When Headaches Are Considered Chronic
What does it mean if you have chronic headaches? Sometimes it only means you have headaches frequently, but there’s a more formal definition. Chronic headaches, or chronic daily headaches, are when you have a headache at least 15 days a month for at least three to six months or more in a row. Persistent headaches can impact anyone, but certain risk factors can make chronic headaches more likely. These include:
- Anxiety or depression
- Caffeine
- Chronic back pain
- Extreme stress
- Fibromyalgia
- Medication use for headaches more than two days per week
- Obesity
- Sleep problems, especially sleep apnea. If you’re overweight, snore and wake up feeling groggy, you should tell your doctor about it.
If you believe you have chronic headaches, start keeping a log of when the headaches occur, their severity, exact area of pain and other symptoms like nausea or vision problems. This information will help your doctor make a diagnosis and create a treatment plan.
5 Types of Chronic Headaches
There are many types of chronic headaches. Which type you have helps determine treatment options and potential preventive measures. Chronic headaches include:
Chronic Migraines
With chronic migraines, you could experience head pain, nausea, sensitivity to noises, lights and odors, auras (having streaks, spots or bursts of light in your field of vision), and more. You’re usually diagnosed with chronic migraines when:
- You have a headache at least 15 days a month for a minimum of three months
- At least eight of the headaches meet the symptoms criteria of a migraine
- Episodic migraines (occurring less than 15 times monthly) can sometimes develop into chronic migraines, especially if you overuse pain relievers.
Chronic Tension-type Headaches
Tension headaches are the most common type of headache. They cause muscle tightness and pain in your head, scalp or neck. As with migraines, tension headaches are usually episodic but can change to chronic over time. Unlike migraines, tension headaches are defined as not having sensitivity to light or noise.
Chronic Post-traumatic Headaches
These kinds of headaches happen if you’ve had a blow to the head. They often show up after a concussion or other traumatic brain injury and continue for two or more months. While headaches are common after any head trauma, a person is more likely to have a chronic post-traumatic headache if he or she has a history of migraine or tension-type headaches.
There can be considerable overlap of these headache types. For example, many migraine patients can also experience tension-type headaches, and some patients with tension-type headaches may experience sensitivity to light and noise if the headache is particularly severe. Post-traumatic headaches frequently have migraine-like characteristics.
New Daily Persistent Headaches
These headaches begin without any warning in people without a history of headaches. They recur every day from the start and are present almost all the time from the onset. The cause of this type of headache syndrome is unknown. A daily persistent headache typically affects both sides of the head and may feel like simultaneous migraine and tension-type headaches.
Hemicrania Continua
Of the five most common types of chronic headaches, hemicrania continua is the least common. It affects only one side of the head, is experienced daily and recurs from the onset. Unlike chronic headaches, hemicrania continua headaches cause non-pain symptoms on the same side of the face as the pain. This kind of headache may include a watery eye, drooping eyelid, nasal congestion or runny nose.
While these five types of chronic headaches are the most common, others such as cluster headaches—severe headaches that are typically located behind one eye, are accompanied by tearing and redness of that eye, and often wake the patient up at the same time every night for weeks on end—may also occur.
Rebound Headaches and Why They Happen
At the first sign of a throbbing, intense headache, your first thought is to reach for an over-the-counter painkiller or anti-inflammatory drug. However, those medications may do more harm than good, especially if taken frequently.
Headache medications taken too often can cause rebound headaches. These occur as pain medication begins to wear off, often causing people to take another dose. Rebound headaches create a cycle of pain and medication use.
While rebound headaches are most commonly related to pain relievers, you can also experience them with other medications, such as sedatives or tranquilizers. Caffeine can have a similar effect. If your headache worsens when you don’t drink caffeine, your habit may be contributing to your pain.
To avoid rebound headaches caused by pain relievers, take only the recommended dosage. If you take the medication more than a couple of times a week, talk with your doctor about whether a different drug could be more helpful.
How to Ease the Pain of Chronic Headaches
If you are diagnosed with chronic headaches, your health care provider will recommend a plan based on your type of headache and other factors. Treatment can involve a combination of medications and lifestyle changes to prevent future headaches.
Some risk factors are not things you can change—such as a family history of chronic headaches. However, many risk factors can be reduced or even eliminated.
These steps may help you lower your risk:
- Find healthy ways to manage stress. Everyone faces pressure sometimes, and a little stress can be a good thing. Too much stress, though, can wreak havoc on your health. Since you can’t eliminate stress from your life, find healthy ways to handle it. Regular exercise and activities such as meditation or mindfulness can help keep your stress under control.
- Prioritize quality sleep. The National Sleep Foundation recommends adults get between seven and nine hours of quality sleep per night. Practice good sleep hygiene by turning off screens, keeping the bedroom cool and dark, and maintaining a regular bedtime and wake time. If you still aren’t getting enough sleep, talk with your doctor about other steps.
- Maintain a healthy weight. Obesity is a risk factor for chronic headaches. Aim to achieve a healthy weight as defined by your doctor by exercising regularly and eating a diet filled with fresh vegetables and fruit, whole grains and lean proteins.
- Reduce your caffeine intake. You may be consuming too much caffeine if yourchronic headaches worsen when you don’t have it. Moderate caffeine consumption of a cup or two of coffee a day is usually not a problem. The most common source of caffeine is coffee or soda, but caffeine can also be an ingredient in aspirin. Take a careful look at everything you’re eating and the medications you’re taking for caffeine content.
- Take medications only as directed. Follow directions on prescription or over-the-counter medications—and don’t overuse them. Too much headache medicine can cause rebound headaches, contributing to chronic headaches. Ask your doctor about there are a number of prescription symptomatic and preventive medications that are available for headache treatment that your doctor can try.
Ask your doctor about vitamins and minerals. Certain vitamin and mineral supplements—specifically vitamin B2, 100 mg a day, and magnesium, 400-500 mg a day—can be helpful for migraine prevention.
