chronic daily headaches treatment & diagnosis

The National Headache Institute treats chronic daily headaches on an ongoing basis. Any recurrent headache almost daily falls under this classification. A chronic tension headache, a transformed migraine, and a chronic migraine can be examples. Generally, chronic daily headaches occur at least 15 times a month and are not associated with illness. An episodic tension headache can turn into chronic tension headaches if it occurs daily or nearly every day.

In general, chronic tension headaches are bilateral or diffuse, affecting both sides of the head or the back and sides of the neck. Including pressing pain but not pulsating, they cause mild to moderate pain. Some people sometimes feel tenderness in the skull.

Experts at the National Headache Institute have found that women almost exclusively suffer from transformed migraines and chronic migraines. Migraines usually start in young adulthood, and they tend to run in families and are related to mental disorders such as depression, panic disorders, and alcoholism. In addition to depression, 80% of people with transformed migraines also suffer from chronic migraines and use medication excessively. Eventually, migraine sufferers can experience more frequent migraines, which can become a daily occurrence.


Migraines with transformed and chronic forms resemble tension headaches. Usually, they are not related to neurological or gastrointestinal disorders. Any associated psychiatric disorder must be taken into consideration as part of treating chronic daily headaches. Prevention is possible through the use of calcium channel blockers, anticonvulsants, and beta-blockers. In addition to behavioral psychotherapy, lifestyle changes can be considered non-pharmacologic treatments.



The duration of chronic headaches varies greatly, usually four hours or more. Other medical conditions cannot cause chronic headaches. Chronic migraine headaches, persistent daily headaches of all kinds, chronic tension headaches, and chronic headaches lasting longer can all fall into these four types.



In contrast to episodic migraines, chronic migraines often involve throbbing pain on one side of the head, without an aura or aura-like symptoms. Physical exertion can aggravate chronic migraines and increase sensitivity to light and sound.



An episodic tension headache can progress to chronic headaches characterized by mild to moderate pain like a pressure sensation. It affects both sides of the head instead of just a specific region. In addition to heightened sensitivity to light and sound, chronic tension headaches are often accompanied by nausea.


An hemicrania continua is characterized by pain on one side of the head that may be intermittently severe at times. There are no periods of relief for several days after they have begun. Some patients can also experience symptoms of migraines and runny noses. On the side of the head affected by the pain, eye redness, reduced pupil size, and drooping eyelids are also common.

What are the other symptoms of a constant headache?ย 

There is a variety of symptoms of a constant headache depending on the type you have. Some of them are:

Head pain, which can: involve one or both sides of your head, feel like a pulsing, throbbing, or tightening feeling, vary in intensity from mild to severe, nausea or vomiting, sweating, sensitivity to lights or sounds, a stuffy or runny nose, redness or tearing up of the eyes.

Causes of Headaches

  • Head and neck muscles become tight, causing tension and pain.
  • Trigeminal nerve stimulation stimulates the primary nerve in your face. When this nerve is activated, it can cause some types of headaches, including pain behind the eyes, stuffy nose, and red eyes.
  • Hormone levels, like serotonin and estrogen, change. Fluctuations in these hormone levels cause headaches.
  • Genetics
  • The most common triggers of headaches include stress, changes in weather, caffeine consumption, or lack of sleep.
  • A constant headache can also be caused by overusing pain medication. Medication overuse causes rebound headaches. When you consume OTC and prescription pain medications more than two times a week, you may get these types of headaches.


Drug Overuse Can Increase Headache Pain Recurrence


Using opiates, analgesics, and ergotamines excessively can induce chronic daily headaches. Frequent use of medications can result in rebound headaches, which can lead to dependence on drugs. It is most common to have an episodic migraine that has become a transformed migraine through medication overuse.




You and your doctor will decide what treatment will work best for your headaches, as many possible treatments are available.


There are several causes of headaches, and they may require different treatments. In the absence of a cause for your headache pain, your doctor will prescribe a treatment that will prevent it from occurring.




  • You can prevent headaches by taking tricyclic antidepressants like amitriptyline and nortriptyline. Additionally, they may ease anxiety or depression that can accompany constant headaches.
  • Beta-blockers such as propranolol (Inderal) and metoprolol (Lopressor)
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin, Advil) and naproxen (Aleve). It is advisable to use these medications sparingly. Overuse may lead to rebound headaches.ย 
  • Anti-seizure medications such as gabapentin (Neurontin) and topiramate (Topamax)
  • Botox injection, which is an injection of a neurotoxin derived from the bacteria that causes botulism. Those who are unable to tolerate daily medication can also benefit from this approach.


Non-medication therapies


It is also possible to combine medications with other treatments.

  • An individual or group can receive behavior therapy. You can discuss ways of coping with headaches and understand the mental effects.
  • Using monitoring devices to improve body control, such as controlling blood pressure, heart rate, and muscle tension is called biofeedback.
  • A small device is inserted into the skull base during a surgical procedure, such as occipital nerve stimulation. In some people, the device can relieve headache pain by sending electrical impulses to the occipital nerve.
  • Acupuncture entails inserting tiny needles into specific points on the body, though it has not been proven to relieve constant headaches.
  • Massage can achieve relaxation and reduce tension.


Lifestyle changes


To manage headaches or avoid your headache triggers, your doctor may recommend making some lifestyle changes. For instance, you may want to avoid using caffeine or smoking cigarettes, as well as getting enough sleep.



Patients who suffer from two or more headaches a week and take pain relievers for headaches on most days should seek medical attention. Additionally, this applies to those who observe their headache patterns changing or worsening or if the pain becomes disabling.


When headache is sudden and severe, accompanied by fever, stiff neck, numbness, a seizure, or double vision, follows a head injury or gets worse despite rest and pain medication, immediate medical care if necessary.


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