Constant Headaches: What they could mean and how to manage

Do you experience headaches on a daily basis?

Is the pain a dull ache? Is it intense? Does it interfere with daily activities? Or can you go on with your day? In all scenarios, you may be suffering from chronic daily headaches (CDH).

CDH can be short-term, meaning the pain lasts less than 4 hours. CDH may also be long-term, meaning the pain lasts longer than 4 hours. The most common types of CDH include chronic tension-type headaches, chronic migraines and medication-overuse headaches. About one in four adults has someone in their household who has experienced migraine headaches. Women experience headaches two to three times more often than men.

Why do I have constant headaches?

Since there are over 150 types of headaches, finding out why frequent headaches occur can be difficult. If you have a family history of migraines, your chances of also having migraines increase by approximately 90%.

• Some common subgroups of short-term headaches include chronic cluster headaches, hypnic headaches, chronic paroxysmal hemicrania, and primary stabbing headaches.
• Long-term headache subgroups include chronic migraines, hemicrania continua, chronic tension-type headaches, and new daily persistent headaches.

When should you consult with a healthcare provider?

People go to the emergency room (ER) with head pain every 10 seconds in the U.S., and about 1.2 million ER visits are for acute migraine attacks.

Not all headaches require medical attention, but some headaches are signals of serious conditions, calling for prompt medical care. Seek medical attention if you experience:

• Sudden or severe headaches associated with a stiff neck.
• Headaches associated with fever, convulsions, or headaches accompanied by confusion or loss of consciousness.
• Headaches after a blow to the head, or headaches associated with pain in the eye or ear.
• New, daily persistent headaches when you have previously been headache-free.

Daily headaches are considered chronic when they occur 15 days or more a month for longer than 3 months. A migraine headache can last one day or more and may occur several times a week or as infrequently as once every few years.

What can be done to manage chronic daily headaches?

Preventive treatment is recommended when headaches occur three or more times a month. Here are some tips:

1. Keep a headache diary or use a digital app to keep track of your headaches for severity, duration and triggers such as stress or changes in weather conditions. Keep track of the medications you have used and how effective they were. This info can be shared with your healthcare provider, enabling more informed decisions regarding treatment plans.
2. Avoid foods that may trigger your headaches. Make a list of foods eaten before a headache, and determine if eliminating those foods reduces or eliminates them.
3. Biofeedback from your healthcare provider—blood pressure, heart rate, skin temperature, brainwave activity and muscle tension—may help individuals determine how to control their involuntary or autonomic nervous systems, which cause headaches.
4. Medications for headaches depend on the type of headache. Still, generally, taking a pain reliever such as aspirin, acetaminophen (Tylenol) or a nonsteroidal anti-inflammatory drug such as ibuprofen (Motrin or Advil) indomethacin or naproxen (Naprosyn or Aleve) may be recommended first. (These pain relievers are especially helpful if you have tension headaches.) Your healthcare provider may prescribe other medications to relieve pain immediately, or recommend certain medications to use on a regular basis for preventing future headaches.
5. Lifestyle changes found to decrease the frequency of headaches include quitting smoking, reducing alcohol consumption, reducing or eliminating caffeine, keeping a regular schedule for eating and sleeping, and getting exercise several times a week.

Taking steps to understand and document your body’s response to headaches can help you manage headaches better.

Remember to always establish strong and effective communication when consulting a healthcare provider. They will be armed with detailed information to provide a more effective and individualized treatment plan that can be modified to meet your needs currently and in the future.

Published on June 30, 2019

References:

Garza, I, and JT Schwedt. 2018. UpToDate: Overview of chronic daily headache. 10 01. Accessed 10 01, 2019. https://www.uptodate.com/contents/overview-of-chronic-daily-headache?search=headache&source=search_result&selectedTitle=4~150&usage_type=default&display_rank=4.

Migraine Research Foundation. 2019. Migraine Research Foundation. Accessed 2019. https://migraineresearchfoundation.org/about-migraine/migraine-facts/.

National Headache Foundation. 2019. National Headache Foundation: Early morning awakening headache. Accessed 2019. https://headaches.org/2007/10/25/early-morning-awakening-headache/.

2019. National Headache Foundation: Tools for individuals with headache or migraine. Accessed 10 02, 2019. https://headaches.org/resources/tools-for-individuals-with-headache-or-migraine/.

NINDS. 2019. National Institute of Neurological Disorder and Stroke: Headache Information Page. 06 15. Accessed 2019. https://www.ninds.nih.gov/Disorders/All-Disorders/Headache-Information-Page.