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Chronic Daily Headaches

What are Chronic Daily Headaches?

Chronic daily headache describes a group of headache disorders in which headache pain occurs at least 15 days per month during a 3-month period. True (primary) chronic daily headaches are not caused by another condition.

These headaches include:

  • Chronic migraine
  • Chronic tension-type headache
  • Medication overuse headache (rebound headache)
  • Hemicrania continua
  • New daily persistent headache

Chronic Daily Headaches Symptoms

By definition, chronic daily headaches occur at least 15 days per month during a 3-month period.

Symptoms of chronic migraine include:

  • Throbbing, pulsating pain that is moderate to severe and usually on one side of the head
  • Nausea, vomiting, or both
  • Sensitivity to light, sound, or smell

Symptoms of chronic tension-type headache include:

  • Dull, aching pain on both sides of the head that feels pressing or tightening but not pulsating

Symptoms of hemicrania continua include:

  • Continuous pain on one side of the head with no pain-free periods
  • Moderate headache pain with spikes of severe pain
  • Tearing or redness of the eye on the affected side
  • Nasal congestion or runny nose on the affected side
  • Ear pressure or fullness
  • Drooping eyelid or narrowing of the pupil on the affected side

New daily persistent headaches begin suddenly, usually in people without a history of headaches, and become constant within three days of the first headache. The headache pain usually has the following characteristics:

  • Mild to moderate
  • Affects both sides of the head
  • Feels pressing or tightening but not pulsating
  • Zero or minimal sensitivity to light, sound, or smell

Chronic Daily Headaches Treatments

Treatments that try to stop or reduce headache symptoms before or shortly after they start have a greater chance of reducing the frequency of chronic headaches than treatments administered after headache symptoms have begun.

Abortive medications—the name for drugs used to treat headache symptoms that have already begun—can cause medication overuse “rebound” headaches if taken too frequently. This can start a cycle in which the medicine, while providing brief relief, ends up causing more headaches over time.

Some medications originally intended for other uses can be effective at preventing chronic daily headaches, such as:

  • Anti-depressants
  • Beta blockers
  • Anti-seizure medications

Botox can be used for the prevention of chronic migraines, but insurance companies usually require people to try preventative medications before they will cover Botox. Botox injections are performed in 31 sites on the head and neck every 12 weeks and can be very effective in reducing the frequency and severity of migraines.

Additional Information

How common are chronic daily headaches?

As much as 5 percent of the United States population may experience severe headaches on a daily or near-daily basis.

Who gets chronic daily headaches?

Anyone can have chronic daily headaches. Although primary chronic headaches are not caused by an underlying medical condition, there are risk factors associated with developing frequent headaches. These include:

  • Female gender
  • Anxiety
  • Depression
  • Sleep disturbances
  • Obesity
  • Overuse of caffeine
  • Overuse of headache medication
  • Other chronic pain conditions

Medication overuse headaches usually develop in people who have an episodic headache disorder, such as migraine or tension-type headaches, and take pain medications more than two days per week. These medications include:

  • Triptans
  • Ergotamines
  • Barbituates
  • Non-steroidal anti-inflammatory drugs (NSAIDs)

Conditions that may cause secondary chronic daily headaches include:

  • Artery inflammation or spasm
  • Venous clots
  • Infections such as meningitis
  • Abnormally high or low intracranial pressure
  • Brain tumors
  • Traumatic brain injuries

How are chronic daily headaches diagnosed?

Your doctor may use the following to diagnose chronic daily headaches:

  • Personal and family medical history
  • Physical and neurological examinations
  • Imaging tests to rule out conditions that can cause headaches
  • Lumbar puncture to evaluate cerebrospinal fluid pressure and for infection and inflammation

Causes of Chronic Daily Headache

Doctors are not exactly sure what causes chronic daily headaches. True, or primary, chronic daily headaches do not have a cause that can be identified. That does not, however, mean that they cannot be treated.

Additional Support + Resources

National Headache Foundation
National Institute of Neurological Disorders and Stroke

Group 12
  %
As much as 5 percent of the United States population may experience severe headaches on a daily or near-daily basis.

Medically Reviewed by Kerry Knievel, DO, FAHS on January 5, 2020

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