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What Causes Constant Migraine Headaches

The Importance Of Achieving A Specific And Accurate Headache Diagnosis

Causes and resolution of chronic headaches

Getting a specific headache diagnosis that is accurate is very important because it will have a major influence on matching your treatment plan to the type of headache and severity of illness. Diagnosis influences the treatment plan by directing the type of medical tests that are run, type of medications recommended and long-term management goals you and your practitioner select. More importantly, matching your beliefs about your headache type to an accurate diagnosis is crucial, as otherwise test recommendations, medications and long-term behavioral management adherence is likely to decrease or not be started at all.

For example, the plan of care will be very different for headaches diagnosed as sinusitis than for headaches diagnosed as migraine. However, if you believe your headaches are due to sinus headache, while your practitioner believes you have migraineresolving the differences so you can comfortably put recommendations into action is critical. For those with chronic migraine, a very different treatment regimen is likely to be offered than for those with less frequent episodic migraine.

Headache diagnoses and treatment plans are made on the basis of:

  • Accurate total of any days with headache in an average month and accurate duration of headache with or without treatment. This identifies the likely headache syndrome.
  • Pain characteristics such as location, severity, pain quality, and response to routine physical activity.
  • Not All Headaches Are The Same

    Before your doctor can start narrowing down the cause of your constant headaches, its helpful for them to know what type of headaches youre experiencing. Its estimated that tension, migraine, and cluster headaches account for 90 percent of all headaches, Dr. Chen says. Only your doctor can determine which type of headache youre having, but its useful to understand the hallmarks of each kind so you can better describe your symptoms to your doctor.

    Major Causes Of Migraine Headaches

    Comments: 0 | January 17th, 2018

    Do you suffer from painful, recurring migraines? Would you like to learn how to prevent them from happening in the first place? The key lies in the underlying cause. Watch as Dr. Hotze discusses 6 major causes of migraine headaches.

    Podcast Video Highlights:

    1:17: Migraine is a form of headache. The headache is just a symptom of underlying problems.

    1:52: The headaches can last for several hours to several days, and theyre very debilitative, and oftentimes, cause people to miss work or just not be able to function at all in their household activities or in their work activities.

    2:36: Remember, when a doctor tells you that you have headaches, or migraine headaches, or cluster headaches, or neurological headaches, hes simply taking the symptom and converting the symptom to a diagnosis, which its not. Headaches have underlying causes theyre not caused by low levels of pharmaceutical drugs.

    3:22: There are really six major causes of severe headaches, which oftentimes are referred to as migraine headaches.

    3:54: If it happens at the same time every month, thats very classical for headaches caused by hormonal imbalance.

    5:09: Low magnesium can be a cause of migraine headaches because, when a person has low magnesium, they can get spasm of their arteries. This can occur in their brain, and when it does, itll cause headaches, severe headache, which are oftentimes referred to as migraine headaches.

    Podcast Video Transcription:

    Research

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    S That Can Help Reduce The Risk Of Headache Progression

    • Avoid using over-the-counter and acute prescription headache medications more than two days a week, with rare exceptions. If this is difficult, a daily medication to prevent migraine attacks may be useful.
    • Minimize, better yet, eliminate use of caffeine.
    • Make lifestyle changes that help to manage stress including:
    • Routine exercise

    How Can My Headache Be Managed

    Chronic Daily Headache

    Many people who experience regular headaches will recognise some of the signs that a headache is about to come on. This might be the right time to take any medicines you have been prescribed by your doctor, or purchased over the counter. It may also help to try:

    • lying down in a dark, quiet room
    • sleeping
    • placing a cold or warm cloth on the back of your neck or on your forehead
    • taking a walk in fresh air

    Your doctor or pharmacist can help you work out if you need medicine for your headache and the best time to take it.

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    What Are Common Risk Factors For Progression From An Episodic Headache To A Chronic Headache Condition

    There are several risk factors that put the headache patient at risk for exacerbation of their condition. Several of these are modifiable or conditions that the patient with their physician can work with to help prevent headaches from progressing.

    Modifiable risk factors are:

  • Obesity
  • Caffeine.
  • Some factors are not modifiable, such as a genetic predisposition. Therefore, it is important that patients work closely with their physician to help establish boundaries for those conditions that they have control over. Some modifiable risk factors are reviewed in detail below:

    Can I Prevent Chronic Migraines

    Taking care of yourself every day may prevent your migraines from turning into a long-term problem. For instance:

    Catch some ZZZs. Not getting enough sleep can trigger a migraine. Aim for 7 to 8 hours of rest each night.

    Watch your diet. While caffeine can soothe your pain, stopping it suddenly is a common cause of migraine. Other common food triggers include MSG , nitrates in cured meats like hot dogs, artificial sweeteners, and alcohol.

    Manage your stress. Tension and worry are common triggers. Try to carve out a few minutes each day to do something you love, or learn to breathe deeply when youâre in the midst of a crisis. You might join a support group or talk to a counselor.

    Have a meal plan. Fasting and skipping meals can trigger headaches. Try to eat around the same times each day.

    Get moving. Exercise is a good way to ease your anxiety and stress. It can also help you get to, and stay at, a healthy weight. Since obesity raises your risk of chronic migraines, getting in shape is crucial.

    Know your triggers. Not all migraines result from triggers. But if yours do, that set of triggers is unique to you. To learn what yours are, keep a headache diary. Each time you have an attack, write down details about what you were doing, how long the headache lasted, and how you felt before it started. This will help you begin to notice patterns — and avoid your triggers.

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    What Diseases Cause Secondary Headaches

    Headache is a symptom associated with many illnesses. While head pain itself is the issue with primary headaches, secondary headaches are due to an underlying disease or injury that needs to be diagnosed and treated. Controlling the headache symptom will need to occur at the same time that diagnostic testing is performed to identify the underlying disease. Some of the causes of secondary headache may be potentially life threatening and deadly. Early diagnosis and treatment is essential if damage is to be limited.

    The International Headache Society lists eight categories of secondary headache. A few examples in each category are noted .

    Head and neck trauma

    • Injuries to the head may cause bleeding in the spaces between the meninges, the layers of tissue that surround the brain or within the brain tissue itself .
    • Edema or swelling within the brain, not associated with bleeding, may cause pain and a change in mental function.
    • Concussions, where head injury occurs without bleeding. Headache is one of the hallmarks of post-concussion syndrome.
    • Whiplash and neck injury also cause head pain.

    Blood vessel problems in the head and neck

    Non-blood vessel problems of the brain

    Medications and drugs

    Infection

    What Are The Symptoms Of Cluster Headaches

    Chronic Daily Headache – Mayo Clinic

      Cluster headaches are headaches that come in groups separated by pain-free periods of months or years. A patient may experience a headache on a daily basis for weeks or months and then be pain-free for years. This type of headache affects men more frequently. They often begin in adolescence but can extend into middle age.

      • During the period in which the cluster headaches occur, pain typically occurs once or twice daily, but some patients may experience pain more than twice daily.
      • Each episode of pain lasts from 30 to 90 minutes.
      • Attacks tend to occur at about the same time every day and often awaken the patient at night from a sound sleep.
      • The pain typically is excruciating and located around or behind one eye.
      • Some patients describe the pain as feeling like a hot poker in the eye. The affected eye may become red, inflamed, and watery.
      • The nose on the affected side may become congested and runny.

      Unlike people with migraine headaches, those with cluster headaches tend to be restless. They often pace the floor and/or bang their heads against a wall. People with cluster headaches can be driven to desperate measures, including suicidal thoughts.

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      Impact Of Chronic Migraine

      If you have chronic migraine it will have a huge impact on your daily life. Chronic migraine is related to greater disability and has a huge impact on your physical, social and work life. It can also have a huge impact on your relationships. Many people with chronic migraine report lower quality of life and poorer health than people with episodic migraine.

      It can be challenging to find an appropriate treatment and you may have spent years trying to find a way to make your migraine manageable.

      If you are struggling with chronic migraine speak to your GP, specialist or contact our Helpline.

      What Is Migraine Symptoms Causes Diagnosis Treatment And Prevention

      Migraine is a neurological disease characterized by repeated episodes of symptoms, called attacks, that usually include headache, often accompanied by nausea vomiting sensitivity to light, touch, smell, or sound dizziness visual disturbances and tingling or numbness in the face, hands, or feet.

      Migraine attacks may come on suddenly without warning, or they may be preceded by certain known triggers, such as skipping a meal, being exposed to smoke or air pollution, or experiencing a change in hormone levels as part of the menstrual cycle. Most migraine attacks last from 4 to 72 hours, although effective treatment can shorten them to a matter of hours. On the other hand, some migraine attacks can last even longer than 72 hours.

      Having migraine can be disabling and can lead to missing days of school or work, being less productive at school or work, being unable to perform household responsibilities, and missing out on family, social, and leisure activities.

      An estimated 1 billion people worldwide, and 39 million Americans, have migraine.

      While a variety of triggers can set off migraine attacks, they dont directly cause the attacks or the underlying disease.

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      What Is Chronic Migraine

      Chronic migraine is defined as having headache on at least 15 days per month, with eight of these having migraine symptoms, for at least three months. People who have fewer headache days with migraine symptoms have episodic migraine.

      If you have chronic migraine your symptoms may include:

      • frequent headache
      • increased sensitivity to light, sound or smells
      • nausea
      • vomiting .

      Other symptoms include aura , dizziness and vertigo .

      What Questions Should I Ask My Healthcare Provider

      Constant Migraines Causes Tiredness Dizziness Symptoms ...
      • Will my child grow out of their migraines?
      • What medications do you recommend for me?
      • What should I change about my lifestyle to prevent my migraine headaches?
      • Should I get tested?
      • What type of migraine do I have?
      • What can my friends and family do to help?
      • Are my migraines considered chronic?

      A note from Cleveland Clinic

      Migraine headaches can be devastating and make it impossible to go to work, school or experience other daily activities. Fortunately, there are some ways to possibly prevent a migraine and other ways to help you manage and endure the symptoms. Work with your healthcare provider to keep migraines from ruling your life.

      Last reviewed by a Cleveland Clinic medical professional on 03/03/2021.

      References

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      How Is Chronic Migraine Treated

      Treatment of chronic migraine is focused on managing lifestyle choices and headache triggers, managing migraine attacks and providing preventive treatments to reduce migraine attacks.

      Lifestyle changes include:

      • Beginning treatment for any existing mood disorder or sleep problem.

      The typical treatment plan for managing migraine attacks includes:

      • Treating migraine attacks early when pain in mild begin with a simple pain killer and slowly increase the dose as needed to the max tolerated dose, unless the headache is severe at the start or will become severe. In such cases add a triptan to the above medication to improve efficacy. Avoid use of opiates if possible. Your doctor will devise a treatment plan to avoid worsening chronic headache by overusing medications.
      • Treat associated side effects, such as nausea.
      • Consider other treatment techniques, including transcranial magnetic stimulation and transcutaneous supraorbital nerve stimulation.

      Preventive treatment is aimed at reducing the number of headaches. Preventive treatments include:

      What Foods Help Relieve Migraine Pain

      Although caffeine is sometimes a migraine trigger, it may help some individuals combat their migraine symptoms. In certain instances, drinking a caffeinated beverage during a migraine attack may help a person alleviate his or her migraine pain.

      Also, research indicates bland foods may help relieve migraine pain. These foods include pears, saltine crackers and white bread.

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      How Can The Doctor Tell What Type Of Headache I Have

      You can help your doctor to diagnose your headache type by keeping a headache diary in the weeks leading up to your appointment. Your diary should record the number of days you have a headache, how severe your headache is and any other symptoms associated with your headache, such as nausea. A headache diary can also help your doctor look for patterns and triggers, which can help with your treatment.

      It is important that you let your doctor know how your headache affects your day-to-day life and the impact it has on your partner, children, employer, work colleagues and friends.

      You Drink Too Much Caffeine

      What are the causes of chronic headache & its management? – Dr. Sanjay Panicker

      Caffeine causes vasoconstriction in your blood vessels, meaning they get a little narrower. If you drink coffee or other caffeinated drinks every day, your body gets used to it, Dr. Hutchinson explains. So when you skip it one day, your blood vessels don’t become constricted and can make your head hurt. It becomes a vicious cycle, slugging back a mug to find relief, and just further deepening your need for caffeine. Additionally, the Mayo Clinic says that adults can safely consume up to 400 milliliters of caffeine per day , butkeeping in mind that everyones tolerance is differentafter that, your body might begin to rebel.

      Fix it:“It’s unrealistic to tell all headache patients to avoid caffeine,” Dr. Hutchinson says. Instead, she recommends moderationa maximum of two caffeinated drinks in one dayto avoid that withdrawal headache when you go without.

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      When Should I Seek Immediate Help Or Contact My Healthcare Provider

      • You are experiencing the worst headache of my life.
      • You are having neurologic symptoms that youve never had before, including speaking difficulty, balance problems, vision problems, mental confusion, seizures or numbing/tingling sensations.
      • Your headache comes on suddenly.
      • You have a headache after experiencing a head injury.

      Schedule a visit with your healthcare provider if:

      • The number or severity of your headaches increase or your headache pattern changes.
      • Your medications no longer seem to be working or youre experiencing new or different side effects.

      How Are Secondary Headaches Diagnosed

      If there is time, the diagnosis of secondary headache begins with a complete patient history followed by a physical examination and laboratory and radiology tests as appropriate.

      However, some patients present in crisis with a decreased level of consciousness or unstable vital signs due to the underlying cause of the headache. In these situations, the health care professional may decide to treat a specific cause without waiting for tests to confirm the diagnosis.

      For example, a patient with headache, fever, stiff neck, and confusion may have meningitis. Since meningitis can be rapidly fatal, antibiotic therapy may be started before blood tests and a lumbar puncture are performed to confirm the diagnosis. It may be that another diagnosis ultimately is found, for example, a brain tumor or subarachnoid hemorrhage, but the benefit of early antibiotics outweighs the risk of not giving them promptly.

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      How Prevalent Are Migraines

      Migraines are about three times more common in women than men, and may affect more than 12 percent of the U.S. adult population. Migraines often run in families, and can start as early as elementary school but most often in early adulthood. They often fade away later in life, but can strike at any time. The most common cause of recurring, disabling headache pain, migraines are also the most common underlying cause of disabling chronic, daily headache pain. While migraines are the No. 1 reason that patients see a neurologist, most cases are handled by primary care physicians.

      Things that can make the headaches more likely to occur include:

      • Alcohol

      Social And Economic Burden Of Headache

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      Headache disorders are a public-health concern given the associated disability and financial costs to society. As headache disorders are most troublesome in the productive years , estimates of their financial cost to society principally from lost working hours and reduced productivity are massive. In the United Kingdom, for example, some 25 million working- or school-days are lost every year because of migraine alone this financial cost may be matched by TTH and MOH combined. Headache is high among causes of consulting medical practitioners: one-third of all neurological consultations were for headache, in one survey.

      Yet, many of those troubled by headache do not receive effective care. For example, in the United States of America and the United Kingdom, only half of those identified with migraine had seen a doctor for headache-related reasons in the previous 12 months, and only two-thirds had been correctly diagnosed. Most were solely reliant on over-the-counter medications.

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