Headaches are a common condition that most of us have experienced at least once in our lives. The term ‘headache’ refers to any pain in the head, varying in intensity and origin.
However, there are cases when the pain persists or lasts for an extended period, indicating a chronic headache. But what exactly characterizes this type of headache?
Headache: When Is It Chronic?
Headaches can be a symptom or a standalone condition.
The most prevalent form of headache is known as tension muscle headache. It is characterized by persistent, pressing pain of varying intensity, ranging from mild to moderate. This type of headache can occur episodically or become chronic.
A headache is considered chronic when the duration of pain exceeds the pain-free intervals. In other words, it occurs for at least 15 days per month, persisting for three consecutive months. One form of chronic tension-type headache is known as chronic daily headache.
Understanding Chronic Daily Headache
Chronic daily headache – or primary headache – is when headaches persist for 15 days or more per month for a minimum of three months. Diagnosing this condition is crucial to rule out secondary daily headaches caused by underlying pathologies. If there are any doubts, it is essential to gather a thorough medical history and conduct specific examinations, such as:
- Imaging studies, including Computed tomography (CT) and Magnetic resonance imaging (MRI)
- Laboratory tests
What Are the Causes of Chronic Headaches?
Chronic headaches typically develop gradually over several years and are particularly prevalent among women.
They may be attributed to various factors, including:
- Abuse of Symptomatic Drugs -Excessive use of medications to alleviate headache symptoms can disrupt the headache itself and impede the effectiveness of preventive therapies. The issue mainly arises when treatment extends beyond three days a week;
- Psychophysical Stress;
- Caffeine Abuse;
- Uncontrolled High Blood Pressure;
- Sleep Disorders and Sleep Apnea;
- Anxiety and Depression;
- Chronic Pain – Conditions characterized by persistent pain, such as chronic back pain and fibromyalgia, can contribute to chronic headaches, mainly if they result from poor posture;
- Underlying Medical Conditions, including hypothyroidism, asthma, and allergies.
What Happens If Chronic Headaches Are Not Properly Treated?
Treating chronic headaches is a complex process involving a personalized diagnostic, therapeutic, and care pathway (PDTA) for each patient.
If left untreated or inadequately managed, chronic headaches can significantly worsen and severely impact the patient’s quality of life. It is crucial to seek medical attention and follow an appropriate treatment plan to alleviate symptoms and improve overall well-being.
What Are the Tests for Headache?
The most common examinations used to investigate headaches include:
- Skull CT Scan. This imaging technique produces scans of the brain, creating a detailed “map” of brain structures;
- Nuclear Magnetic Resonance Imaging (MRI). MRI is functional for studying headaches with atypical patterns, neurological deficits, dementia, tumors, and other underlying pathologies;
- Polysomnography. This examination is suitable for patients with sleep disturbances and headaches that occur during sleep or upon waking;
- Echo Color Doppler of the Supra-Aortic Trunks. This test allows for the evaluation of arterial circulation directed towards the brain.
How Are Chronic Headaches Treated?
The first step when treating chronic headaches is to consult a specialist in the field.
Depending on the individual case, the specialist may recommend lifestyle modifications such as:
- Dietary changes
- Establishing regular sleep patterns
- Drug therapy
In preventing migraines, monoclonal antibodies have emerged as a highly effective treatment. These antibodies can block a specific protein often present in excessive amounts in the brains of migraine sufferers and trigger headaches by dilating blood vessels. A monthly injection of these antibodies can reduce the number of headache days per month by 70-80%. It is important to note that only headache specialists, typically neurologists, are qualified to prescribe these medications.