Chronic Headaches and Migraines

Any type of headache is unwelcome. If your headaches or migraines are chronic, they can be debilitating. It is essential that you do not let the pain and suffering caused by chronic headaches and migraines interfere with your quality of living. A pain specialist can help you understand and treat your condition to live your life as normally and comfortably as possible.

What Are The Symptoms of Chronic Headaches and Migraines?

A headache is defined as "pain in any region of the head. Headaches may occur on one or both sides of the head, be isolated to a certain location, radiate across the head from one point, or have a viselike quality. A headache may appear as a sharp pain, a throbbing sensation, or a dull ache. Headaches can develop gradually or suddenly and may last from less than an hour to several days." Headaches or migraines are considered chronic if you have more than 15 of them in a month. Headaches can either be primary, meaning that they are a condition on their own, or secondary, where they occur as a side effect of a particular medical condition. There are several different types of headaches, each carrying various symptoms. 

What Are the Different Types of Headaches?

Tension Headache

A tension headache is the most common type of headache. It can be chronic if it occurs more than 15 times a month. Symptoms of a tension headache include:

  • A dull aching pain
  • Feeling like there is pressure along the sides and back of your head or across your forehead
  • Tenderness in your neck, shoulders, and scalp
  • It lasts anywhere from several hours to a week

Cluster Headache

Cluster headaches come in cycles and are considered one of the most painful headaches. These headaches usually hit without warning. They can awaken you in the middle of the night and last for weeks. Fortunately, these headaches are rare. Symptoms of a cluster headache include:

  • Excruciating pain that is centered behind or around one eye but can radiate to other parts of your face, head, or neck
  • The pain usually affects only one side of your head
  • Restlessness
  • Uncontrollable and excessive tearing
  • A stuffy nose only on the affected side
  • Redness in the eye on the affected side
  • Swelling around your eye on the affected side
  • Facial sweating that only occurs on the affected side
  • Either a pale pallor or flushing in your face

Sinus Headache

A sinus headache is typically associated with a sinus infection. Symptoms of a sinus headache include:

  • Pain or pressure in your brow area, cheeks, and forehead
  • Increased pain if you bend forward or lie down
  • Fatigue
  • Stuffy nose
  • Aching feeling in your front teeth

Medication Overuse Headaches

You could be in danger of a medication overuse headache if you have any headache disorder for which you take medication, either over the counter or prescription. These headaches may occur daily. When you take medication to deal with the headache, symptoms might subside until the drug wears off. Symptoms of a medication overuse headache include:

  • Nausea
  • Restlessness
  • Irritability
  • Memory issues
  • Trouble concentrating

Migraine Headaches

A migraine headache can be debilitating. Some people who suffer from migraines will experience a warning sign in the form of an aura before the headache begins. Auras are usually visual perceptions such as a flash of light, shapes, or even vision loss. Once the actual migraine begins, symptoms include:

  • A throbbing or pulsing pain that is usually limited to one side of the head but can affect both sides.
  • Nausea and vomiting.
  • Sensitivity to light, sounds, smells, and even touch.

What Causes Chronic Headaches and Migraines?

The causes of chronic headaches and migraines can be complicated. Some headaches, like sinus headaches, have an apparent related reason. The causes of most other types of headaches are still somewhat of a mystery. As a patient becomes accustomed to their chronic headache condition, they begin to identify what triggers their headaches. Common headache triggers include:

  • Stress: Studies show that 50%-80% of migraine patients report stress as the primary triggering event for a migraine. Stress has also been linked to the onset of tension headaches.
  • InsufficientSleep: Lack of sleep due to jet lag, insomnia, and other sleep disorders have been found to be connected to migraine headache onset.
  • Dehydration: Dehydration has long been known as a trigger for headaches and migraines. 
  • Food: Some foods have contributed to migraines, including cured meats, chocolate, too much caffeine, artificial sweeteners, and foods containing monosodium glutamate (MSG).
  • Alcohol: In some cases, alcohol can trigger a migraine.
  • Sensory Stimulation: Some studies show that migraines are a disorder of sensory processing.
  • Weather: When the weather changes, it can bring on a migraine.

What Are the Risk Factors for Chronic Headaches and Migraines?

The following groups are at greater risk for migraines:

  • Those who overuse medication
  • Obesity
  • Depression
  • Stressful life events

What Are the Complications of Chronic Headaches and Migraines?

Some complications are possible from migraines. These include:

  • Stroke
  • Seizure
  • Side-effects from medications
  • Persistent aura

Can You Prevent Migraines?

There are a few steps you can take to try to prevent the onset of migraines.

  • Start keeping a headache diary to document what your triggers might be
  • Maintain standard sleep patterns
  • Don't skip meals
  • Stay hydrated
  • Get regular aerobic exercise
  • Take the preventive medication at the first sign that a headache might be coming on

How Are Migraines and Chronic Headaches Diagnosed?

The first step to effective treatment is a confirmed diagnosis. A variety of factors diagnoses the condition of chronic migraines. Your doctor will ask you to track your headache activity for a month or more before your appointment. They will then look at the following factors before making a diagnosis:

  • Patterns related to your migraines are usually related to when and how they began
  • A description of the pain since typical migraines have a specific combination of pain and pressure
  • Other potential symptoms related to your migraine condition including lack of energy, changes in your vision, or a stiff neck
  • Other elements of your medical history, such as the pre-existing conditions of heart disease, fibromyalgia, or sleep apnea

How Are Migraines and Chronic Headaches Treated?

Traditionally, chronic migraine conditions have been treated through acute and preventive treatment accompanied by lifestyle changes. It has become common practice for a patient to treat their symptoms and side effects early on. 

Preventive therapies include a combination of medications combined with non-medication therapies and lifestyle changes.

Medication Therapies 

Traditional medication preventative treatments have included medications in the following categories:

  • Beta-blockers
  • Angiotensin blockers
  • Tricyclic antidepressants
  • Anticonvulsant medications
  • Botox injections

Lifestyle Changes

Recommended lifestyle changes include:

  • Weight loss
  • Exercise
  • Stress management
  • Developing a meal routine
  • Staying hydrated
  • Treatment of mood disorders or sleep apnea

Non-Medication Therapies

The non-medication therapies standard in the treatment of chronic migraine include the use of:

  • Nerve stimulator
  • Nerve block
  • Alternative medicine such as acupuncture and meditation
  • Cognitive-behavioral therapy where the patient actively substitutes their traditional responses with new ones
  • Avoiding triggers
  • Treatment of any underlying conditions such as depression, fibromyalgia, and sleep apnea

Make An Appointment with San Diego’s Best Pain Specialist

If you are suffering from chronic headaches or migraines, the Dr. Sandra Thompson with the Pain Center of San Diego might be able to help. Contact us today to schedule a consultation for more information.









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