- If you get a headache 15 or more days each month, you most likely have a chronic headache.
- Migraines and other types of headaches can become chronic if you take painkillers regularly.
- A doctor can help diagnose your chronic headaches and recommend an effective treatment approach.
Let’s face it — headaches can be a real pain. They can make it hard to focus and keep you from the things you want to do, whether that’s reading, listening to music, going for a run with your dog, or anything else.
And headaches that keep coming back, or never seem to go away, can make your life pretty miserable.
Pretty much everyone gets an occasional headache. But if you have a headache at least 15 days each month for three consecutive months, you most likely have some type of chronic headache.
You do have options for treating your headaches, but the right remedy can depend on the type and cause — so your go-to painkiller may not do the trick.
Read on to learn the seven main types of chronic headaches and get a few tips to ease your pain and help prevent future headaches.
1. Chronic migraine headaches
A migraine episode isn’t just a bad headache. A migraine is a neurological condition that affects your nervous system, causing symptoms like:
- Moderate to severe head pain on one or both sides of the head
- Sensitivity to light, sounds, and smells
- Nausea, vomiting, and dizziness
- Confusion, irritability, and other mood changes
- Changes in your vision, like seeing blurry spots, lights, or sparkles
Migraines can last for anywhere from four hours to three days.
Researchers have yet to discover exactly what causes migraine episodes, but they believe certain brain chemicals and hormones, such as estrogen and serotonin, play a part.
Anyone can develop chronic migraines. That said, Dr. Dimitar Marinov, a medical doctor and assistant professor of Preventative Medicine and Nutrition at Medical University Varna and Dr. Ketan Parmar, a neuropsychiatrist at Swaminarayan Clinic, Mumbai, say you’re more likely to experience them if you:
If you experience regular migraines, it’s best to ask your primary care doctor about other treatments. They can prescribe medication to help ease your symptoms and prevent or reduce the frequency of chronic migraines, such as:
- Beta blockers like metoprolol and propranolol
- Tricyclic antidepressants like amitriptyline and nortriptyline
- Angiotensin blockers like candesartan
2. Chronic tension headaches
Chronic tension headaches typically begin as a regular tension headache — which, according to Marinov, generally feels like you have a tight band around your head.
Symptoms of chronic tension headaches include:
- Dull, aching head pain
- Tenderness in your neck, shoulder, and scalp
- A sensation of pressure around your head
Unlike migraine episodes, chronic tension headaches do not cause nausea or vomiting. But they do cause mild to moderate pain, which can last days or weeks at a time, Parmar says. These headaches are especially common if you have a family history of headaches, arthritis, or fibromyalgia.
Experts have yet to identify a specific cause of these headaches, but factors like emotional stress and muscle tension in the head and neck may increase your risk.
You can treat the pain associated with chronic tension headaches with OTC painkillers such as aspirin, ibuprofen, and naproxen. Your doctor may also prescribe tricyclic antidepressants — such as protriptyline and amitriptyline — to reduce the frequency of headache episodes.
3. Chronic post-traumatic headaches
Headaches that begin after a head trauma like a concussion are known as post-traumatic headaches.
These headaches typically show up within a week after a head injury and generally go away within three months after the trauma, Marinov says.
A chronic post-traumatic headache, however, persists for more than three months following the trauma. This type of chronic headache can involve some of the same symptoms as migraines and tension headaches.
According to Marinov and Parmar, these symptoms include:
- Nausea and vomiting
- Dizziness and memory problems
- Hypersensitivity to light and sound
- Mild to severe head pain that may affect your neck, eyes and forehead, the top of your head, and the back and sides of your head
Depending on your specific situation, you may be able to treat this headache with OTC painkillers such as ibuprofen or naproxen.
Other options your doctor may recommend include cognitive behavioral therapy (CBT), acupuncture, and physical therapy.
4. New daily persistent headaches (NDPH)
These headaches come on suddenly, often in people with no headache history.
About three days after your head pain first begins, it becomes continuous, Marinov says. If you have this type of headache, the pain will linger, day in and day out, for at least three consecutive months.
The main symptoms of this type of headache include:
- Mild to moderate pounding pain on one or both sides of the head
- Nausea and vomiting
- Light and sound hypersensitivity
In many cases, this type of headache doesn’t respond to OTC painkillers, though experts don’t know exactly why.
You do have options for treatment, though. Depending on your specific symptoms, your doctor may prescribe:
- Antiseizure medications like topiramate or gabapentin
- Antidepressants like nortriptyline and amitriptyline
- Beta blockers like candesartan and propranolol
- Botox injections
5. Hemicrania continua
Hemicrania continua is a rare type of headache with no known cause. It’s more common in women and people between the ages of 20 and 40.
With this type of headache, you’ll experience pain all day, every day for at least three consecutive months. The pain ranges from moderate to severe and affects only one side of your head.
Other symptoms include:
- Runny nose
- Feelings of restlessness
- Teary or red eye on the same side as the pain
- A drooping eyelid or narrowed pupil on the same side as the pain
Although hemicrania continua typically doesn’t respond to most painkillers, it can be treated with indomethacin, a medication that fights inflammation. Your doctor can prescribe this medication if they diagnose this type of headache.
6. Rebound headaches
Also called medication overuse headaches, these happen due to the regular, prolonged use of headache medications designed to provide immediate pain relief. Taking more than the recommended daily dosage of painkillers can also increase your risk.
Experts don’t know exactly why this happens, though it may have something to do with the withdrawal symptoms you can experience when your medication wears off.
Many different types of headache medications can cause them, including:
- OTC painkillers like acetaminophen and aspirin
- Combination OTC painkillers, which include both pain relieving medications and caffeine or a sedative
- Migraine medications, like triptans
- Opioids such as codeine
A healthcare professional may diagnose this type of headache if you experience head pain for 15 or more days each month for three consecutive months, while taking OTC and prescription pain medications.
Other symptoms of rebound headaches may include:
- Memory problems
These headaches typically won’t go away until you stop taking pain medications — so they’ll most likely get worse before they improve. Your care team can offer more guidance on ways to get relief in the meantime.
7. Cluster headaches
Cluster headaches — a rare type of headache — occur in cycles. The cluster periods, or cycles where your headaches happen more frequently, can last from 15 days to several months.
After a cluster period, you’ll immediately experience a pain-free period known as remission, which can last anywhere from weeks to years.
Other symptoms of cluster headaches include:
- Red or teary eyes accompanied by intense pain around one eye
- Feelings of restlessness
- Runny or stuffy nose
- Pale skin
- Excessive facial sweating on the affected side
Although there is no cure for cluster headaches, several treatment options can offer some relief. Your doctor may recommend:
- Medications such as dihydroergotamine, sumatriptan, and calcium channel blockers
- Oxygen therapy
- Massage therapy
How to get relief
If you’re dealing with chronic headaches, you have plenty of options for home remedies and lifestyle changes that can help you get some relief.
A few strategies to try:
- Aim to get a full night of sleep: Sleep problems can often lead to headaches, so regularly getting between seven and nine hours of sleep may offer a helpful first step toward getting relief.
- Try stress reduction techniques: Stress can easily trigger migraine episodes and other types of headaches. So, adding stress-reducing activities like exercise, meditation, or yoga into your daily routine can help you get some relief and may prevent future headaches.
- Keep track of headache triggers: Different things can trigger headaches in different people. So, keeping track of and avoiding specific situations that trigger yours can make a difference.
- Consider your diet: What you eat — or don’t eat — could play a part in the frequency of your headaches. For instance, eating more fatty fish and less vegetable oils may help reduce migraine episodes. You may also notice eating certain foods triggers your headaches, though the specific foods can vary widely.
- Limit caffeine consumption: Consuming caffeine in a moderate amount — up to 200 milligrams (mg) daily — could actually improve some headaches. But too much caffeine could have the opposite effect.
When to make an appointment with your doctor
If you have chronic headaches, a doctor or healthcare professional can offer more guidance with pinpointing possible triggers and recommending strategies to reduce pain and prevent future headaches.
You’ll want to make an appointment with your doctor as soon as possible if:
- Your headache becomes sudden and alarming.
- You have more than two headaches per week.
- Your headaches get worse.
- You develop a new type of headache and you’re over the age of 50.
- You have other symptoms along with your headache, including fever, weakness, or double vision.
- Your headache requires more than the recommended dose of your OTC painkillers to get relief.
But you’ll want to get immediate medical attention by visiting urgent care or the emergency room if:
- You experience a sudden, very severe headache that you describe as “the worst headache of your life.”
- Your headache follows a head injury.
- Your head pain doesn’t improve after taking medication and resting.
- Your headache is accompanied by seizures, stiff neck, fever, numbness, or double vision.
If you get headaches at least 15 days out of the month, then you have chronic headaches.
Endless headaches can leave you drained, but here’s some good news — most chronic headaches do improve with treatment, such as OTC pain relievers, antidepressants, and beta blockers.
That said, the right treatment can depend on the type of headache you have. So, if you experience headaches that last several days or come back again and again, it’s always best to connect with a doctor who can diagnose your headaches and recommend the right treatment.
The earlier you get treatment, the sooner you can start to feel better, not to mention take steps to reduce future headaches.