Chronic Daily Headache: Headaches Migraines

Content provided by the Faculty of the Harvard Medical School

Chronic daily headache

Although most people experience headaches only from time to time, an unfortunate but significant minority — about 1 in 20 people — experience them almost every day. Women are twice as likely as men to develop chronic daily headache.

Chronic daily headache is diagnosed when headaches occur every day or nearly every day for a prolonged period of time, such as at least five days a week for a year or longer. In two out of three cases, chronic daily headache develops in people who previously experienced only intermittent migraine, tension, or other types of headaches. In such people, the headaches tend to increase in frequency gradually — over the course of a decade or so — until they occur daily. In the remaining one-third of cases, chronic daily headache develops without warning, sometimes as a result of illness, surgery, or an injury to the head, neck, or back, and sometimes for no apparent reason.

Regardless of the cause, chronic daily headache is notoriously difficult to treat and, understandably, often produces anxiety and depression. To make matters worse, more than 90% of people with chronic daily headache also experience additional and more severe headaches on a regular basis.

Chronic daily headache usually manifests in one of two distinct patterns. About half of those affected experience headaches that begin in the morning and worsen through the day, while one-quarter experience the reverse (pain that is worst in the morning and gradually diminishes). The remaining one-quarter experience a variable pattern, with pain sometimes diminishing and sometimes worsening as the day goes on. Regardless, these headache patterns all contrast with the patterns typical of other types of headache. For example, tension headache generally starts in the afternoon and then wanes, and a migraine often develops at night.

The types of headaches you've had in the past may also affect symptoms once chronic daily headache develops. People with a history of migraine who develop daily headache find that the pain starts to resemble the steady, vice-like grip of tension headache, although throbbing often continues at the temples. In addition, the aura often diminishes (see "Anatomy of an attack"). Meanwhile, those with a history of tension headache often develop nausea and vomiting, sensitivity to light and noise, and throbbing in the temples — hallmarks of migraine.

Last updated:	September 05, 2008