Headaches

Chronic headaches

What causes chronic headaches?

When you experience chronic headaches, it can significantly reduce your quality of life. Finding the specific causes and developing an appropriate treatment plan starts by determining the type of headache you have.

What are the different types of headaches?

There are two major forms of headache, primary and secondary. Primary headaches include:

• Tension headaches: These are the most common type of primary headache. They are characterized by a constant pressure or ache in the forehead, temples or neck. Tension headaches may occur randomly and are often the result of temporary factors such as situational stress, fatigue or anger.
• Migraine headaches: Migraines are the second most common type of primary headache. For many migraine sufferers, the onset of a migraine attack can seriously disrupt their daily routine, causing them to miss work, household chores, and family or social activities. Women are more likely than men to experience migraines.
• Cluster headaches: Men are more likely to experience this rare type of headache, which typically occurs for weeks at a time, followed by a period of remission. Generally, only one side of the head is affected, and associated symptoms on the painful side may include a runny or stuffy nose, or a bloodshot or tearing eye.

Secondary headaches and emergencies

Secondary headaches, on the other hand, are caused by another medical condition. This may include a person who suffers from a chronic condition such as sinusitis, a structural issue that can lead to frequent headaches. In some cases, headaches are the body’s way of signaling there is a serious medical condition that needs to be addressed, such as a tumor, stroke or brain hemorrhage. If you or a loved one experience any of the following symptoms, seek immediate medical attention:

• A new, severe headache that happens suddenly
• A headache that is worse than any you have ever experienced before
• Any headache that is accompanied by a stiff neck, fever or shortness of breath
• Headache pain that is strong enough to wake you up at night
• A headache that is accompanied by neurological symptoms such as severe nausea or vomiting
• Headaches that occur following a head injury

How do I know if it’s a migraine?

Migraines occur in stages, although not everyone will experience all four:

• Prodrome: A day or two before a migraine attack, you may notice slight changes in your body, such as digestive issues, changes in appetite or energy level, concentration issues, or an increase in irritability.
• Aura: Some migraine sufferers experience an aura, a temporary effect that typically includes visual symptoms such as flashing lights, blind spots, or seeing geometric patterns or other hallucinations. In some cases, the aura may affect the other senses, including hearing, smell and touch, or you may experience numbness or have difficulty speaking.
• Attack: Migraine headaches may last from a few hours to a few days, and the severity and duration of a migraine attack varies based on the person. Common symptoms include a dull ache that develops into a pulsating, throbbing pain, which may be confined to one side of the head. In addition, you may have an increased sensitivity to light, sounds or other stimuli, or experience nausea or vomiting.
• Postdrome: Following the attack, you may experience fatigue, muscle weakness, lightheadedness or depression. Some people experience the opposite, getting a brief sense of euphoria.

Are migraines hereditary?

In many cases, but not all, people who experience migraines have a family history for the condition. Knowing your family’s history for migraines and other headaches is an important first step for treatment.

What triggers migraines?

For some people, the onset of a migraine may occur following exposure to specific physical or environmental stimuli, known as “triggers.” Depending on the person, these triggers may include stress, changes in weather, eating certain foods, hormonal changes and even sensory stimuli such as bright lights, loud sounds or certain scents.

How do you treat chronic headaches?

Many people turn to over-the-counter medications for headache relief. While this can help to alleviate minor headaches such as the occasional tension headache, habitual overuse of these pain medications as an attempt to treat a chronic condition may make the problem worse, causing what are known as rebound headaches.

If you are experiencing a migraine or other form of chronic headache, a variety of treatments are available.

The Henry Ford Pain Center approach

At the Henry Ford Pain Center, pain treatment begins with a thorough medical history and physical exam. All patients are evaluated by board-certified pain medicine physicians, physician assistants and certified nurse practitioners to identify the cause of their pain. Following initial assessment, we work with you to develop a personalized treatment plan that may include interventional pain procedures, medication therapy, physical therapy, massage and other complementary options.