Chronic Daily Headaches – Diagnosis & Treatment

Chronic Daily Headaches, popularly known as CDH, refer to headaches of any type which generally occur after certain risk factors and can last more than two weeks a month in general.

Daily headaches are more complicated than they seem. Among the multiple types of headaches, most people have unique symptoms and thus need a different kind of treatment too. Predominantly, people suffer from headaches from time to time. But if you have headaches regularly, you might suffer from daily chronic headaches. Instead of a particular type of headache, chronic daily headaches include multiple subtypes of headaches. 

Daily headaches are not only unbearable but also disable and disrupt our daily lives. Long-term management along with treatment might lead to fewer headaches or even reduce pain.

Causes of daily headaches

So, what causes daily headaches? The causes of most chronic daily headaches aren't well understood or known. A lot of times, chronic daily headaches don't have an identifiable underlying cause. 

However, as per medical experts, some identifiable causes of chronic daily headaches are:

• Traumatic brain injury
• Genetics
• Inflammation with the blood vessels in and around the brain may lead to stroke
• Surrounding environment
• Brain tumor
• Meningitis or other infections
• Illness
• Too high or too low intracranial pressure, and 
• Stress.

When identifiable, based on the causes, your doctor can help you out with the type of headache you might be having. 

Types of headache

There are many subtypes of daily headaches even, but here we've listed down some of the most common daily headaches for you:

• Chronic migraine – Chronic migraine is somewhat similar to episodic migraine. Migraines are a genetic disorder caused by excitable electrical activity in the brain and dysregulation of neurotransmitters. Episodic in nature means you'll have periods of no pain preceded by a migraine headache. A common cause of the transition from episodic migraine to chronic migraine is lifestyle factors. Even the overuse prescription and over-the-counter (OTC) headache medication can lead to medication overuse headache. 
• New Daily Persistent Headache(NDPH) – Usually, people without a history of headaches suddenly start experiencing this type of headache. This type of headache often causes mild to moderate pain while affecting both sides of the head and causes pain that can feel pressing or tightening but not pulsating.
• Chronic tension-These types of headaches often begin as episodic headaches but then become chronic headaches like chronic migraine. Symptoms of chronic tension-type headaches and chronic migraines are different. These headaches typically cause mild to moderate pain, affect both sides of the head, and don't disrupt a person's daily life.
• Chronic post-traumatic headache- This is a recurring type of headache that develops after a sort of head trauma. A history of chronic tension-type headache and chronic migraine can put a person at increased risk of developing a chronic post-traumatic headache after a trauma-like concussion. 
• Hemicrania continua – It is a relatively rare sort of headache and is different from the headaches mentioned above as it is associated with autonomic symptoms such as:
  • Affect only one side of your head with redness or tearing of the eye on the affected side;
  • Are continuous and days without any pain-free periods;
  • Generally, it causes moderate pain but can have a spike of severe pain; and
  • It can sometimes become severe while showing migraine-like symptoms.

The cause of this type of headache isn't exactly known. However, it can cause runny or congested nose, pupil narrowing or drooping eyelid, and sensation of restlessness. 

To not let chronic migraine be a part of your daily life, you must consult a medical professional and rule out some migraine symptoms such as:

• Feeling confused or tired;
• Pain that worsens with physical activity; 
• Blurred vision or blind spots; and
• Nausea or vomiting, etc. 

Furthermore, headaches can be caused by a sudden increase or decrease in blood pressure (hypertension or hypotension). Daily headaches can also be a result of your fluctuating blood pressure. 

Additionally, you can also sometimes experience dull pain, tightness, or pressure around the back of your head, neck, and forehead. This sort of pain feels like a clamp squeezing your skull and is known as tension headache or stress headaches which is the most common type of headache adults have. 

Tension headaches are of two types such as:

• Chronic tension headaches – can occur more than two weeks a month. The pain may ease up or get stronger through your day and
• Episodic tension headaches – generally occur less than two weeks a month and can last up to a few days, which often starts slow. 

Tension headaches don't hamper your daily life and won't affect any part of your vision or strength. 

Symptoms of tension headaches

• Muscle aches;
• Moderate to mild pain with pressure in the front, top, or sides of your head;
• Mild sensitivity to light and noise;
• Tiredness;
• Inability to sleep;
• Irritability; and
• Trouble focusing. 

These headaches, even when diagnosed as chronic daily headache, isn't as severe as chronic migraine.

When to get diagnosed or see a doctor?

Headaches are common occasionally and usually are self-treatable. However, you should consult a physician, if:

• Your headaches are disabling and disrupting your daily life,
• You have two or more headaches in a single week,
• The pattern of headache changes or worsens, and
• You have to take a painkiller on most days.

Without delay, you should be seeking medical advice, if:

• It doesn't seem to improve, rather gets worse even after medication and proper rest,
• It is severe and sudden,
• It is preceded by an injury to the head, and
• Headache is accompanied by difficulty speaking, stiffness around the neck, numbness, weakness, fever, confusion, or a seizure. 

Getting your chronic daily headache diagnosed is utterly crucial as it will have a major influence on matching the type of treatment and medicines required for your headache type. The diagnosis affects the treatment plan by type of medications prescribed, directing the type of medical tests and long-term management goals you and your doctor select. Moreover, matching your beliefs about your headache type(s) to an accurate diagnosis is essential as otherwise tests can't be run and medication can't be prescribed at all.