Chronic Headache Pain

Chronic headache pain is one of the most common pain complaints, and covers a wide range of conditions and causes, from occasional, benign tension headaches to debilitating and chronic migraines. In addition to true headaches, neck or upper back pain may also sometimes be interpreted as a headache.

There are several different ways to classify headaches, but let's start by dividing them up into primary and secondary headaches. In primary headaches, the headache itself is the main problem. In secondary headaches, the headache is just one symptom of an underlying problem that can range from caffeine withdrawal to simusitis to high blood pressure or a stroke. Both primary and secondary headaches have the potential to result in chronic pain, so we'll discuss both types here.

It is a myth that chronic headache pain is a part of life and you should just suffer with it. It is still frustrating for me to see how often a client comes in and tells me they have been having headache pain for years without relief. It's true that everyone gets headaches once in a while; however chronic, painful headaches are not normal or acceptable. Once you have an idea of what might be causing your headaches, there are a variety of treatment options available,

Primary Headaches

The most common type of primary headaches are tension headaches, migraine headaches, and cluster headaches. It is very unlikely that these types of headaches are actually dangerous; however, without accurate diagnosis it's hard to be sure that there is not an underlying medical cause that might need treatment.
Tension Headaches usually begin in the back of the head or the neck. The most common description of the pain is that it feels like a or a feeling of pressure. Sometimes you may feel like there is a band pressing across your forehead or eyebrows.
Migraine Headaches are probably the type of headache most likely to be thought of as chronic, and is also among the most debilitating. People with migraines (including me) describe them with words like pounding or throbbing. Migraine headaches are often limited to one side of the head, but not always. Migraines are often made worse by sounds, light and physical activity. Click here for an in-depth discussion of chronic pain related to migraines, and ways to prevent or control migraines.

Cluster Headache Pain Generally comes on quickly and without the warning aura frequently found with migraines. The pain reaches its peak within 15 minutes, and is often described as deeply intense, explosive and nonfluctuating. A minority of people describe an additional sensation of a stabbing sensation in the area just behind the eyebrows. The pain nearly always is limited to one side of the head. Follow this link for a full discussion of cluster headache pain and alternatives for treatment.

There may be cases in which what appear to be migraine headaches are actually symptoms of problems in jaw alignment, specifically the temporomandibular joint (TMJ).

Secondary Headaches

While primary headaches are generally presumed to not be dangerous, secondary headaches by definition have underlying causes that can be very serious. These causes can include, but are not limited to:

High Blood Pressure - particulary when it comes on suddenly.

Infections - such as meningitis caused by bacterial infection.

Tumors - in the brain, including tumors that have spread from another part of the body.

Hypothyroidism - in which the thyroid gland does not produce sufficient thyroid hormone.

Strokes - due to either a ruptured vessel in the brain or a blood clot in the brain.

Chronic Sinus Infections.

Overuse of Over-The-Counter Pain Relievers.

You should always see a doctor if you have any concerns that your headaches may have an serious underlying cause that needs treatment.

Alternative Headache Treatments

As with any type of chronic pain, the emphasis is on management of pain, rather than finding an ultimate cure, and there are a number of treatment alternatives that can help. Combine these treatments with a wellness mindset and lifestyle, and most people can significantly reduce the intensity and frequency of their chronic headache pain.

Caffeine and Headaches

Caffeine is an ingredient in a number of pain medications, but there continues to be a little controversy about its role in chronic headache pain. View a summary of some recent research.