“Daily headaches” are headaches that happen at least 15 times a month. If daily headaches last for three months or more, they’re considered “chronic daily headaches.” l Most headaches, like migraines or tension headaches, occur occasionally. But when they happen more often, they qualify as chronic daily headaches. The pain can be severe or moderate, stabbing or dull, throbbing or continuous, on one side of the head or on both sides. The headache may last for a few minutes or for several hours. There can be other symptoms such as nausea, vomiting, or sensitivity to light. Less commonly, daily headaches start unexpectedly in people without a history of headaches.
Common causes of daily headaches include migraine , muscle tension , nerve pain, medication overuse, medication side effects, physical activity, and problems with sleep., Less common but more serious causes include infections, bleeding in the brain, brain tumors, increased pressure in the brain, blood vessel problems, and problems with spinal fluid.
Most causes of daily headaches do not require immediate medical attention, but a few are serious.
Daily headaches can interfere with daily living and generally require treatment.
Treatments of daily headaches vary, depending on the underlying cause. Read more about treatment for migraines here and other types of chronic headaches here.
Daily headaches can often be managed with good sleep hygiene, using cold compresses, staying hydrated, avoiding triggers, and practicing relaxation techniques.
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The most common causes of daily headaches are migraine headaches and tension headaches. These usually start as episodic headaches and may develop into chronic daily headaches.
Chronic daily headaches that usually last a short time (less than four hours) may be caused by:
Sleep disorders
Coughing or straining
Physical exertion
Cluster headaches (stabbing pain behind one eye, often with other symptoms on the same side)
Paroxysmal hemicrania ( headaches and face pain on one side of the head)
Nerve pain (neuralgia) on one side of the face
Chronic daily headaches that last a long time (more than four hours) are typically caused by :
Migraine headaches
Tension-type headaches
Hemicrania continua (long-duration headaches and face pain on one side of the head)
Medication-overuse headaches (MOH) happen when pain medications like nonsteroidal anti-inflammatory drugs (NSAIDs), migraine drugs, and opioids are used chronically. As the drug wears off, people experience rebound headaches. Because the headache temporarily gets better with more medication, this leads to a cycle of more medication and more headaches.
Many headache syndromes have triggers such as stress, caffeine, sensory stimulation, anxiety, coughing, physical activity, poor sleep, dehydration, and hormone changes.
New daily persistent headaches (NDPH) are daily headaches that begin in someone who doesn’t have a history of headaches. They could be a symptom of a serious problem. If the pain is severe or is getting worse, possible causes may include:
Bleeding in the brain
High fluid pressure in the brain
Brain tumor
Blood vessel disorders in the brain
Infection
Head injury
Spine disorders
These causes of headache require immediate medical attention.
RELATED: Can you get a headache from treating your headache? Medication overuse explained
Migraines, tension headaches, cluster headaches, and other regular headache problems aren’t life-threatening. The same applies to brief headaches caused by things like coughing or physical activity. However, if you have no history of headache disorders and start having daily headaches, then it’s time to get medical care. If the pain is severe or doesn’t get better, then emergency medical treatment may be needed.
Even so, chronic daily headaches do require treatment. At the very least, they interfere with daily life. At worst, they can be disabling. Left untreated, chronic daily headaches can result in complications like:
Reduced quality of life
Anxiety
Unemployment
Vision loss
Seizures
Sleep problems
Blurred vision
A healthcare professional diagnoses daily headaches by taking a medical history, particularly a headache history. Be prepared to answer questions like:
Did your headache pain start suddenly, or have you had regular headaches before?
Have you been diagnosed with a cause for your headaches before?
How often do headaches occur? When do they occur?
How long do they last?
Where does it hurt?
Is the pain on one or both sides of your head?
What does the pain feel like?
How intense is the pain? Is it moderate pain? Severe pain?
Is there anything that makes your symptoms better or worse?
Are there any other symptoms such as nausea, tenderness, stiff neck, runny nose, watery eyes, sweating, vision changes, or pupil changes?
What happens before the headaches start?
What medications do you take? How often?
Are there other problems such as weight loss, fever, skin rash, problems with memory or thinking, blurred vision, seizures, or eye pain?
In a physical examination, the healthcare provider will look for neurological symptoms, perform a head and neck examination, and look for any signs that the headaches may be caused by some other medical condition. In some cases, people may need to be referred to a neurologist or headache specialist.
For most headache diagnoses, X-rays, CT scans, or MRIs are not required. They will be used only if there are signs or symptoms that are concerning for something happening in the brain.
RELATED: What is migraine? Your guide to talking about the condition
Depending on the underlying cause, chronic headaches can last for minutes (cough-induced headaches), a few hours (cluster headaches), many hours to days (migraines or tension headaches), or be constant (new daily persistent headaches).
RELATED: How long do migraines last?
Most headache disorders require treatment. They can interfere with daily functioning, lower your quality of life, and lead to other problems like depression.
Chronic headache treatments primarily focus on preventing headaches from occurring. Depending on the underlying headache disorder, treatment options include:
Prescription drugs
Cognitive or behavioral therapy
Lifestyle changes
Physical therapy
Biofeedback
Acupuncture
Once a headache starts, the way to stop it will depend on the type of headache:
Migraine and cluster headaches are typically stopped by headache medications including triptans, ergots, NSAIDs, or acetaminophen.
Tension headaches are often treated by over-the-counter pain relievers or prescription triptans, but can also be relieved by applying heat or ice to the muscles causing the headache.
Indomethacin, a prescription NSAID, is the pain reliever of choice for neuralgia headaches and hemicrania.
The only way to stop medication-overuse headaches is to stop taking the pain medications that are causing the rebound headaches. A healthcare provider may prescribe other medications or therapies to prevent and treat headaches during this time.
RELATED: When to talk to your doctor about a prescription for migraine
Living with chronic daily headaches can be difficult, but preventive treatment can help. Lifestyle changes and personal interventions can help to treat and prevent headaches:
Keep a headache diary. Record when headaches occur, how long they last, and how they feel. Make sure to note any activities or triggers that precede the headache and anything that seems to help.
Adopt good sleep hygiene habits. Go to bed around the same time every night. Wake up around the same time each morning. Relax before going to bed. You can meditate or take a bath. When you go to bed, turn off all the lights and get rid of all distractions.
Exercise
Maintain a healthy weight
Stop smoking
Avoid or limit caffeine
Reduce and manage stress
Practice relaxation techniques such as yoga, meditation, and Tai chi
Learn mindfulness and practice it when stressed or when a headache strikes
Although daily headaches may not be life-threatening, they can be disabling. Visit a healthcare professional. If the headaches are due to another medical condition, treating it will also help the headaches. In some cases, that condition may need treatment sooner rather than later. If it is a headache disorder, preventive treatments do work at reducing both the frequency and severity of headaches. Even if you have already received a diagnosis, it’s worth another visit or a second opinion. Studies have found that 82% of non migraine headache diagnoses and 88% of sinus headache diagnoses were actually migraine headaches.
Stress or anxiety are common triggers of migraine and tension headaches. Learning to manage stress and practice mindfulness can help reduce the incidence of migraine or tension headaches.
RELATED: 6 surprising ways stress can affect your body
Several studies have shown an association between the prolonged use of tight-fitting masks in healthcare workers and headaches. These tend to be tension or migraine headaches that are likely triggered by pressure from the headband for long periods of time. Wearing surgical masks or cloth masks for limited amounts of time have not been associated with headaches.
RELATED: Face masks 101: what you need to know about covering up
Headaches are the most common side effect of vaping. While the exact cause is not known, the headaches are probably caused by nicotine, flavors, or other chemicals in the vaping mist.
RELATED: The dangers of vaping—and how to help your teen quit
Recurring morning headaches may be a symptom of medication-overuse headaches (MOH), a headache disorder that results from taking pain relievers too often. They occur in the morning because the pain relievers have worn off overnight. Other common causes of morning headaches include sleep problems like sleep apnea, grinding your teeth, drinking alcohol the night before, and muscle tension from your sleeping position.
Chronic daily headache: diagnosis and management, American Family Physician
Chronic headaches, StatPearls
Frequent headaches: evaluation and management, American Family Physician
Hemicrania continua, National Institutes of Health (NIH)
New daily persistent headache (NDPH), Cleveland Clinic
Chronic headaches, StatPearls
Can you get a headache from treating your headache? Medication overuse explained, SingleCare
The patient with daily headaches, American Family Physician
8 types of headaches—and how to treat them, SingleCare
Are you at risk for chronic migraine?, American Migraine Foundation
Migraine treatments and medications, SingleCare
Anne Jacobson, MD, MPH, is a board-certified family physician, writer, editor, teacher, and consultant. She is a graduate of University of Wisconsin School of Medicine and Public Health, and trained at West Suburban Family Medicine in Oak Park, Illinois. She later completed a fellowship in community medicine at PCC Community Wellness and a master's in Public Health at the University of Illinois-Chicago. She lives with her family near Chicago.
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