From drinking too much last night to stressing out about finances or family concerns, there are so many possible causes of the common headache. However, when headaches go from being few and far between to frequent and long-lasting, it may be time to make an appointment to see your primary care physician.
"Practical clinical criteria defines chronic migraine as a headache that occurs greater than 15 days a month with each headache episode lasting longer than four hours for at least three consecutive months," said Dr. Denis G. Patterson, medical director of the Northern Nevada Pain Center and founder of Nevada Advanced Pain Specialists. "It does not matter how severe the headaches are — the medical term for chronic headaches is migraine headache."
According to Patterson, who is board-certified in pain medicine and physical medicine and rehabilitation, common headache triggers include hormonal changes in women, stress and changes in sleep patterns. Certain foods, such as alcohol, aged cheeses, chocolate, aspartame, too much caffeine, monosodium glutamate, processed and salty items, also may set off headaches. Among other potential triggers are bright lights, loud sounds, unusual smells, changes in the weather or barometric pressure, intense physical exertion or sexual activity.
"The causes of chronic headaches are not well understood," Patterson said. "Medical experts believe that genetics and environmental factors seem to both play a role."
No matter the cause, if you find that you're hampered by headaches a little too often, experts suggest first making an appointment with your primary care physician. If unable to alleviate the headaches, this doctor may then refer you to a headache specialist, such as a neurologist or pain management physician.
"A physician trained in treating headaches will likely diagnose the condition on the basis of your medical history, a review of your symptoms, and a physical and neurological examination," said Patterson, who specializes in common and complex neurological disorders, as well as musculoskeletal issues. "Your doctor may also recommend a variety of tests to rule out other possible causes for your pain if your condition is unusual, complex or suddenly becomes severe."
As for treating chronic headaches, there are quite a few options for today's patients. Your doctor may advise starting with noninvasive and nonpharmacological solutions to see if the migraines can be reduced naturally. For example, you may be encouraged to engage in muscle relaxation exercises and commit to getting enough sleep. Other treatment options may involve alternative medicine, such as acupuncture or massage therapy.
Pain-relieving medications or preventive medications also might be prescribed to address chronic headaches. Finally, certain patients may need injections to ease or prevent the pain. This might involve the use of nerve blocks, nerve stimulators or Botox injections.
"Botox is the first and only preventive treatment approved by the FDA for adults with chronic migraine," Patterson said. "It may reduce the number of headache days a month and/or decrease the severity of headache episodes."
Without treatment, the frequent pain of chronic headaches can lead to decreased quality of life. If you find that your headaches go beyond the occasional hangover or tension-filled day, reach out for relief.
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