Chronic daily headache (CDH) is more of a state of being rather than an actual diagnosis. The definition of chronic daily headache is a headache that occurs over half of the time, or at least 15 days each month.
CDH can occur from migraine headaches, tension headaches, cluster headaches, or even a combination of different types of headaches. Patients with chronic daily headaches may live with head pain at all times, with varying degrees of intensity and varying degrees of debility arising from their headaches.
We all have occasional headaches. They don’t require the help of Dr. Lowenstein or anyone else. Chronic headaches are another thing altogether.
If the following characteristics sound like you, you’re probably at your wit’s end and you could benefit from coming see Dr. Lowenstein at the Migraine Surgery Specialty Center for help.
• You should call us if…
• You typically have two or more headaches every week
• You take a pain reliever for your headaches most days
• To relieve your pain requires more than the recommended dose of over-the-counter pain medication
• Your headache pattern changes
• Your headaches become worse
• Your headaches are disabling
While the above characteristics or symptoms are not life threatening and don’t require immediate treatment, there are certain times when a person requires immediate medical care:
• If your headache is sudden and severe
• If your headache accompanies a fever, stiff neck, confusion, seizure, double vision, weakness, numbness, or difficulty speaking
• If your headache follows a head injury
• If your headache worsens despite rest and pain medication
Associated symptoms of nausea, dizziness, photophobia, and other problems may accompany the symptoms of CDH. Many chronic headache patients can be helped with headache surgery as the inflammatory condition of nerve trigger points may play a central role in their headache and can be relieved by nerve release in headache surgery.
Chronic daily headaches can be debilitating. Patients should see a doctor for a comprehensive consultation and examination in the following situations:
• Headaches occur two or more times a week
• Pain reliever is needed nearly every day to control headaches
• The recommended dose of over-the-counter pain medication is not sufficient to reduce pain
• Headaches worsen or change in pattern
• Headaches minimize the ability to work or engage in normal activities
Several medications have been used to treat patients with frequent headaches. These include:
• NSAIDs. Prescription-strength nonsteroidal anti-inflammatory drugs may help relieve pain for some patients.
• Antidepressants. Many headache sufferers are prescribed tricyclic antidepressants to reduce headache pain, as well as the sleep disturbances, anxiety, and depression that may accompany them.
• Anti-seizure drugs have shown efficacy in reducing chronic daily headaches and migraines in some patients.
• Beta-blockers, which are commonly prescribed to reduce high blood pressure, may be effective at managing episodic migraines.
• Botox. Botox and other botulinum toxin neuromodulators have recently become a popular method of treating headaches.
Nonpharmacological modalities may be more appealing to some people than prescription drugs for the management of chronic daily headaches. Options include acupuncture and massage. Both can provide relief from muscle tension and stress but may have a limited impact on moderate to severe headaches.
Patients who visit our Santa Barbara office can explore the benefits of migraine surgery as a treatment option for chronic daily headaches. Dr. Lowenstein performs precise testing to determine if the inflammation of a peripheral nerve is contributing to chronic pain. Peripheral nerve pain is a common factor in migraines as well as other types of headaches. Surgery relieves pressure on the affected nerve and thus reduces or eliminates pain.
The treatments Dr. Lowenstein uses for chronic headaches typically don’t require any downtime or recovery. If non-invasive treatments are not solving the patient’s chronic headaches, peripheral nerve surgery could be necessary to relieve nerve compression that is causing the problem. If this is the treatment used, there will be one to two weeks of recovery time. Over this time the patient needs to avoid any activities that raise his or her blood pressure, especially to the face and head. The key to recovery after peripheral nerve release is to lay low and relax.
Usually when a person’s headaches have progressed from occasional normal headaches to chronic headaches, something has changed in their health or their lifestyle. For that reason, once headaches have become chronic, occurring at least 15 days out of every month, they are unlikely to resolve without treatment from a headache specialist like Dr. Lowenstein.
People assume they can manage their chronic headaches. They often assume this is a phase in life — maybe more stress, maybe less sleep — and things will change. In the meantime, their headaches are directly impacting life.
This isn’t something to hope changes or goes away. Your chronic headaches need to be treated by an expert.
As mentioned above, it’s not likely that these headaches are suddenly going to go away. After all, they’ve progressed from being an occasional problem to impacting at least half of the days of the month. No doubt your headaches have begun to affect your relationships, work, and most other areas of your life.
Why let that continue?
Dr. Lowenstein is a board-certified plastic surgeon with extensive specialized training and education with migraine and chronic headaches. This aspect of helping patients get past the chronic pain associated with these headaches has become a large part of our practice.
So, while you can opt to go it alone, suffering through these near daily headaches, it makes far more sense to seek the help of Dr. Lowenstein for treatment.
Nerve decompression surgery usually provides permanent relief. While it may not stop all of the patient’s headache occurrences, their frequency and intensity drop. Around 40 percent of our migraine surgery patients become completely free of pain.
Other non-surgical treatments may or may not need repeating in the future. Every patient’s situation is different.
Several strategies may help ease chronic daily headaches. These include:
• Identify and avoid triggers, such as caffeine. To do this, one may have to keep a headache diary and note when headaches occur and what happened beforehand, such as what foods were consumed.
• Get sufficient sleep. Studies suggest that insufficient sleep (less than 7 ½ hours) may contribute to headaches. Poor sleep could also be caused by a condition such as sleep apnea, which could also trigger headaches.
• Eat regularly. Skipping meals could lead to headaches, according to some studies.
• Exercise regularly. This reduces stress and promotes good circulation throughout the body.
• Manage stress. Stress leads to the release of certain hormones, as well as chronic muscle tension, both of which could cause headaches.
• Avoid medication overuse. Taking headache medications more than a few times a week could increase the frequency and severity of headaches.
Strategies to avoid chronic daily headaches may not work for everyone. If headaches continue, it is important to seek appropriate medical care. Dr. Lowenstein has particular training that enables him to identify the cause of chronic daily headaches so an appropriate treatment plan can be developed.
Be sure to check out Dr. Lowenstein’s podcast for all the information you would need regarding chronic daily headaches and migraines. You can access the podcast through the site by clicking here!
If you are suffering from chronic daily headaches, give Dr. Lowenstein a call at 805-969-9004.
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