.
Alt text: Woman experiencing a severe headache, illustrating the pain of chronic daily headaches.
What are Chronic Daily Headaches?
By definition, chronic daily headaches are defined as headaches that occur 15 days or more per month, consistently for over three months. These are classified as true or primary chronic daily headaches when they are not caused by an underlying medical condition.
Chronic daily headaches can be further categorized by their duration, being either short-lasting (less than 4 hours) or long-lasting (more than 4 hours). Long-lasting chronic daily headaches include several subtypes:
- Chronic migraine
- Chronic tension-type headache
- New daily persistent headache
- Hemicrania continua
Chronic Migraine
Chronic migraine often develops in individuals with a history of episodic migraines. Key characteristics of chronic migraines include:
- Pain affecting one or both sides of the head
- A pulsating, throbbing sensation
- Moderate to severe pain intensity
- Association with nausea, vomiting, or both
- Sensitivity to light and sound
Chronic Tension-Type Headache
Chronic tension-type headaches are characterized by:
- Pain affecting both sides of the head
- Mild to moderate pain level
- A pressing or tightening quality of pain, rather than pulsating
New Daily Persistent Headache
New daily persistent headaches are distinct due to their sudden onset, typically in individuals without a prior history of frequent headaches. They become persistent within three days of the initial headache and are marked by:
- Pain often on both sides of the head
- A pressing or tightening pain, not pulsating
- Mild to moderate pain intensity
- Potential features overlapping with chronic migraine or chronic tension-type headache
Alt text: Detailed view of a woman’s face expressing headache pain, emphasizing the commonality and impact of headaches.
Hemicrania Continua
Hemicrania continua headaches are identified by:
- Pain exclusively on one side of the head
- Daily and continuous occurrence without pain-free periods
- Moderate baseline pain with sharp spikes of severe pain
- Responsiveness to indomethacin, a prescription pain reliever
- Possible escalation to migraine-like symptoms
Furthermore, hemicrania continua headaches may be accompanied by at least one of the following:
- Tearing or redness of the eye on the affected side
- Nasal congestion or a runny nose
- Drooping eyelid or pupil constriction
- A sense of restlessness
Why Do Chronic Daily Headaches Happen? (Causes)
The exact causes of many chronic daily headaches remain not fully understood. Primary chronic daily headaches, by definition, do not have an identifiable underlying cause. However, secondary chronic daily headaches can be linked to various conditions, including:
- Inflammation or abnormalities of blood vessels in and around the brain, such as stroke
- Infections, for example, meningitis
- Abnormal intracranial pressure, either too high or too low
- Brain tumors
- Traumatic brain injury
Medication Overuse Headache
A significant contributor to chronic daily headaches is medication overuse. This type of headache typically arises in individuals with pre-existing episodic headache disorders, most commonly migraine or tension-type headache, who excessively use pain relief medication. Regular use of pain medications, even over-the-counter options, for more than two days per week (or nine days per month) can increase the risk of developing rebound headaches, also known as medication overuse headaches.
Risk Factors for Chronic Daily Headaches
Several factors are associated with an increased likelihood of developing frequent headaches:
- Female gender
- Pre-existing anxiety disorders
- Depression
- Sleep disturbances, such as insomnia or sleep apnea
- Obesity
- Snoring
- Excessive caffeine intake
- Overuse of headache medications
- Presence of other chronic pain conditions, like arthritis or fibromyalgia
Complications of Chronic Daily Headaches
Living with chronic daily headaches extends beyond physical pain. Individuals with this condition are more susceptible to developing:
- Depression
- Anxiety disorders
- Sleep disturbances
- Other psychological and physical health problems, significantly impacting overall quality of life.
When to Seek Medical Advice for Headaches
Occasional headaches are generally not a cause for concern and typically do not require medical intervention. However, it’s advisable to consult a doctor if:
- Headaches occur two or more times per week on a regular basis
- Pain relievers are needed for headaches on most days
- Over-the-counter pain medications are insufficient to relieve headache pain, or require exceeding the recommended dose
- There’s a change in the pattern of headaches or a worsening of headache severity
- Headaches become disabling, interfering with daily activities
Seek immediate medical attention if a headache:
- Is sudden and severe in onset
- Is accompanied by fever, stiff neck, confusion, seizures, double vision, weakness, numbness, or speech difficulties
- Occurs after a head injury
- Worsens despite rest and pain medication
Alt text: Doctor consulting with a patient about their headache symptoms, emphasizing the importance of medical advice for chronic headaches.
Prevention Strategies for Frequent Headaches
Adopting proactive self-care strategies can play a crucial role in managing and easing chronic daily headaches:
- Identify and Avoid Headache Triggers: Keeping a detailed headache diary can be instrumental in pinpointing headache triggers. Record details such as the onset time, preceding activities, and duration of each headache.
- Avoid Medication Overuse: Be mindful of headache medication usage. Regular use more than twice a week can exacerbate headache frequency and severity. Consult your doctor for guidance on safely reducing medication use, as improper withdrawal can lead to adverse effects.
- Prioritize Adequate Sleep: Aim for seven to eight hours of sleep per night for the average adult. Maintain a consistent sleep schedule by going to bed and waking up at the same time daily. Address any sleep disturbances, such as snoring, by consulting a healthcare professional.
- Maintain Regular Meal Schedules: Eat nutritious meals at consistent times each day. Be aware of dietary triggers, such as caffeine-containing foods and beverages, and avoid them if they seem to provoke headaches. Consider weight loss if obesity is a factor.
- Engage in Regular Exercise: Regular aerobic exercise promotes physical and mental well-being and can reduce stress levels. With your doctor’s approval, choose enjoyable activities like walking, swimming, or cycling, starting gradually to prevent injury.
- Manage Stress Effectively: Stress is a known headache trigger. Employ stress-reduction techniques such as yoga, tai chi, or meditation. Organize your tasks, simplify your schedule, plan ahead, and cultivate a positive outlook.
- Limit Caffeine Intake: While caffeine is sometimes included in headache medications for its pain-reducing properties, it can also worsen headaches. Minimize or eliminate caffeine consumption from your diet.
By Mayo Clinic Staff
References
- Garza I, et al. Overview of chronic daily headache. https://www.uptodate.com/contents/search. Accessed Jan. 16, 2018.
- Chronic daily headache: An overview. American Migraine Foundation. https://americanmigrainefoundation.org/understanding-migraine/chronic-daily-headache-an-overview/. Accessed Jan. 16, 2018.
- Yancey JR, et al. Chronic daily headache: Diagnosis and management. American Family Physician. 2014;89:642.
- Chronic daily headache and chronic migraine. American Headache Society. https://americanheadachesociety.org/wp-content/uploads/2016/07/NAP_for_Web_-_CDH___Chronic_Migraine.pdf. Accessed Jan. 16, 2018.
- Headaches and complementary health approaches. National Center for Complementary and Integrative Health. https://nccih.nih.gov/health/pain/headachefacts.htm. Accessed Jan. 18, 2018.
- Riggin EA. Allscripts EPSi. Mayo Clinic, Rochester, Minn. Dec. 15, 2017.
