If you have a headache for more than ten or fifteen days a month, the problem falls under the category of chronic daily Headaches. This term is not a medical diagnosis but a descriptive term, since many types of headache can lead to chronic daily headaches.
Such frequent headaches require careful assessment by a specialist doctor in headaches, both to determine the headache causes, and suggest ways for the headache treatment. Whether the patient should do the diagnostic tests will be decided by the doctor (specialised in daily headaches), based on the clinical history and neurological examination. If the neurological examination is normal and has ruled out the existence of an underlying cause (for example cancer), then probably the daily headaches are due to one of the following six reasons:
1. Abuse of headache drugs
2. Chronic migraines
3. Chronic tension headache
4. Recent beginning of daily headaches
5. Cumulative headache
6. Continuous unilateral headache
See below a brief description of each of the situations that can cause daily headaches for more than ten or fifteen times a month.
1. Abuse of headache drugs
The abuse of headache drugs is a frequent cause of chronic daily headaches. This can occur in people with migraine or tension-type headache. Usually these are people who have migraine or tension headaches for many years and over the years, the headache incidents become more frequent and more powerful. As a result patients are receiving more and more drugs. Gradually the headaches can occur daily and are accompanied by the daily use of medicines. Increased use of drugs makes the headache most resistant and thus perpetuating the situation, leading to ever-greater use of medication and to frequent daily headaches. It should be noted that it is not to blame a particular medicine but that chronic daily headaches due to drug abuse may occur with any medicine, from the simplest (eg paracetamol) to the most modern (eg triptanes). It appears that what’s wrong is the misuse of drugs and the lack of limit on their usage. In general every person who takes any medicine for headaches in a dose over 10-15 pills a month, possibly he/she is making drug abuse and it is faced with the risk to switch gradually to chronic daily headaches.
Treatment of chronic daily headaches with daily drug abuse requires complex preventive therapy (at least two drugs) and is quite difficult because many patients initially improve but then relapse.
2. Chronic migraine headaches
While for most medical conditions the term «chronic» means that the condition existed for many years, for migraine headaches the condition «chronic» means that the migraine occurs very frequently i.e. more than 15 days a month. There are not many people who suffer from chronic daily migraine headaches. Most people with migraine headaches have only occasional crises, usually from 1 to 3 times a month or less.
In some people however, the migraine crisis may gradually become very common and may even develop into a situation where the patient is experiencing 15 daily headaches per month (or more) to gradually become chronic migraine headaches. Chronic migraines may lose the typical characteristics of migraine and the headache is continuous or nearly continuous without apparent intolerance to light and noise, without nausea and vomiting. People with chronic daily migraines are really suffering; they are constantly in a state of suffering and feel powerless. Chronic migraines require preventive treatment.
3. Chronic tension headaches
As with chronic migraines, people experience chronic tension headaches for more than 15 days a month. The tension-type headache is often described as a «burden» or «tightness» in the head, often on both sides. Although the tension-type headache is usually milder than migraine, when it occurs can be really cruel. The chronic tension-type headache usually develops gradually in people with a history of episodic tension headaches and requires preventive treatment.
4. Daily persistent headaches
This is a really rare form of headache. It concerns people who have no history of headaches and suddenly they develop daily severe headaches. The headache can last for years and almost every day for several hours. It should be noted that such a record is suspicious for a serious underlying cause (for example cancer) and only after testing and exclusion of any such possibility can the diagnosis lead to daily headaches. It is unknown what causes daily persistent headaches. One theory is that at least some of them are caused by a viral infection.
5. Cumulative headache
The cumulative headache has a characteristic pattern. It exists for some time (usually several weeks) every day and then disappears for months or years. The cumulative headache pain always lies on the same side of the head, often behind the eye and temple. It is accompanied by tears running from the eye (only on the side of the pain), stoppage or «running» nostril on the side of pain, red eye or eyelid fall from the side of pain.
6. Continuous unilateral daily headache
It is a rare form of continuous daily headache (all day and all night!) Headache, as the name suggests, affects only one side of the head. The pain is generally moderate intensity but there may be severe pain crises, during which the eye can in turn tear and be in pain.
Treatment of chronic daily headaches
The successful treatment of daily headaches depends on correct diagnosis. You should always consult a specialist doctor before starting any form of medication for the treatment of daily headaches.
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