Chronic Daily Headache

Chronic daily headache is an umbrella term that
includes 4 primary headache entities:

 

  • Chronic/Transformational Migraine
  • Chronic Tension-type Headache
  • New Daily Persistent Headache
  • Hemicrania Continua

By definition, these headaches occur more than 15 days per month, and one or more of these 
entities are likely to affect at least 4-5% of the general population.

Because varieties of these conditions, including the term chronic daily headache, have been used so many different ways, this overall category of 
illnesses has been greatly misunderstood and confused.

Chronic/Transformed Migraine

The most common of the entities, chronic/transformed migraine, reflects the 
presence of pre-existent, intermittent migraine attacks which over time have 
become progressively more frequent until they occur more than 15 days a 
month. Some days patients may experience only a mild to moderate background 
headache, where as on other days a more intense full-blown migraine attack
 may occur.

Among the reasons for the progression from intermittent to more frequent 
headaches, medication overuse stands above the rest. This occurs when an
 abortive medication (pain killer, triptan, some others) is used more than 2-3 days a week, week after week, month after month. Other causes of this progression may include emotional distress, genetic influences, obesity, hypothyroidism, and other factors. At times no apparent reason for the progression occurs.

Headaches That PersistA complete article on chronic daily headache is included in our new book, 
Headaches That Persist. The article was
 authored by a headache neurologist and includes the subcategories of chronic
 daily headache.

 

By Dr. Joel Saper, M.D., F.A.C.P., F.A.A.N.
Neurologist - Headache specialty
Michigan Headache & Neurological Institute
Ann Arbor, Michigan

The opioids (narcotics) cause progression of the illness (Chronic Daily Headache), not termination, and will actually make the individual much worse over time. It is easier and quicker to give the patient a pain killer than to "get into the trench" and try solve the problem. Patients with chronic daily headache require time, diligence, and frequent access from their physician.

Interview: Dr. Joel Saper, MHNI
-from the book Chronic Daily Headache

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The book Chronic Daily Headache features
an article reviewed by a Headache Neurologist
entitled "Why Some Headache Patients do
not Improve"!