Headaches

Some people have a headache more days than not, this can be debilitating and can affect your quality of life. The definition of a chronic daily headache is when you have a headache at least 15 days each month, for at least three months, and the pain is not as a result of another condition. 

There are three main types of chronic daily headaches:

• Migraines - Generally one sided of the head (can be both in children and adolescence) and can involve sensitivity to light and sound, and can be accompanied by vomiting or nausea. Can last up to 72 hours.
• Tension Headache - Chronic tension headaches can last 30 minutes to 7 days, this affects both sides of the head. Nausea or sensitivity to light and sound does not always occur.
• Cluster Headache – Unilateral severe pain clustered around one eye or temple can involve eye redness, tear production, nasal stuffiness &/or drooping eyelid. Can last up to 15 minutes to 3 hours
   

There are many effective treatments available to treat and prevent migraines. Ensure you get your condition diagnosed by your doctor and follow their advice about treatment options. You can also talk to your community pharmacist about managing your lifestyle to lessen the effects of these conditions.

Causes

The cause of chronic daily headaches is unknown in many cases, but for some people can be:

Migraine

• Dehydration
• Hormonal changes
• Bright lights
• Strong odours
• Certain medicines
• Changes in weather or altitude
• Lack of/too much of sleep
• Dietary factors

Tension Headache

• Poor posture
• Fatigue
• Depression
• Anxiety
• Loud noise
• Bright lights

Other Causes

• Overuse of pain medication - Taking prescription pain medicines, or even over-the-counter analgesics (paracetamol or ibuprofen) several days each week, may cause what is known as a rebound effect
• Lack of Sleep
• Stress
• Consuming the wrong food/drink or too much/little
• Sinus pain from an infection/cold or flu
• Caffeine overuse or sudden withdrawal of caffeine
• Overexertion.
• Nicotine
• Jaw tension and teeth grinding
• Eye strain

Treatment

Over the counter pain relieving medications usually can provide relief:

• Paracetamol
• Ibuprofen
• Diclofenac
• Naproxen
• Aspirin

Migraines

• Sumatriptan (Available Over The Counter)

Also try measures such as:

• If you have a migraine – Rest in a quiet, dark room and avoid movement/activity  and maintain fluid intake
• Cold packs on the forehead or back of skill
• Heat packs on the neck or shoulders
• Physical therapy i.e. massage, stretching, postural correction, etc.
• Regular exercise, physiotherapy and relaxation training
• Stress management
• Cognitive behavioural therapy (CBT)
   

If the above hasn’t helped then your pharmacist will be able to advise you on the next step to take to resolve your symptoms.

Chronic Daily Headaches

Most of us get headaches from time to time, but some people have a headache more days than not, and may be suffering from a chronic daily headache. The definition of a chronic daily headache is when you have a headache at least 15 days each month, for at least three months, and the pain is not as a result of another condition.

There are three main types of chronic daily headaches: chronic migraine, chronic tension headache and new daily persistent headache. The differences between the types is that the migraine type of pain is generally on one side of the head and usually involves sensitivity to light and sound, and is usually accompanied by vomiting or nausea. Chronic tension headaches usually only last a few hours, the pain affects both sides of the head and nausea or sensitivity to light and sound does not always occur. New daily persistent headaches continue as a constant pain on both sides of the head from the moment they start, with similar symptoms to the tension headache.

All of these types of head pain affect the sufferer from carrying out their normal activities, preventing them from working to their full potential. They are regarded as disabling because they produce such a poor effect on the quality of life.  

The cause of chronic daily headaches is unknown in many cases, but for some people it is the result of overusing pain medications. Taking prescription pain medicines, or even over-the-counter analgesics, such as paracetamol or ibuprofen several days each week, may cause what is known as a rebound effect. This happens when a treatment starts to cause the problem it is being used to treat. Other sufferers of this condition have also reported difficulty sleeping, anxiety, depression, as well as caffeine overuse or sudden withdrawal of caffeine containing drinks.

Treatment for chronic daily headaches depends on the type of headache.  Ideally, you need to remove the cause of the problem, if possible and if it has been identified. The first step is generally withdrawing all pain relieving medicines and any likely substances that may be causing the head pain, such as coffee. Treating underlying conditions, such as anxiety, may help to prevent the condition occurring, so antidepressants are often the first treatments used as they have a dual effect. Low doses of migraine-preventing medicines, such as beta blockers, may also be helpful as preventers of these headaches, and if these are not successful then specialist intervention is required for more complex medication to prevent and relive this condition.

If you or your family are affected by chronic or persistent headaches, then talk to your pharmacist. Your pharmacist will be able to talk to you about what you may have used to treat the pain, what the possible causes might be, and refer you on for further diagnosis and treatment if required.

Chronic daily headaches limit the quality of life for all who suffer from them and they are distressing for all to see. Don’t rely on self-diagnosis and treatment for common pain problems - consult your community pharmacist. They are trained and able to help you with both treatments and advice.