Chronic Daily Headache,
Migraine, or Tension Pain?

The head is one of the most common sites of pain in the body. Headache disorders are defined as pain in any region of the head. Although there are many different types of headaches, they all cause pain. Some pain occurs on one or both sides of the head, can be isolated to a certain region of the head, radiates across the head, or feels like a vise around the head. Headaches are divided into three classifications – primary, secondary, and chronic daily headache disorder – each with its own causes, symptoms, and treatments.

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Causes & Risk Factors

The most common primary headaches include:

  • Migraines
  • Cluster headaches
  • Tension headaches
  • Chronic daily headache (CDH)
  • Hypnic headaches
  • Cough headaches
  • Exercise headaches
  • Sex headaches

  Risk factors for headache chronification  

  • Poor head or neck posture
  • Overuse of pain medication
  • Snoring and sleep disturbances
  • Obesity
  • Overuse of caffeine
  • Anxiety and depression

  Secondary headaches  

A secondary headache is a symptom of a disease that can activate the pain-sensitive nerves of the head. Any number of conditions can cause secondary headaches, including:

  • Arterial tears
  • Blood clot in the brain
  • Brain aneurism
  • Brain tumor
  • Concussion
  • Hangovers
  • Flu
  • Overuse of pain medication
  • Stroke
  • Sinus headaches

  Chronic daily headache disorder  

  • Chronic migraine: happen 15 days or more a month for at least three months.
  • Chronic tension-type headache: evolve from episodic tension-type headaches and can last for hours or be constant.
  • New daily persistent headache: become constant within a few days of a person’s first headache.
  • Hemicranias continua: constant headaches on one side of the head that don’t shift sides.


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    There are as many symptoms of headaches as there are headaches. Symptoms of some of the most common types of headaches include:


    • Moderate to severe pain that can affect the whole head or shift from one side of the head to the other.
    • Sensitivity to light, noise, or odors.
    • Blurred vision, fatigue, or dizziness.
    • Nausea, vomiting, or loss of appetite.
    • The sensation of being very warm or cold.

      Cluster headaches  

    • Intense, one-sided pain with a burning or piercing quality that is throbbing or constant.
    • Pain locates behind one eye or in the eye region.
    • Headache disappears and reappears later.
    • Headaches occur very regularly, generally at the same time each day.

      Sinus headaches  

    • Deep, constant pain in cheekbones, forehead, or nose bridge.
    • Pain intensifies with sudden head movements or straining.

      Chronic tension headaches  

    • Occur more than 15 days a month.
    • Pain that affects the front, top, and sides of the head.
    • Pain varies in intensity throughout the day, over a prolonged period of time.

      Episodic tension headaches  

    • Pain is mild to moderate; occurs less than 15 days a month.
    • Pain that affects the front, top, and sides of the head.
    • Pain often begins in the middle of the day.

    Chronic Daily Headache (CDH) Diagnosis

    To properly diagnose a headache, physical and neurological exams are usually necessary. During the physical examination, your pain specialist will look for symptoms that include:

    • Fever or infection
    • Breathing, pulse, or blood pressure abnormalities
    • Nausea and vomiting
    • Mental confusion
    • Excessive fatigue
    • Speech difficulties
    • Balance problems and falling
    • Dizziness
    • Vision changes

    Neurological tests can be used to rule out the brain’s disease or nerves that may also cause headaches. Your pain specialist can look for a physical or structural abnormality in the brain, including:

    • Tumor
    • Abscess
    • Hemorrhage
    • Bacterial or viral meningitis
    • Blood clots
    • Blood vessel abnormalities
    • Injuries
    • Head trauma

    Other tests can be used to diagnose the source of certain headaches:

    • Blood chemistry and urinalysis tests can help determine the number of medical conditions that can cause headaches, including diabetes, thyroid problems, and infections.
    • CT scans and MRIs can evaluate certain parts of the brain that may be causing headaches.
    • An eye pressure test can help rule out glaucoma or pressure on the optic nerve due to headaches.

    Chronic Daily Headache (CDH) Treatments

    At PMIR Medical Center, we understand that pain is a complex condition that affects the whole person – body, mind, and spirit. We provide a comprehensive, multidisciplinary approach to treatment, customizing the most effective treatment plans for our patients and empowering them to become collaborative partners in their recovery process. At PMIR Medical Center, chronic daily headache treatment begins by treating the underlying disease or condition, causing the headache, if applicable.

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