Chronic Daily Headaches

Within chronic daily headaches are four types of headaches, which refer to the kind of actual pain you are experiencing. These include chronic migraines and chronic tension headaches. Also included are the chronic appearance of new daily persistent type headaches, which refer to mild to medium pressure headaches that come on suddenly in people that generally don’t experience headaches, and chronic hemicrania continua headaches, which are moderate to severe headaches that affect one side of the head and are accompanied by factors such as a red, teary eye on the affected side and nasal congestion.

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Chronic daily headaches are associated with a variety of conditions and actions; whether these are cause or effect is as yet unclear. These conditions are anxiety, depression, disturbed sleep, snoring, other chronic pain conditions and overuse of caffeine.

Sometimes, chronic daily headaches are caused by the rebound effect of taking too much headache medication. If you have been taking headache medicine and are experiencing this kind of headache, talk to your physician. You will likely need to taper off under medical supervision, while still needing to treat the pain of the original headaches that started the spiral.

Prevention

The best way to prevent these kinds of headaches is to know your triggers — and the best way to do that is to keep a headache diary. Helpful information to write down includes:

• Time(s) of day or night that headache occurs
• Weather
• Environment (the presence of noise, smoke, crowds, or other)
• Response to light
• Foods eaten
• Hydration
• Alcohol consumption

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Adopting a healthy lifestyle can help you ward off chronic headaches. That includes figuring out how to maximize sleep, nutrition and exercise, and minimize stress.

Make sure you get to bed every night in a dark and quiet room, and allow time for enough sleep. Eat meals that are regular, consistent and healthy. Exercise every day (walking outdoors is helpful) — taking short breaks from a demanding job to breathe and move around will help your head and your body. Do what you can to be aware of stressful factors in your life and reduce them, perhaps incorporating meditation or yoga into your day, as these are proven to be helpful in lowering stress. And reduce caffeine — even though caffeine might be included in certain headache medications, it can also aggravate them.

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Because of the persistence of these kinds of headaches, there are certain conditions that need to be ruled out as possible causes. These include infections, such as meningitis; an inflammation of the blood vessels around the brain, or a stroke; brain tumor; traumatic brain injury; and intracranial pressure that is too high or too low.

A complete physical exam is performed, and a complete medical history taken, to determine possible headache causes. The physicians at the St. Luke’s Headache Center can also perform imaging tests, such as CT scans or MRIs, to rule out some of these possibilities. A lumbar pressure test may be used to determine the presence of meningitis; this kind of test is also used to determine intracranial pressure.

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Treatments for chronic daily headaches vary, often depending on the type of headache it is and your individual response to medication.

The tricyclic class of antidepressants has proven effective, for example; it treats both the headaches and the conditions of depression, anxiety and sleep disruption that may go along with it. Beta blockers have been shown to work for chronic migraines and anti-seizure medicines have also proven helpful. Non-steroidal anti-inflammatory drugs work in some cases. And Botox — which acts to block the reception of neurotransmitter signals, thus, perhaps, intercepting pain — has been shown to be helpful in some cases as well.

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