Living With Chronic Daily Headaches

The only thing worse than a terrible headache is one that occurs more days than not, with no apparent end in sight. Yet, for about four percent of the general population, that nightmare is a reality. Chronic daily headaches describe a cluster of chronic conditions that cause headaches on more than 15 days a month, for at least three months in a row, with various causes and associated risk factors.

Defining Chronic Daily Headaches

Chronic daily headaches can range in severity and location and can sometimes be debilitating. Treatments differ from condition to condition, and some are not easily treatable (or treatable at all). In most cases, chronic daily headaches refer to a chronic primary headache (i.e., the headaches themselves are the disease, and a different condition doesn’t cause them).

Depending on the specific condition, chronic daily headaches can be short-lasting (less than four hours) or long-lasting (more than four hours). Headaches in and of themselves are not something to be worried about. However, a chronic daily headache is a serious condition that requires aggressive early treatment to combat symptoms and improve quality of life. Strongly consider seeking medical help if:

• • You frequently experience more than two headaches a week.
  • You take over-the-counter medication (or any pain reliever) on most days.
  • You often exceed the recommended dose because it is not effective otherwise.
  • Your headaches have recently been getting worse, or the pattern has changed.
  • Your headaches interfere with your work and personal life.

NOTE: If your headaches are accompanied by dizziness, nausea, a stiff neck, numbness, slurred speech, are occurring after a head injury, and/or are getting progressively worse despite home remedies, seek immediate care.

Types of Chronic Daily Headaches

Four common types of chronic daily headaches include a chronic tension headache, a chronic or transformative migraine, a new persistent daily headache, and hemicrania continua. These are four distinct conditions with different symptoms and treatments, characterized by recurring chronic headaches.

Chronic Tension Headache

A tension headache is typically associated with the feeling of a tightening band around the side or base of the head. The pain is typically mild to moderate and can be felt on both sides of the head.

Chronic Migraine (Transformed Migraine)

Migraine is commonly felt on one side, accompanied by massive sensitivity to light and nausea. Migraine headaches are pulsating or throbbing and can be very severe. When migraine becomes chronic, it is usually also called a transformed migraine. This is because migraine attacks are usually episodic and can occur once or more per week. Patients who frequently experienced more than one episode per week are usually at greater risk of having their migraine “transform” into a chronic condition.

Hemicrania Continua

Hemicrania continua are characterized by chronic pain and pressure on one side of the head, with nearly no pain-free period and a slow progression towards a greater severity. It is often described as a dull ache, with a periodic stabbing pain. Other physical symptoms of hemicrania continua include nasal congestion, tearing or redness in the affected side’s eye, and trouble sleeping.

New Persistent Daily Headache

When a person has no prior history of regular headaches and suddenly becomes a chronic daily headache, they have a new daily persistent headache. These headaches usually feel more like tension headaches than migraine headaches but can have features of both.

What Causes Chronic Daily Headaches?

While causes vary widely and primary headache conditions have no understood or clear cause, there are identifiable risk factors associated with recurring and chronic headaches. Nonprimary chronic daily headaches (i.e., caused by a separate condition) may occur because of a stroke, head injury, infection, intracranial pressure, and more. But primary headaches are usually associated with:

• • Stress
  • Excessive caffeine (or caffeine sensitivity)
  • Medication overuse
  • Sex (females are statistically more susceptible to chronic daily headaches)
  • Anxiety and depression
  • Obesity
  • Poor quality of sleep
  • Other types of chronic pain (arthritis, rheumatoid or otherwise; fibromyalgia; chronic fatigue syndrome, and more)

Addressing Chronic Daily Headaches at Home

Addressing some of these risk factors may help reduce headache severity or frequency. Things that are known to help with chronic daily headaches include:

• • A healthy meal plan. This includes nutrition, but also timing. Avoid skipping meals, reduce caffeine, and track your food choices to identify certain potential headache triggers. Common drinks and foods that trigger headaches include alcohol, aged cheeses, chocolate, organ meats, nuts and seeds, tomatoes, certain artificial sweeteners, and more.
  • Frequent and appropriate exercise. Moderate aerobic exercise may help with headache severity and frequency and can help address potential risk factors. The endorphins released during exercise also help reduce pain sensitivity.
  • Taking care of your mental health. Symptoms of anxiety and depression can actively worsen existing pain, decrease pain tolerance, and increase the likelihood of headaches. If you are constantly stressed, reducing stress sources can also make a big impact on your pain. Consider seeking professional help, including therapy.
  • Tackle your sleep problems. Good sleep is important, and people who sleep very little or have poor sleep quality are more likely to experience chronic daily headaches. If simple measures like reducing screen time before bed, winding down properly, avoiding eating, or exercising too late, making sure your room are cold and dark, and investing in a better bed do not help with sleep quality, consider asking your doctor about other potential measures, from melatonin to other sleep aids.

Treatments for Chronic Daily Headaches

True primary chronic headaches are complicated to treat. But if an underlying cause can be identified, treating it will usually help address headache severity and frequency. Aside from remedies and protective factors listed above, common medications and interventions for chronic headaches include:

• • Antidepressants
  • Anti-seizure drugs
  • Botox injections
  • Beta-blockers
  • Non-steroidal anti-inflammatory drugs

Chronic daily headaches can significantly reduce the quality of life and interfere with work and family life. While there is no guaranteed treatment, and identifying a cause can be difficult, early and aggressive treatment is often the best chance to reduce symptoms and tackle the condition. Do not delay – seek care now.