Chronic Daily Headaches


Most people occasionally have headaches. But, you may get persistent daily headaches if you experience a headache more often than not. Chronic daily headaches encompass several distinct headache subtypes rather than a single headache type. Chronic describes both the frequency and duration of the headaches.

Chronic daily headaches are among the most incapacitating headache syndromes due to their recurrent frequency. Headaches may be less frequent as a result of aggressive early therapy and stable, long-term maintenance.

Chronic Daily Headaches: Causes

Several severe everyday headaches have unknown origins. Genuine (primary) persistent daily headaches lack an underlying cause that can be determined.

Non-primary chronic daily headaches can result from several conditions, including −

  • Stroke or other issues with the blood arteries in and around the brain, such as inflammation

  • Illnesses like meningitis

  • Unhealthy intracranial pressure that might be either high or low

  • Brain cancer

  • Harm to the brain from trauma

  • Over-medication headache

Those who use too much pain medication and have episodic headache disease, often a tension or migraine headache, are more likely to get this form of headache. You run the risk of getting rebound headaches if you use painkillers, including over-the-counter ones, more than two days a week (or nine days a month).

Chronic Daily Headaches: Symptoms

Chronic daily headaches are those that last longer than three months and last for at least 15 days out of every 30. Real (primary) persistent daily headaches have no secondary etiology.

There are everyday headaches that are both brief and long-lasting chronic. Headaches that endure a long time persist for more than four hours. They consist of −

  • Persistent migraine

  • Persistent tension headache

  • New, ongoing headaches every day

  • Hemicrania persists

Persistent Migraine

Those with a history of episodic migraines are more likely to experience this kind of headache. Persistent headaches typically −

  • Either one or both of your head's sides

  • Feel like my heart is beating and pulsing

  • Produce at least one of the following and moderate to severe pain −

    • Vomiting, nausea, or both Light and sound sensitivity

    • Persistent tension headache

These migraines typically −

  • Affect both sides of your head

  • Bring about light to medium pain

  • Cause discomfort that is not pulsing but feels pressing or tight.

New, on going Headaches Every Day

These headaches often strike those who have never before had them unexpectedly. Within three days following your initial headache, they start to become regular. They are −

  • Both sides of your head often

  • Cause a pressing or tightening discomfort that is not pulsing

  • Bring about light to medium pain

  • Perhaps exhibiting persistent migraine or tension-type headache symptoms

  • Hemicrania persists

These migraines −

  • Just impact one side of your skull.

  • Are constant and every day, with no respite from the ache.

  • Cause intermittent bouts of moderate to severe discomfort

  • In response to indomethacin, a pharmaceutical painkiller

  • Can worsen if migraine-like symptoms start to appear

In addition, at least one of the following conditions is linked to hemicrania continua headaches −

  • Tearing or redness in the afflicted side's eye

  • Runny nose or congestion in the nose

  • Shrinking or drooping eyelids

  • The feeling of being restless

Chronic Daily Headaches: Risk Factors

The major risk factors include −

  • Anxiety

  • Depression

  • Disruptions in sleep

  • Obesity

  • Snoring

  • Excessive caffeine usage

  • Medicine for headaches too often

  • Other chronic pain disorders

Chronic Daily Headaches: Diagnosis

Your doctor will probably question you about your history of headaches while checking you for symptoms of disease, infection, or neurological issues.

Your doctor may prescribe imaging tests, such as a CT scan or MRI, to search for an underlying medical disease if the origin of your headaches is still unknown.

Chronic Daily Headaches: Treatment

Frequent headaches are frequently relieved with treatment for an underlying problem. In the absence of such a disease, pain management is the main goal of treatment.

The type of headache you get and whether drug usage is a factor in your headaches will determine the best prevention method for you. To wean yourself off of painkillers with the help of your doctor may be the first step if you take them more than three days a week.

  • Antidepressants. Nortriptyline is one example of a tricyclic antidepressant that can be used to treat persistent headaches. Moreover, these drugs can assist with the melancholy, anxiety, and sleep issues that frequently accompany persistent daily headaches.

  • Blockers of beta receptors. These medications are a cornerstone for avoiding episodic migraines and are frequently prescribed to manage excessive blood pressure.

  • Anti-epileptic drugs. Certain anti-seizure medications may also be used to prevent persistent daily headaches since they appear to prevent migraines and seizures.

  • NSAIDs. Nonsteroidal anti-inflammatory medications on prescription may be advantageous, particularly if you're stopping using other painkillers. When the headache is more severe, it can also be used regularly.

Some people find comfort in botulinum toxin, and those who have trouble tolerating daily medicine may find it to be a good alternative.

Chronic Daily Headaches: Prevention

Steer clear of things that cause headaches. You can identify the factors that cause your headaches and prevent them by keeping a headache diary. Add information about each headache, including the time it began, what you were doing at the time, and how long it lasted.

  • Avoid overusing medications. More than twice a week using over-the-counter or prescription pain relievers might make your headaches worse and more frequent. Incorrect weaning off of the medicine might have major negative effects, so talk to your doctor about how to accomplish it.

  • Obtain adequate rest. An adult requires seven to eight hours of sleep every night on average. It's ideal to have a consistent bedtime and wake-up time each day.

  • Avoid skipping meals. Eat wholesome meals at around the same times each day. Avoid foods and beverages that tend to bring on headaches, such as those containing caffeine. If you're overweight, lose weight.

  • Regularly moving about. Frequent aerobic exercise can lessen stress and enhance your physical and mental health. Choose enjoyable hobbies like cycling, walking, or swimming with the approval of your doctor. Start carefully to prevent harm.

  • Be less stressed. A major cause of persistent headaches is stress. Be prepared. Make your schedule simpler. Think ahead. Keep upbeat. Consider stress-relieving exercises like yoga, tai chi, or meditation.

  • Reduce the amount of caffeine intake. While caffeine can help to lessen headache discomfort, it can also make headaches worse. This is why some headache treatments contain caffeine. Reduce or completely avoid caffeine in your diet.

Conclusion

As a result of the frequent co-occurrence of drug misuse, which makes it challenging to interpret clinical studies with pharmacological agents in this disease, there is still no universally accepted diagnosis of chronic headache. Both their causes and effects are still up for debate.

Patient perception has altered as a result of patient access to electronic information via mobile devices and the Internet. They exhibit higher compliance with therapy and guidance and are more inclined to admit that analgesics may be the source of their everyday headaches. The therapy choices for many subtypes of chronic daily headaches will significantly change as a result of the development of neuro-stimulation.

Dr. Durgesh Kumar Sinha
Dr. Durgesh Kumar Sinha

MBBS MS [ OPHTHALMOLOGY ]

Updated on: 30-Mar-2023

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