Causes and Treatments of Migraine Headaches (cont.)
IN THIS ARTICLE
Daily Chronic Headache
Daily chronic headache is defined as a headache that is present for more than 15 days a month and for at least 6 months a year. Three main types are noted: chronic tension-type headache, migraine chronic tension-type headache complex, and rebound (analgesic abuse) headache. How the body produces chronic daily headaches is not well understood. They have been associated with depression, anxiety, bipolar disorders, panic attacks, mouth/jaw problems, stress, and drug overuse.
Chronic tension-type headache
Chronic tension-type headaches are not associated with a history of migraine or cluster headaches. Patients report almost constant daily headaches of mild-to-moderate intensity. The headache is described as a feeling of tightness or pressure that is not worsened, and may actually be improved, by activity. Patients with chronic tension-type headaches can carry on their daily activities. Nausea and photophobia (sensitivity to light) may occur, but vomiting usually does not. A small group of patients may have head and neck tenderness.
Chronic tension-type headache, Treatment
Patients who are less responsive to previous treatment and those with conditions like depression and stress may be good candidates for psychological treatments. Biofeedback has been successful in patients with tension headache. They are taught how to relax their tense muscles. Thermal biofeedback, in which patients are taught to increase their body temperatures to improve their headaches, has also worked. Other less conventional treatments, such as relaxation training and stress-coping training, may be helpful in the long term.
Migraine transformation has been a term used by some experts to describe when intermittent migraines become daily migraines. This type of headache is believed to be associated with analgesic or ergotamine overuse. Patients report intermittent typical migraine attacks along with the daily chronic headaches.
Transformed migraine, Treatment
Other uncommon chronic headaches
Hemicrania continua and chronic paroxysmal hemicrania are uncommon forms of chronic headache. Chronic paroxysmal hemicrania is a severe chronic headache similar to cluster headache. It has a male predominance. The headaches are paroxysmal (pulsing), with pain in the temple/eye region lasting 20-30 minutes. The paroxysms occur several times a day. This type of headache can last several years. Treatment with indomethacin (Indocin) results in a dramatic response.
Medically Reviewed by a Doctor on 2/10/2016
Robert Cowan, MD
Soma Sahai, MD
Joseph Carcione Jr, DO, MBA
Francisco Talavera, PharmD, PhD
James H Halsey, MD
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Headache is a pervasive symptom and the most common problem neurologists encounter in their clinical practices.