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Chronic Headaches

Chronic headaches, also known as chronic daily headaches, are headaches experienced 15 or more days each month for more than three months duration. Chronic headaches can be different types of headache subtypes, including migraines, tension headaches and hemicrania continua headaches.


Due to the consistency of having headaches, chronic headaches can be very disabling, requiring lots of time taken off work and responsibilities. Having chronic headaches is also likely to increase the risk of certain mental health problems, such as depression, anxiety, and sleep problems. If the headaches are caused by an underlying condition, treatment of this should relieve the headaches. However, if there is no underlying condition, treatment focuses on relieving pain.

What are the symptoms?

Grinding or clenching teeth can put pressure on the oral structure: muscles, tissues, and jaw. This pressure translates into:

  • anxiety, stress, and tension
  • earache, as some temporomandibular joint structures are close to the outer ear canal. The pain may not be directly in the ear, it may be referred pain from a nearby area
  • eating disorders
  • headache
  • muscle sensitivity, especially in the morning
  • dental sensitivity when consuming hot, cold, or sweet foods
  • insomnia
  • jaw pain or swelling

These are general symptoms, although some people may grind and clench their teeth but show no symptoms. Things that can affect how long the clenching lasts include: patient stress levels, teeth not being aligned, posture, diet, and sleeping habits.

Medical tests to diagnose chronic headaches:

In order to understand the cause behind your chronic headaches, a doctor will likely perform or CT or MRI scan. They will also take a detailed history of your headaches and your general medical history.

What causes it?

Primary chronic daily headaches do not have an underlying condition. Non-primary chronic daily headaches can have underlying causes, including:

  • Infection (e.g. meningitis)
  • Brain tumour
  • Traumatic brain injury
  • Intracranial pressure imbalance
  • Vascular inflammation around the brain
  • Stoke

Having frequent headaches is also more commonly associated with:

  • Obesity
  • Females
  • Depression
  • Sleep problems
  • Anxiety
  • Overuse of caffeine or pain medication

How can it be prevented?

The following measures can help to avoid chronic headaches:

  • Have enough sleep
  • Avoid overuse of painkillers
  • Exercise regularly
  • Reduce caffeine intake
  • Avoid skipping meals
  • Manage stress

What is the treatment?

Treatment focuses on relieving pain if there is no underlying condition to treat. This may include:

  • NSAIDs (nonsteroidal anti-inflammatory drugs)
  • Beta-blockers – used to treat migraines
  • Anti-seizure medication – can treat migraines and chronic daily headaches
  • Antidepressants – tricyclic medications are shown to help reduce pain from chronic headaches, and treat accompanying depression or anxiety.
  • Botulinum toxin – injections of Botox can help to relieve pain from daily headaches for some people.

What specialist should I see?

Chronic headaches are treated by a range of specialists, depending on their cause. They may be treated by neurologistspsychiatrists or pain management specialists.

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