We’ve all had headaches at the most inopportune moments, whether before a big presentation, a long drive, or a strenuous physical task. New daily persistent headache (NDPH), however, is another matter altogether, describing head pain that lasts for as long as three months or longer. Headaches are not quite easily diagnosed – they can be caused by various reasons and often pass as quickly as they begin. Persistent headaches, however, can affect a person for months with no end in sight.
Treating these headaches helps reintroduce some quality of life and may illuminate a severe underlying issue, such as an ongoing viral infection or stress disorder. New daily persistent headaches are rare and unique among most headache types. These headaches are characterized as new (meaning this is the first time the patient has experienced this type of headache), daily (meaning the patient experiences some level of pain at least once a day), and persistent (lasting at least three months).
New Daily Persistent Headache Causes
An NDPH diagnosis can be extraordinarily frustrating because many patients have no apparent trigger or cause for their headaches. In other words, many patients presenting with NDPH wake up with a massive headache one day and find that it won’t go away on its own or with conventional headache remedies. Some NDPH cases can be traced to an infection (about 20 percent) or post-surgical pain (roughly 10 percent).
But most patients have no discernable cause, reason, or precipitating event, at least not yet. More time is needed to research the mechanism of action behind different cases of NDPH and how they set themselves apart. Prevalence ranges from about 0.03 to 0.1 percent of the population, although men are more likely to develop new daily persistent headaches than women. Most adult age ranges are well represented among patients with NDPH.
In all cases, a significant characteristic necessary to differentiate NDPH from other headaches is that the pain is a daily occurrence with no remission. This means patients presenting with NDPH don’t get a break from the pain for more than a few hours, if at all. Whether or not genes play a significant role in the development of NDPH is also hard to say. Most patients surveyed for studies did not report a similar case of chronic headaches in other family members, suggesting that it might not necessarily be a hereditary condition.
One common correlation was mental health. A significant portion of patients with NDPH also presented symptoms of major depression (about 40 percent) and severe anxiety problems (65.5 percent). Whether or not this has anything to do with the headaches is still unknown. However, NDPH is also differentiated from other common causes of daily head pain, such as migraines. A persistent headache should not be conflated with a migraine.
Differentiating Headache Types
A headache is characterized by pain in any part of the head. Headaches can be caused by a bump to the skull, tension in the surrounding muscles, stress, a hereditary disorder, an infection, and several other causes. Headaches can also be described and felt in a variety of different ways, including:
- Burning pain;
- Pain that comes in waves;
- Sharp pain, throbbing pain;
- Unilateral (one-sided) pain;
- Pain that remains consistent yet low;
- Vice-like pain in a ring around the head;
- Pain accompanied by blurry vision, nausea, sickness, or other symptoms of physical illness.
Headaches can also be classified as either primary or secondary. Persistent headaches are a primary headache disease. These are headaches that act as the main symptom of a patient’s condition, meaning they aren’t presenting as correlating symptoms of a different illness. Persistent headaches are also chronic and last weeks and months without interruption.
Aside from differentiating between acute or chronic headaches, primary headaches are split into different types depending on their probable causes or characteristic symptoms, such as when or where the pain occurs. Among headaches that can be classified and differentiated, there are three major types:
Sinus headaches are usually generated by the pressure and pain of an infected or swollen sinus area. An inflamed sinus is a common symptom of the flu or cold. The swelling of the sinuses can affect the nerves throughout the head, meaning that pain can spread from one area to the next. The pain in a sinus headache usually worsens when bending over, and it’s at its worst in the mornings when waking up sick.
Tension headaches are usually generated by stiff and painful muscles in the neck, head, and shoulders. These are often associated with stress, both mental stress, and mechanical stress, to the upper body. Tension headaches are also usually the most common sort of headache. If you’re having a rough time at work and suddenly develop an acute headache, it’s probably a tension headache.
Cluster headaches result from a circulatory problem, specifically the dilation of blood vessels in the brain due to the release of certain neurotransmitters. They can be triggered through food combinations, altitude, or physical exertion. Unlike tension headaches, cluster headaches are recurring and often happen at a set time several times a month. These can be extremely painful in comparison to a tension headache.
NDPH is usually not classified as a tension headache or a cluster headache, and the areas of the head affected by the pain might differ from individual to individual. However, it is essential to differentiate between a persistent headache and a migraine. Migraines are a unique form of headache that differentiates itself from other typical headaches through three significant characteristics:
- Unilateral pain: migraine symptoms are often one-sided.
- Nausea and dizziness: migraine symptoms usually include involuntary nausea and extreme sensitivity, especially toward light, sounds, and smells.
- Migraine phases: migraine is preceded by the prodrome phase, which consists of all non-pain related migraine symptoms, ranging from mood swings to stiff muscles, before entering the aura phase, headache phase, and finally, the postdrome phase.
Treating New Daily Persistent Headache
Because the underlying cause can vary from patient to patient and is often unidentifiable, pain and symptom management is the primary concern of treating an NDPH. To that end, a patient might be recommended several different medications to determine which pharmacology works best (from muscle relaxants and over-the-counter NSAIDs to antidepressants), as well as other experiential and therapeutical modalities.
If you or your loved one is struggling with daily headaches, it’s essential to seek a professional’s help. Thorough individual testing is the best way to find out if there is an effective way to treat your pain. What might work for some people isn’t guaranteed to work for others, and the Internet is a poor substitute for medical advice.