Przewlekłe codzienne bóle głowy – Etiologia i przyczyny

Przewlekłe codzienne bóle głowy
Etiologia i przyczyny

Przewlekłe codzienne bóle głowy (CDH) definiuje się jako bóle występujące ≥15 dni/miesiąc przez >3 miesiące, dotykające 4-5% populacji. CDH dzieli się na pierwotne (np. przewlekła migrena, przewlekły ból typu napięciowego, NDPH, hemikrania ciągła) oraz wtórne, będące objawem innych schorzeń (np. nadużywanie leków, zaburzenia naczyniowe, infekcje, urazy, guzy mózgu). Patofizjologia CDH jest złożona, obejmuje aktywację nerwu trójdzielnego, centralną sensytyzację, zapalenie neurogenne i dysregulację neuroprzekaźników (serotonina, dopamina). Czynniki ryzyka progresji od epizodycznych do przewlekłych bólów głowy to m.in. nadużywanie leków przeciwbólowych, otyłość (BMI >30), zaburzenia snu, wysokie spożycie kofeiny, stres oraz predyspozycje genetyczne (70% migrenowców ma rodzinne obciążenie). Współistniejące zaburzenia psychiczne (lęk, depresja) nasilają objawy i utrudniają leczenie.

Etiologia przewlekłych codziennych bólów głowy

Przewlekłe codzienne bóle głowy (ang. Chronic Daily Headache, CDH) definiuje się jako bóle głowy występujące przez co najmniej 15 dni w miesiącu, trwające ponad 3 miesiące. Stanowią one istotny problem medyczny i społeczny, dotykając około 4-5% populacji ogólnej¹². Nie są one pojedynczą jednostką chorobową, ale terminem opisującym różne typy bólów głowy charakteryzujące się wysoką częstotliwością występowania³.

Pierwotne i wtórne przewlekłe bóle głowy

Przewlekłe codzienne bóle głowy można podzielić na pierwotne i wtórne, w zależności od ich etiologii⁴. Pierwotne (samoistne) przewlekłe bóle głowy nie mają zidentyfikowanej przyczyny organicznej i nie są objawem innej choroby⁵⁶. Międzynarodowa Klasyfikacja Bólów Głowy (ICHD) rozpoznaje ponad 200 różnych zaburzeń bólowych głowy, dzieląc je na trzy grupy: pierwotne, wtórne oraz bolesne neuropatie czaszkowe⁷.

Lekarze nadal nie rozumieją dokładnie, co powoduje większość przewlekłych codziennych bólów głowy. Prawdziwe (pierwotne) przewlekłe codzienne bóle głowy nie mają identyfikowalnej przyczyny podstawowej⁸. Nie oznacza to jednak, że nie można ich leczyć⁹. Pierwotne CDH obejmują głównie przewlekłą migrenę, przewlekły ból głowy typu napięciowego, nowy codzienny uporczywy ból głowy oraz hemikranię ciągłą¹⁰.

Wtórne bóle głowy są objawem innego problemu zdrowotnego¹¹. Mogą być spowodowane wieloma czynnikami, takimi jak infekcje, urazy, nowotwory czy zaburzenia naczyniowe¹²¹³.

Patofizjologia przewlekłych codziennych bólów głowy

Patofizjologia przewlekłych codziennych bólów głowy jest złożona i nie do końca poznana. Badania wskazują na zaangażowanie kilku mechanizmów, w tym aktywację nerwu trójdzielnego, centralną sensytyzację, zapalenie neurogeniczne oraz zmiany w regulacji neuroprzekaźników¹⁴¹⁵.

Eksperci obecnie uważają, że stałe lub przewlekłe bóle głowy powstają, gdy epizodyczne zaburzenie bólowe przekształca się w przewlekłe. Chociaż mechanizmy leżące u podstaw tej zmiany są słabo poznane, zidentyfikowano niektóre czynniki ryzyka przejścia od epizodycznego do przewlekłego bólu głowy, w tym nadużywanie leków przeciwbólowych, otyłość, zaburzenia snu, wysokie spożycie kofeiny i utrzymujący się wysoki poziom stresu¹⁶.

W przypadku przewlekłej migreny postuluje się, że pacjenci z tą dolegliwością mają wyższą i bardziej trwałą pobudliwość korową niż osoby z migreną epizodyczną¹⁷. Postuluje się także, że powtarzająca się aktywacja nocyceptorów trójdzielnych prowadzi do sensytyzacji neuronów drugiego i trzeciego rzędu w ośrodkowym układzie nerwowym (OUN). Powoduje to zmiany funkcjonalne, które mogą leżeć u podstaw allodynii i hiperalgezji u pacjentów z przewlekłym codziennym bólem głowy¹⁸.

W powstawaniu przewlekłych bólów głowy istotną rolę może odgrywać także aktywacja nerwu trójdzielnego, który jest głównym nerwem znajdującym się w głowie i twarzy. Jedna z jego funkcji polega na przesyłaniu informacji sensorycznych z różnych struktur i tkanek w tych obszarach do mózgu. Aktywacja tego nerwu może prowadzić do objawów wielu typów bólu głowy¹⁹.

Przyczyny pierwotnych przewlekłych codziennych bólów głowy

Pierwotne przewlekłe codzienne bóle głowy są złożonymi zaburzeniami bez jasno określonej przyczyny. Istnieje jednak kilka zidentyfikowanych czynników przyczyniających się do ich rozwoju i utrzymywania.

Czynniki genetyczne i predyspozycje rodzinne

Genetyka odgrywa istotną rolę w rozwoju przewlekłych codziennych bólów głowy. Badania wykazują, że jeśli członkowie rodziny cierpią na problemy z bólami głowy, w tym migrenę, ryzyko wystąpienia CDH również będzie wysokie. Amerykańskie Towarzystwo Bólu Głowy podkreśla, że osoby z predyspozycjami genetycznymi doświadczają przewlekłych bólów głowy, ponieważ dziedziczy się geny definiujące szlaki bólowe i reakcje neurologiczne²⁰.

Genetyka odgrywa rolę, ponieważ 70% osób cierpiących na migrenę ma co najmniej jednego bliskiego krewnego z tym problemem²¹. Niektóre badania sugerują, że genetyka może być czynnikiem wpływającym na tendencję do rozwijania bólów głowy typu napięciowego u niektórych osób, gdy są zestresowane lub niespokojne²².

Pacjenci z przewlekłym codziennym bólem głowy wydają się mieć dziedziczną skłonność do niskiej tolerancji na bodźce sensoryczne²³. Ta nadwrażliwość może przyczyniać się do rozwoju i utrzymywania się przewlekłych bólów głowy.

Zmiany neurochemiczne i sensytyzacja ośrodkowa

Przewlekłe codzienne bóle głowy są często związane ze zmianami w składzie mózgu i chemikaliach zwanych neuroprzekaźnikami, w tym serotoninę i dopaminę. Nasilenie zaburzeń równowagi chemicznej może zwiększać wrażliwość na ból, a tym samym ustanawiać wzorce przewlekłego bólu głowy²⁴.

Przewlekły ból głowy może być spowodowany przekręconym „pokrętłem głośności” w szlakach bólowych w mózgu²⁵. Ta metafora odnosi się do sensytyzacji ośrodkowej, zjawiska, w którym ośrodkowy układ nerwowy staje się nadwrażliwy na bodźce bólowe, co prowadzi do wzmocnienia odczuwania bólu.

Neurolodzy uważają, że migreny są spowodowane zmianami w przepływie krwi w mózgu i aktywności komórek nerwowych²⁶, co może przyczyniać się do rozwoju przewlekłych migren jako podtypu CDH.

Stres i zaburzenia psychiczne

Stres i wynikające z niego zaburzenia emocjonalne są jednymi z głównych przyczyn CDH. Długotrwały stres, lęk i zaburzenia depresyjne są uznawane zarówno przez Amerykańskie Towarzystwo Bólu Głowy, jak i Narodową Fundację Bólu Głowy jako potencjalne czynniki wpływające na zwiększenie zarówno intensywności, jak i częstotliwości bólów głowy²⁷. Stres powoduje napięcie mięśni, w tym mięśni pokrytych, i umożliwia mózgowi nasilenie percepcji bólu, wydłużając tym samym bóle głowy.

Istnieje związek między stresem a tymi rodzajami bólu głowy. Stres pogarsza ten ból głowy, a ból głowy wywołuje stres, zarówno dlatego, że jest bolesny, jak i dlatego, że może być niepokojący²⁸. To tworzy błędne koło, które może przyczyniać się do chroniczności bólu głowy.

Większość pacjentów z przewlekłym codziennym bólem głowy cierpi również na zaburzenia psychiczne, takie jak lęk i depresja²⁹. Te współistniejące schorzenia mogą zarówno przyczyniać się do rozwoju, jak i utrudniać leczenie przewlekłych bólów głowy.

Zaburzenia snu

Zaburzenia snu, szczególnie chrapanie, są częstsze u pacjentów z przewlekłymi codziennymi bólami głowy³⁰. Sen jest jak przycisk resetujący dla mózgu. „Resetuje” pompy sodowo-potasowe w mózgu, które generują potencjały czynnościowe, które powodują wyładowania neuronów. Jeśli cierpisz na bezsenność, reset zostaje przerwany i może prowadzić do bólów głowy³¹.

Pierwotne zaburzenia snu, takie jak bezsenność, bezdech senny i zaburzenia pracy zmianowej, mogą powodować przewlekłe zaburzenia bólu głowy³². Brak snu lub drzemka w niewłaściwym czasie może zmieniać tolerancję bólu pacjenta i predysponować do bólów głowy.

Zaburzenia snu są bardzo powszechne i występują u około dwóch trzecich pacjentów z przewlekłym bólem głowy³³. Leczenie tych zaburzeń może pomóc w łagodzeniu przewlekłych bólów głowy.

Czynniki stylu życia i środowiskowe

Istnieje kilka czynników stylu życia i środowiskowych, które mogą przyczyniać się do rozwoju i utrzymywania się przewlekłych codziennych bólów głowy:

Kofeina: Kofeina zawarta w kawie, czarnej herbacie lub napojach gazowanych może również powodować bóle głowy. Jeśli pijesz kofeinę regularnie lub wypijasz kilka filiżanek kawy dziennie, masz zwiększone ryzyko rozwoju przewlekłych codziennych bólów głowy³⁴.
Otyłość: Otyłość staje się epidemią w naszym kraju i jest przyczyną wielu przewlekłych problemów zdrowotnych, takich jak cukrzyca, wysokie ciśnienie krwi i choroby serca. Może również powodować przewlekłe codzienne bóle głowy³⁵. Jest czynnikiem ryzyka przewlekłego codziennego bólu głowy, z nieznanych przyczyn³⁶.
Czynniki środowiskowe: Czynniki środowiskowe, takie jak jasne światło, dym, wilgotność, intensywne zapachy lub zimna pogoda, są związane z bólami migrenowymi³⁷. Identyfikowanie i unikanie tych czynników wyzwalających może pomóc w zarządzaniu przewlekłymi bólami głowy.
Napięcie mięśniowe: Napięcie w mięśniach głowy, szyi i ramion, spowodowane skurczami mięśni, może przyczyniać się do przewlekłych bólów głowy typu napięciowego³⁸.
Czynniki dietetyczne: Niektóre badania sugerują, że to, co jemy i kiedy to jemy, może odgrywać znaczącą rolę w bólu głowy³⁹. Niektóre osoby mogą być wrażliwe na określone dodatki do żywności, naturalnie występujące chemikalia w żywności lub wahania poziomu cukru we krwi.

Przyczyny wtórnych przewlekłych codziennych bólów głowy

Wtórne przewlekłe codzienne bóle głowy są spowodowane innym schorzeniem lub przyczyną zewnętrzną. Identyfikacja i leczenie pierwotnej przyczyny są kluczowe dla skutecznego zarządzania tymi bólami głowy.

Nadużywanie leków

Najbardziej rozpowszechnioną wtórną przyczyną przewlekłego codziennego bólu głowy jest nadużywanie leków, które często współistnieje z pierwotnym zespołem bólu głowy⁴⁰. Ból głowy spowodowany nadużywaniem leków (MOH, ang. Medication Overuse Headache) to najpowszechniejszy ból głowy występujący w specjalistycznej klinice bólu głowy, z szacowanymi 1-1,5% populacji cierpiącej na ten stan, stanowiący 50-80% pacjentów zgłaszających się do kliniki bólu głowy trzeciego stopnia⁴¹.

Regularne i długotrwałe stosowanie leków przeciwbólowych może prowadzić do bólów głowy z nadużywania leków. Pacjenci z przewlekłymi codziennymi bólami głowy mają tendencję do wysokiego zużycia leków, co zostało udokumentowane przez wielu autorów. Szacuje się, że około jedna trzecia pacjentów z przewlekłym codziennym bólem głowy nadużywa leków⁴².

Nadużywanie każdego rodzaju leków przeciwbólowych może zwiększyć ryzyko rozwoju bólów głowy związanych z nadużywaniem leków⁴³. Regularne stosowanie leków przeciwbólowych może prowadzić do bólów głowy z „odbicia”, które mogą pojawić się, gdy działanie leku ustępuje⁴⁴.

Bóle głowy związane z nadużywaniem leków mają wiele wspólnej patofizjologii z migreną i bólami głowy typu napięciowego, ponieważ występują zmiany funkcjonalne i strukturalne w ośrodkowym układzie nerwowym. Zmiany w serotoninergicznym układzie neuromodulacyjnym i zwiększenie regulacji czynników wazoaktywnych i prozapalnych również przyczyniają się do tego⁴⁵.

Zaburzenia naczyniowe

Zaburzenia naczyniowe mogą być przyczyną wtórnych przewlekłych codziennych bólów głowy. Obejmują one:

Zapalenie lub inne problemy z naczyniami krwionośnymi w i wokół mózgu, w tym udar mózgu⁴⁶.
Zakrzepy krwi, które tworzą się w lub w pobliżu mózgu, zwane zakrzepicą zatok żylnych mózgu (CVST), mogą również powodować przewlekłe bóle głowy⁴⁷.
Krwawienie podpajęczynówkowe (krwawienie do przestrzeni podpajęczynówkowej między mózgiem a zewnętrzną błoną; często zaczyna się bardzo nagle od piorunującego bólu głowy)⁴⁸.
Zapalenie naczyń może również powodować wtórne przewlekłe bóle głowy⁴⁹.

Zaburzenia naczyniowe mogą prowadzić do poważnych problemów zdrowotnych i wymagają natychmiastowej oceny medycznej. Obrzęk lub krwawienie w mózgu lub wokół niego są nagłymi przypadkami medycznymi, które wymagają natychmiastowej pomocy medycznej⁵⁰.

Infekcje i stany zapalne

Infekcje mogą być przyczyną wtórnych przewlekłych codziennych bólów głowy. Do najczęstszych należą:

Infekcje ośrodkowego układu nerwowego, takie jak zapalenie opon mózgowych i zapalenie mózgu⁵¹.
Infekcje górnych dróg oddechowych, takie jak nieżyt nosa, zapalenie gardła, mogą poprzedzać początek bólu głowy⁵².
Infekcje wirusowe lub bakteryjne, w tym wirus Epsteina-Barr (główna przyczyna mononukleozy), Salmonella, E. coli, gorączka denga, COVID-19⁵³.

Choroby zakaźne, takie jak zapalenie opon mózgowych, mogą zwiększać ciśnienie wewnątrzczaszkowe lub rdzeniowe, co może również być przyczyną przewlekłych codziennych bólów głowy⁵⁴.

Podstawowa przyczyna NDPH (nowy codzienny uporczywy ból głowy) jest słabo rozumiana, a niektóre badania wskazują na zaangażowanie zapalenia lub układu odpornościowego organizmu w wywołanie NDPH⁵⁵. Pochodzenie poinfekcyjne stanowi od 30 do 80% pacjentów z NDPH w różnych badaniach⁵⁶.

Urazy głowy i szyi

Urazy głowy i szyi mogą prowadzić do przewlekłych codziennych bólów głowy. Uraz mózgu pourazowy (TBI) lub wstrząśnienie mózgu mogą prowadzić do wielu długoterminowych powikłań, takich jak rozwój nowych lub pogarszających się bólów głowy⁵⁷.

Jeśli mózg zostanie uderzony zbyt mocno, może odbić się w czaszce, powodując wstrząśnienie mózgu, które może prowadzić do przewlekłych bólów głowy. Każdy uraz samego mózgu może również skutkować przewlekłymi bólami głowy⁵⁸.

Przewlekłe codzienne bóle głowy mogą wynikać z uderzenia w głowę⁵⁹. Umiarkowane lub ciężkie TBI mogą powodować utrzymujące się bóle głowy, które nie ustępują lub pogarszają się z czasem⁶⁰.

Zaburzenia ciśnienia wewnątrzczaszkowego

Zaburzenia ciśnienia wewnątrzczaszkowego mogą powodować wtórne przewlekłe codzienne bóle głowy. Ciśnienie wewnątrzczaszkowe, które jest zbyt wysokie lub zbyt niskie, może prowadzić do przewlekłych bólów głowy⁶¹.

Niskie ciśnienie płynu mózgowo-rdzeniowego (PMR), zwykle z powodu wycieku PMR w czaszce lub wokół rdzenia kręgowego, może powodować bóle głowy⁶². Z kolei wysokie ciśnienie PMR, które powoduje ból głowy, również może przyczyniać się do przewlekłych bólów głowy.

Możliwe przyczyny NDPH obejmują też zmniejszone ciśnienie płynu mózgowo-rdzeniowego, które prowadzi do bólu głowy rdzeniowego, oraz zwiększone ciśnienie płynu mózgowo-rdzeniowego, które prowadzi do rzekomego guza mózgu⁶³.

Nowotwory mózgu

Guzy mózgu mogą być przyczyną wtórnych przewlekłych codziennych bólów głowy⁶⁴. W niektórych przypadkach przewlekłe bóle głowy mogą wynikać z guza mózgu – łagodnego lub złośliwego⁶⁵.

Chociaż większość bólów głowy nie jest spowodowana guzami mózgu, gdy są, wymagają specjalistycznego leczenia⁶⁶. To ważny powód, dla którego przewlekłe bóle głowy powinny być dokładnie oceniane przez lekarza.

Inne przyczyny wtórnych przewlekłych bólów głowy

Istnieje wiele innych przyczyn wtórnych przewlekłych codziennych bólów głowy, które powinny być brane pod uwagę podczas oceny pacjenta:

Nerwobóle: Dwa najczęstsze nerwobóle to nerwoból trójdzielny i nerwoból potyliczny, oba mogą powodować przewlekłe bóle głowy⁶⁷.
Zaburzenia hormonalne: Zmiany poziomu estrogenu związane z cyklami miesiączkowymi są związane z migrenami u kobiet, szczególnie w okresie okołomenopauzalnym⁶⁸.
Bóle głowy szyjnopochodne: Problemy z szyją mogą powodować bóle głowy, które rozwijają się jako wtórne bóle głowy wynikające z problemów strukturalnych w głowie, szyi i kręgosłupie⁶⁹.
Choroby współistniejące: Wiele chorób współistniejących, takich jak lęk, depresja i współistniejący ból, jest częstszych u pacjentów z przewlekłymi codziennymi bólami głowy⁷⁰.
Zaburzenia okulistyczne: Jeśli dana osoba ma trudności z widzeniem, takie jak dalekowzroczność, ma tendencję do mrużenia oczu i napinania mięśni oka, aby lepiej skupić wzrok⁷¹. To napięcie może przyczyniać się do bólów głowy.

Czynniki ryzyka przewlekłych codziennych bólów głowy

Zidentyfikowano wiele czynników ryzyka, które przewidują rozwój CDH, zwłaszcza przewlekłej migreny⁷². Niektóre z tych czynników można modyfikować, co stwarza możliwości profilaktyki i interwencji.

Czynniki demograficzne i indywidualne

Przewlekły codzienny ból głowy jest częstszy u osób o niższych dochodach i/lub mniejszym wykształceniu⁷³. Płeć jest również istotnym czynnikiem ryzyka, przy czym kobiety są statystycznie bardziej podatne na przewlekłe codzienne bóle głowy⁷⁴.

Osoby cierpiące na przewlekłe codzienne bóle głowy często zgłaszają również związane ze stresem wydarzenia życiowe, w tym śmierć w rodzinie lub chorobę, przeprowadzki, zmiany pracy, zmiany stanu cywilnego i problemy związane z dziećmi⁷⁵.

Czynnik ryzyka	Opis	Wpływ na CDH
Płeć	Kobiety są bardziej podatne	Większa częstość występowania u kobiet
Status socjoekonomiczny	Niższe dochody i wykształcenie	Zwiększone ryzyko
Stresujące wydarzenia życiowe	Śmierć, choroba, przeprowadzki itp.	Może wyzwalać i nasilać bóle głowy
Historia migreny	Wcześniejsze epizodyczne migreny	Zwiększone ryzyko progresji do przewlekłej migreny
Depresja i zaburzenia lękowe	Współistniejące zaburzenia psychiczne	Związek dwukierunkowy z CDH
Otyłość	BMI > 30	Zwiększone ryzyko z nieznanych przyczyn
Nadużywanie leków	Regularne stosowanie leków przeciwbólowych	Zwiększa częstotliwość i nasilenie bólów głowy
Zaburzenia snu	Bezsenność, bezdech senny, chrapanie	Przyczynia się do rozwoju i utrzymywania CDH
Nadużywanie kofeiny	Wysokie spożycie lub odstawienie	Wyzwala bóle głowy i zwiększa ryzyko chroniczności

Progresja od epizodycznych do przewlekłych bólów głowy

Progresja od epizodycznej do przewlekłej migreny występuje u 6% w badaniach populacyjnych i 14% w badaniach klinicznych⁷⁶. U wielu osób przewlekła migrena rozwija się stopniowo, a ataki migreny stają się coraz częstsze z czasem⁷⁷.

W przypadku pacjentów z migreną, modyfikowalne czynniki ryzyka progresji do przewlekłej migreny obejmują otyłość, nadużywanie leków, stresujące wydarzenia życiowe, chrapanie, nadużywanie kofeiny i inne przyczyny przewlekłego bólu⁷⁸.

Większość nastolatków z przewlekłym codziennym bólem głowy ma historię epizodycznych migren. Transformacja do przewlekłej migreny może nastąpić w ciągu tygodni, miesięcy lub lat⁷⁹.

Współistniejące schorzenia i ich wpływ

Istnieje kilka schorzeń medycznych, które mogą zwiększyć tendencję do migren. Należą do nich: depresja, lęk, inne stany bólowe, takie jak fibromilagia, bezdech senny, zespół posturalnej tachykardii ortostatycznej (PoTS)⁸⁰. Zarządzanie tymi schorzeniami może pomóc w zarządzaniu migreną i skuteczności leczenia migreny.

Ból głowy nie jest jedynym objawem przewlekłego codziennego bólu głowy. Częste dodatkowe objawy obejmują zawroty głowy, zaburzenia snu, ból w innych miejscach ciała (w tym ból szyi, pleców i ból brzucha), zmęczenie, trudności w koncentracji, obniżony nastrój i zwiększony niepokój⁸¹.

NDPH, podobnie jak inne pierwotne bóle głowy, może być również powiązany z zaburzeniami zdrowia psychicznego, takimi jak zaburzenia lękowe i paniczne. W rzeczywistości jedna trzecia dzieci z przewlekłymi bólami głowy będzie miała powiązane problemy, takie jak zaburzenia lękowe lub depresja⁸².

Nadużywanie leków a przewlekłe codzienne bóle głowy

Nadużywanie leków jest znaczącym czynnikiem przyczyniającym się do rozwoju i utrzymywania się przewlekłych codziennych bólów głowy. Zrozumienie tego związku jest kluczowe dla skutecznego zarządzania CDH.

Mechanizm powstawania bólów głowy z nadużywania leków

Bóle głowy z nadużywania leków (MOH) mają wiele wspólnej patofizjologii z migreną i bólami głowy typu napięciowego, ponieważ występują zmiany funkcjonalne i strukturalne w ośrodkowym układzie nerwowym⁸³. Zmiany w serotoninergicznym układzie neuromodulacyjnym i zwiększenie regulacji czynników wazoaktywnych i prozapalnych również przyczyniają się do tego.

Niektóre badania wysunęły teorię potencjalnego genetycznego ryzyka jako etiologii rozwoju MOH⁸⁴. To sugeruje, że niektóre osoby mogą być genetycznie predysponowane do rozwoju bólów głowy z nadużywania leków.

Pacjenci z przewlekłymi codziennymi bólami głowy nadużywają i nadużywają leków, zwłaszcza analgetyków i tryptanów⁸⁵. Amerykańskie Towarzystwo Bólu Głowy donosi, że zbyt długie przyjmowanie leków na ból głowy spowoduje ból głowy z nadużywania leków, gdzie efektem leku jest pogorszenie bólu głowy z czasem, częściej i ciężej.

Leki wywołujące bóle głowy z odbicia

Bóle głowy z odbicia, znane również jako bóle głowy z nadużywania leków, mają tendencję do występowania w sposób nawracający. Międzynarodowe Towarzystwo Bólu Głowy (IHS) opisuje ból głowy z odbicia jako taki, który występuje 15 lub więcej dni w miesiącu u osób z wcześniej istniejącym pierwotnym zaburzeniem bólu głowy i historią nadużywania leków⁸⁶.

Najczęstszą historią jest epizodyczna migrena przekształcona w migrenę przekształconą przez nadużywanie leków⁸⁷. Przekształcone migreny mogą rozwinąć się z nadużywania leków, ale mogą również wystąpić bez niego.

Bóle głowy, znane również jako bóle głowy z odbicia, są spowodowane nadużywaniem leków przeciwbólowych, takich jak aspiryna, acetaminofen i ibuprofen⁸⁸. Regularne przyjmowanie leków na ból, a następnie nagłe ich odstawienie może prowadzić do bólów głowy z odbicia.

Znaczenie edukacji i zarządzania lekami

Edukacja na temat bólu głowy spowodowanego nadużywaniem leków jest niezbędna⁸⁹. Pacjenci muszą zrozumieć, że nadużywanie leków przeciwbólowych może faktycznie pogorszyć ich bóle głowy w dłuższej perspektywie.

Bóle głowy związane z nadużywaniem leków z dowolnego rodzaju leków przeciwbólowych (dostępnych bez recepty lub na receptę) zwykle nie poprawią się bez przerwania przez pacjenta codziennych leków przeciwbólowych⁹⁰. To ważne, aby pacjenci byli świadomi tego związku.

Zatrzymanie regularnego przyjmowania leków przeciwbólowych nie jest łatwe, ale może być istotnym krokiem na drodze do zdrowienia⁹¹. Pacjenci powinni współpracować ze swoimi dostawcami opieki zdrowotnej w celu opracowania planu bezpiecznego odstawienia leków i przejścia na bardziej skuteczne strategie zarządzania bólem.

Podsumowanie przyczyn przewlekłych codziennych bólów głowy

Przewlekłe codzienne bóle głowy są złożonym zjawiskiem z wieloma różnymi przyczynami i czynnikami przyczyniającymi się. Zrozumienie etiologii tych bólów głowy jest kluczowe dla skutecznego zarządzania i leczenia.

Pierwotne przewlekłe codzienne bóle głowy nie mają jednoznacznie identyfikowalnej przyczyny, ale mogą być związane z czynnikami genetycznymi, zmianami neurochemicznymi, stresem, zaburzeniami snu i różnymi czynnikami stylu życia. Z kolei wtórne przewlekłe codzienne bóle głowy są spowodowane innymi schorzeniami, takimi jak nadużywanie leków, zaburzenia naczyniowe, infekcje, urazy głowy, zaburzenia ciśnienia wewnątrzczaszkowego i guzy mózgu.

Identyfikacja i zarządzanie modyfikowalnymi czynnikami ryzyka, takimi jak nadużywanie leków, otyłość, nadużywanie kofeiny i zaburzenia snu, mogą pomóc zapobiec progresji od epizodycznych do przewlekłych bólów głowy. Ponadto leczenie współistniejących schorzeń, takich jak lęk i depresja, może poprawić wyniki dla pacjentów z przewlekłymi codziennymi bólami głowy.

Kompleksowe podejście do zarządzania przewlekłymi codziennymi bólami głowy powinno uwzględniać indywidualną etiologię i czynniki ryzyka każdego pacjenta, a także jego specyficzne objawy i współistniejące schorzenia. Dzięki lepszemu zrozumieniu przyczyn przewlekłych codziennych bólów głowy, lekarze mogą opracować bardziej skuteczne strategie leczenia, które poprawiają jakość życia pacjentów cierpiących na to uciążliwe schorzenie.

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Materiały źródłowe

#1
https://consensus.app/questions/daily-headache-causes/
Chronic Daily Headache (CDH) is defined as experiencing headaches on at least 15 days per month for a minimum of three months. This condition affects approximately 4-5% of the population, making it a significant public health concern. CDH is not a single diagnosis but a descriptive term that encompasses various headache disorders, including chronic migraine and chronic tension-type headache. […] Primary headache disorders are those without an identifiable underlying cause. The most common primary headaches leading to CDH are chronic migraines and tension-type headaches. Chronic migraines often evolve from episodic migraines due to factors such as stress and medication overuse. Tension-type headaches, characterized by a constant, dull pain, can also become chronic, contributing to CDH. […] Secondary headaches are those with an identifiable underlying cause. These can include medication overuse, which is a significant and treatable cause of refractory daily headaches. Other secondary causes may include structural abnormalities, infections, or systemic conditions, which necessitate thorough diagnostic evaluations, often involving MRI scans.
#2 Chronic Headaches – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK559083/
Chronic headache is not a single disease entity but an umbrella term that encompasses all chronic headaches. A chronic daily headache can be divided into primary and secondary headache disorders depending upon its etiology. Primary chronic headache disorders do not have secondary organic etiology. […] Secondary headaches can occur due to secondary causes such as medication overuse, intracranial tumors, central nervous system (CNS) infections, raised intracranial pressure, metabolic abnormalities, post-traumatic, vascular, and structural pathologies. It is important to realize that chronic headaches are often caused by a multifactorial combination of the causes mentioned above and can occur along a continuum. […] The International Classification of Headache Disorders (ICHD) recognizes over 200 headache disorders and divides them into three groups, which are primary, secondary, and painful cranial neuropathies. All chronic headaches meet the criteria of occurring at least 15 times a month for at least three months, but both primary and secondary chronic headaches have unique characteristics.
#3 Chronic daily headache: Associated syndromes, evaluation, and management – UpToDate
https://www.uptodate.com/contents/chronic-daily-headache-associated-syndromes-evaluation-and-management
Chronic daily headache (CDH) is a descriptive term that encompasses several different specific headache diagnoses characterized by frequent headaches. […] Primary CDH subtypes of long duration (ie, four hours or more) include chronic migraine, chronic tension-type headache, hemicrania continua, and new daily persistent headache. Medication overuse headache, a secondary headache disorder, frequently complicates management of multiple primary headache disorders. […] CDH is not a specific headache type, but a descriptive term that encompasses other primary and secondary headaches. The term „chronic” in CDH refers either to the frequency of headaches or to the duration of the disease, depending upon the specific headache type.
#4 Chronic Headaches – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK559083/
Chronic headache is not a single disease entity but an umbrella term that encompasses all chronic headaches. A chronic daily headache can be divided into primary and secondary headache disorders depending upon its etiology. Primary chronic headache disorders do not have secondary organic etiology. […] Secondary headaches can occur due to secondary causes such as medication overuse, intracranial tumors, central nervous system (CNS) infections, raised intracranial pressure, metabolic abnormalities, post-traumatic, vascular, and structural pathologies. It is important to realize that chronic headaches are often caused by a multifactorial combination of the causes mentioned above and can occur along a continuum. […] The International Classification of Headache Disorders (ICHD) recognizes over 200 headache disorders and divides them into three groups, which are primary, secondary, and painful cranial neuropathies. All chronic headaches meet the criteria of occurring at least 15 times a month for at least three months, but both primary and secondary chronic headaches have unique characteristics.
#5 Chronic daily headaches | Beacon Health System
https://www.beaconhealthsystem.org/library/diseases-and-conditions/chronic-daily-headaches?content_id=CON-20370872
By definition, chronic daily headaches occur 15 days or more a month, for longer than three months. True (primary) chronic daily headaches aren’t caused by another condition. […] The causes of many chronic daily headaches aren’t well-understood. True (primary) chronic daily headaches don’t have an identifiable underlying cause. […] Conditions that might cause nonprimary chronic daily headaches include: Inflammation or other problems with the blood vessels in and around the brain, including stroke, Infections, such as meningitis, Intracranial pressure that’s either too high or too low, Brain tumor, Traumatic brain injury.
#6 Chronic Daily Headaches | Jan & Tom Lewis Migraine Treatment Program | Barrow Neurological InstituteGroup 9Group 9Group 49
https://www.barrowneuro.org/condition/chronic-daily-headaches/
Chronic daily headache describes a group of headache disorders in which headache pain occurs at least 15 days per month during a 3-month period. True (primary) chronic daily headaches are not caused by another condition. […] Doctors are not exactly sure what causes chronic daily headaches. True, or primary, chronic daily headaches do not have a cause that can be identified. That does not, however, mean that they cannot be treated.
#7 Chronic Headaches – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK559083/
Chronic headache is not a single disease entity but an umbrella term that encompasses all chronic headaches. A chronic daily headache can be divided into primary and secondary headache disorders depending upon its etiology. Primary chronic headache disorders do not have secondary organic etiology. […] Secondary headaches can occur due to secondary causes such as medication overuse, intracranial tumors, central nervous system (CNS) infections, raised intracranial pressure, metabolic abnormalities, post-traumatic, vascular, and structural pathologies. It is important to realize that chronic headaches are often caused by a multifactorial combination of the causes mentioned above and can occur along a continuum. […] The International Classification of Headache Disorders (ICHD) recognizes over 200 headache disorders and divides them into three groups, which are primary, secondary, and painful cranial neuropathies. All chronic headaches meet the criteria of occurring at least 15 times a month for at least three months, but both primary and secondary chronic headaches have unique characteristics.
#8 Headache that won’t go away: Causes and treatments
https://www.medicalnewstoday.com/articles/326091
A persistent headache can result from an injury or a structural problem in the spine, such as arthritis. It can also affect people who have migraine or have had a stroke. The overuse of pain relief drugs can also cause a headache that does not go away. […] Migraine, head injuries, and medication misuse can cause head pain that lasts for several hours or days. […] Intractable migraine, also known as status migrainosus, is a severe migraine headache that lasts for longer than 72 hours. […] Rebound headaches tend to occur on a recurring basis. The International Headache Society (IHS) describe a rebound headache as one that occurs on 15 or more days per month in people with a preexisting primary headache disorder and a history of medication overuse. […] Cervicogenic headaches are secondary headaches that result from structural problems in the head, neck, and spine.
#9 Chronic Daily Headaches | Jan & Tom Lewis Migraine Treatment Program | Barrow Neurological InstituteGroup 9Group 9Group 49
https://www.barrowneuro.org/condition/chronic-daily-headaches/
Chronic daily headache describes a group of headache disorders in which headache pain occurs at least 15 days per month during a 3-month period. True (primary) chronic daily headaches are not caused by another condition. […] Doctors are not exactly sure what causes chronic daily headaches. True, or primary, chronic daily headaches do not have a cause that can be identified. That does not, however, mean that they cannot be treated.
#10 Chronic daily headaches
https://pmc.ncbi.nlm.nih.gov/articles/PMC3444216/
Chronic Daily Headache is a descriptive term that includes disorders with headaches on more days than not and affects 4% of the general population. […] Chronic migraine, chronic tension-type headache, new daily persistent headache and medication overuse headache accounts for the vast majority of chronic daily headaches. […] The primary CDH is divided into short and long duration. […] Many risk factors have been identified that predict the development of CDH, in particular CM, some of which are modifiable. […] The term CDH is mainly referred to the primary headache disorder, although secondary CDH must be excluded. […] Medication overuse headaches (MOH), essentially a secondary headache disorder commonly accompany the primary headache disorders and are described with them. […] The concept of high frequency migraine has been in the literature for a long time with terms such as transformed migraine, mixed headache syndrome and evolutive migraine.
#11 Headache Information, Causes, and Symptoms
https://www.healthline.com/health/headache
Headache disorders are painful, with discomfort felt in the head, neck, and shoulders. A headache occurs because of a primary or secondary cause. […] Primary headaches, like migraine or tension headaches, are among the most common headaches that lead people to seek medical treatment, and they affect an estimated 3 billion people each year. […] Secondary headaches manifest as a symptom of another health disorder. Different types of illnesses and disorders can cause a headache, including: infection, medication overuse, high blood pressure, mental health conditions, head injury or trauma, stroke, tumor, nerve disorders, sinus congestion. […] The long-term and excessive use of medication to treat a headache can cause medication-overuse headache (MOH). This condition is considered a secondary headache disorder.
#12 Chronic daily headaches | Beacon Health System
https://www.beaconhealthsystem.org/library/diseases-and-conditions/chronic-daily-headaches?content_id=CON-20370872
By definition, chronic daily headaches occur 15 days or more a month, for longer than three months. True (primary) chronic daily headaches aren’t caused by another condition. […] The causes of many chronic daily headaches aren’t well-understood. True (primary) chronic daily headaches don’t have an identifiable underlying cause. […] Conditions that might cause nonprimary chronic daily headaches include: Inflammation or other problems with the blood vessels in and around the brain, including stroke, Infections, such as meningitis, Intracranial pressure that’s either too high or too low, Brain tumor, Traumatic brain injury.
#13 Chronic Headaches – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK559083/
Secondary chronic daily headaches include medication overuse, CNS infection, CNS hematomas, intracranial tumor, raised intracranial pressure, low-pressure headache, vasculitis, aneurysms, and cerebrospinal fluid (CSF) leak. […] Medication overuse headaches share much of the pathophysiology of migraine and tension headaches as functional and structural changes in the central nervous system. Changes in the serotonergic neuromodulatory system and upregulation of vasoactive and pro-inflammatory mediators also contribute. […] Some studies have theorized a potential genetic risk as to the etiology of the development of MOH.
#14 Constant or Chronic Headaches: Symptoms, Causes, and More
https://www.healthline.com/health/constant-headache
Chronic daily headaches are when you have a headache for 15 days or more per month during a 3-month period. […] Doctors still dont know what exactly causes daily headache symptoms. Some possible causes include one or a combination of the following: Trigeminal nerve activation. The trigeminal nerve is a major nerve thats found in your head and face. One of its functions is sending sensory information from the various structures and tissues in these areas to the brain. Activation of this nerve can lead to the symptoms of many types of headache. […] Experts currently believe that constant, or chronic, headaches result when an episodic headache disorder transforms into a chronic one. While the mechanisms behind this change are poorly understood, some risk factors for the transition from episodic to chronic headache include: overuse of pain medication, obesity, disrupted sleep, high caffeine intake, persistently high stress levels.
#15
https://consensus.app/questions/why-do-i-keep-getting-headaches-everyday/
Chronic daily headache (CDH) is a term used to describe headaches that occur on 15 or more days per month for at least three months. This condition affects approximately 4% of the population and can significantly reduce the quality of life. CDH often stems from underlying primary headache disorders such as migraines and tension-type headaches. […] Several risk factors can contribute to the transformation of episodic headaches into chronic daily headaches. Stressful life events and medication overuse are significant contributors to this transformation. These factors can lead to changes in brain processes, including the activation of glial cells and the sensitization of primary afferent neurons, which lower the threshold for headache induction. Additionally, obesity, female sex, and a high frequency of headaches before transformation are identified as risk factors for chronic migraine, a common subtype of CDH.
#16 Constant or Chronic Headaches: Symptoms, Causes, and More
https://www.healthline.com/health/constant-headache
Chronic daily headaches are when you have a headache for 15 days or more per month during a 3-month period. […] Doctors still dont know what exactly causes daily headache symptoms. Some possible causes include one or a combination of the following: Trigeminal nerve activation. The trigeminal nerve is a major nerve thats found in your head and face. One of its functions is sending sensory information from the various structures and tissues in these areas to the brain. Activation of this nerve can lead to the symptoms of many types of headache. […] Experts currently believe that constant, or chronic, headaches result when an episodic headache disorder transforms into a chronic one. While the mechanisms behind this change are poorly understood, some risk factors for the transition from episodic to chronic headache include: overuse of pain medication, obesity, disrupted sleep, high caffeine intake, persistently high stress levels.
#17 Chronic daily headaches
https://pmc.ncbi.nlm.nih.gov/articles/PMC3444216/
The definition of CM is not universally accepted and there is lack of consensus among professionals on its application in clinical practice. […] Progression from episodic to chronic migraine is seen in 6% in the population-based and 14% in clinic-based studies. […] Co-morbidities such as anxiety, depression and co-existent pain are more common and 76% – 95% of patients report recognisable triggers. […] It is postulated that patients with CM have a high and more persistent cortical excitability than those with EM. […] The recognition and management of CM poses considerable challenge to primary care physicians. […] The disorder generates more referrals to secondary or tertiary care and accounts for more emergency care visits than the episodic form. […] The IHS used the term medication overuse headache (MOH) in their 2nd edition of classification (ICHD-II, 2004), although this was revised with details of various sub-types by Silberstein in 2005.
#18 Chronic Daily Headache: Understanding and Treating It
https://www.psychiatrictimes.com/view/chronic-daily-headache-understanding-and-treating-it
Patients with chronic daily headache appear to have an inherited propensity for a low tolerance to sensory stimuli. […] Some investigators have postulated that repeated activation of the trigeminal nociceptors leads to sensitization of the second and third order neurons in the CNS. This causes functional changes that may underlie the allodynia hyperalgesia in patients with chronic daily headache and perhaps other chronic pain syndromes. […] It is further possible that chronic bombardment of impulses may be transmitted from the periphery to the CNS from such disorders as fibromyalgia and myofascial pain syndrome. These, in turn, may lead to overstimulation of the receptor sites, resulting in a pain perception disproportionate to what is felt at the peripheral level. […] The pain initiated by the comorbid condition finally inundates the normal ameliorating mechanisms in the brain, much as floodwaters overwhelm a deteriorating dam. As a consequence, preventive medications seem to be relatively ineffective in the face of analgesic rebound for the patient who presents with suspected analgesic overuse and for the patient with complicating comorbid disorders.
#19 Constant or Chronic Headaches: Symptoms, Causes, and More
https://www.healthline.com/health/constant-headache
Chronic daily headaches are when you have a headache for 15 days or more per month during a 3-month period. […] Doctors still dont know what exactly causes daily headache symptoms. Some possible causes include one or a combination of the following: Trigeminal nerve activation. The trigeminal nerve is a major nerve thats found in your head and face. One of its functions is sending sensory information from the various structures and tissues in these areas to the brain. Activation of this nerve can lead to the symptoms of many types of headache. […] Experts currently believe that constant, or chronic, headaches result when an episodic headache disorder transforms into a chronic one. While the mechanisms behind this change are poorly understood, some risk factors for the transition from episodic to chronic headache include: overuse of pain medication, obesity, disrupted sleep, high caffeine intake, persistently high stress levels.
#20 Causes and Triggers of Chronic Daily Headaches
https://www.ehacstl.com/blog/1186736-causes-and-triggers-of-chronic-daily-headaches/
Ones genetic makeup has a very strong influence on chronic daily headaches (CDH). The research shows that if ones family members are suffering from the problems of headaches, including migraine, the risk of getting CDH will also be high. The American Headache Society underlines that people with genetic predispositions get chronic headaches because genes that define pain pathways and neurological reactions are inherited. […] These are headaches that are present daily, and their main cause is usually irregularities in the CNS. The National Headache Foundation notes that the causes of chronic headache disorders include changes in the composition of the brain and chemicals referred to as neurotransmitters including serotonin, dopamine among others. It is within this context that the severity of the chemical imbalances may enhance pain sensitivity, and hence establish chronic headache patterns.
#21 Headache Pain: When to Worry, What to Do – Harvard Health Publishing – Harvard Health
https://www.health.harvard.edu/pain/headache-when-to-worry-what-to-do
Doctors don’t fully understand what causes most headaches. […] The others are called primary headaches. […] Neurologists believe that migraines are caused by changes in the brain’s blood flow and nerve cell activity. […] Genetics play a role since 70% of migraine victims have at least one close relative with the problem. […] Many drugs number headaches among their side effects. […] Sinusitis is not a common cause of chronic or recurrent headaches.
#22 Chronic Tension Headache: Causes and Treatment
https://patient.info/brain-nerves/headache-leaflet/chronic-tension-headache
Chronic tension headache is a condition where you have a tension headache on at least 15 days every month for at least three months. The cause of chronic tension headache is often not clear. […] The cause of the tension headaches is not always clear, and may be more than one thing. These include: Tension in the muscles at the back of the head, neck and shoulders, caused by muscle contractions. Stress. Tiredness and lack of sleep. Hunger. Eye strain. Drinking too much caffeine and alcohol. Dehydration. […] Many chronic tension headaches develop for no apparent reason and are not caused by other conditions. […] Some research suggests that genetics may be a factor. Some people may inherit a tendency to be more prone to develop tension headaches than others when stressed or anxious.
#23 Chronic Daily Headache: Understanding and Treating It
https://www.psychiatrictimes.com/view/chronic-daily-headache-understanding-and-treating-it
Patients with chronic daily headache appear to have an inherited propensity for a low tolerance to sensory stimuli. […] Some investigators have postulated that repeated activation of the trigeminal nociceptors leads to sensitization of the second and third order neurons in the CNS. This causes functional changes that may underlie the allodynia hyperalgesia in patients with chronic daily headache and perhaps other chronic pain syndromes. […] It is further possible that chronic bombardment of impulses may be transmitted from the periphery to the CNS from such disorders as fibromyalgia and myofascial pain syndrome. These, in turn, may lead to overstimulation of the receptor sites, resulting in a pain perception disproportionate to what is felt at the peripheral level. […] The pain initiated by the comorbid condition finally inundates the normal ameliorating mechanisms in the brain, much as floodwaters overwhelm a deteriorating dam. As a consequence, preventive medications seem to be relatively ineffective in the face of analgesic rebound for the patient who presents with suspected analgesic overuse and for the patient with complicating comorbid disorders.
#24 Causes and Triggers of Chronic Daily Headaches
https://www.ehacstl.com/blog/1186736-causes-and-triggers-of-chronic-daily-headaches/
Ones genetic makeup has a very strong influence on chronic daily headaches (CDH). The research shows that if ones family members are suffering from the problems of headaches, including migraine, the risk of getting CDH will also be high. The American Headache Society underlines that people with genetic predispositions get chronic headaches because genes that define pain pathways and neurological reactions are inherited. […] These are headaches that are present daily, and their main cause is usually irregularities in the CNS. The National Headache Foundation notes that the causes of chronic headache disorders include changes in the composition of the brain and chemicals referred to as neurotransmitters including serotonin, dopamine among others. It is within this context that the severity of the chemical imbalances may enhance pain sensitivity, and hence establish chronic headache patterns.
#25 Headache – Functional Neurological Disorder (FND)
https://neurosymptoms.org/en/symptoms/common-associated-symptoms/headache/
Chronic Daily Headache is the commonest type of headache that is referred to a neurology clinic. It refers to a headache that is present most days, often for most of the day. Typically it has the following features: Constant pressing or bursting sensation, sometimes pounding. Can be all over head, on one side or sometimes in a small area. It is often variable but tends to get worse as the day goes on. Conventional painkillers only take the edge off the pain. […] Chronic headache is due to a volume knob turned up in the pain pathways in your brain. Stopping regular painkillers is not easy but can be a vital step on the road to recovery. […] Chronic Daily Headache is a complex phenomenon that probably has lots of different causes. Try thinking of the problem as a volume knob in your head that has been turned up too high.
#26 Headache Pain: When to Worry, What to Do – Harvard Health Publishing – Harvard Health
https://www.health.harvard.edu/pain/headache-when-to-worry-what-to-do
Doctors don’t fully understand what causes most headaches. […] The others are called primary headaches. […] Neurologists believe that migraines are caused by changes in the brain’s blood flow and nerve cell activity. […] Genetics play a role since 70% of migraine victims have at least one close relative with the problem. […] Many drugs number headaches among their side effects. […] Sinusitis is not a common cause of chronic or recurrent headaches.
#27 Causes and Triggers of Chronic Daily Headaches
https://www.ehacstl.com/blog/1186736-causes-and-triggers-of-chronic-daily-headaches/
Stress and the resulting emotional disorders can be considered as some of the main causes of CDH. Therefore, long-term stress, anxiety, and depressive disorder are endorsed by both the American Headache Society and the National Headache Foundation as potential influencers to increase both the intensity and frequency of headaches. Stress causes tension of muscles, including muscles that are covered, and enables the brain to heighten the perception of pain thus elongating headaches. […] Another factor that has been identified to be a cause of chronic daily headaches is sleep, especially if it is insufficient and/or of poor quality. Lack of sleep or nap at the wrong time may alter the patients pain tolerance and make them prone to headaches. According to the National Headache Foundation, primary sleep disorders include insomnia, sleep apnea, and shift work disorder which causes chronic headache disorders.
#28 Headache – Functional Neurological Disorder (FND)
https://neurosymptoms.org/en/symptoms/common-associated-symptoms/headache/
The majority of people with chronic daily headache have a history of other headaches, usually migraine. When a series of migraines leads on to chronic daily headache it is sometimes called transformed migraine. […] There does seem to be a link between stress and these sorts of headache. Stress makes this headache worse and the headache causes stress, both because it’s painful but also because it can be worrying. […] In recent years we have recognised that using painkillers such as codeine and paracetamol can actually make chronic daily headache worse. You have probably already discovered that regular painkillers only take the edge off the pain and don’t work well. In fact it is worse than that, these painkillers often cause a rebound headache when they wear off. Over time this can make the headache gradually worse.
#29 Chronic daily headaches
https://pmc.ncbi.nlm.nih.gov/articles/PMC3444216/
The definition of CM is not universally accepted and there is lack of consensus among professionals on its application in clinical practice. […] Progression from episodic to chronic migraine is seen in 6% in the population-based and 14% in clinic-based studies. […] Co-morbidities such as anxiety, depression and co-existent pain are more common and 76% – 95% of patients report recognisable triggers. […] It is postulated that patients with CM have a high and more persistent cortical excitability than those with EM. […] The recognition and management of CM poses considerable challenge to primary care physicians. […] The disorder generates more referrals to secondary or tertiary care and accounts for more emergency care visits than the episodic form. […] The IHS used the term medication overuse headache (MOH) in their 2nd edition of classification (ICHD-II, 2004), although this was revised with details of various sub-types by Silberstein in 2005.
#30 Diagnosing and treating chronic daily headaches | Medmastery
https://www.medmastery.com/guides/headaches-clinical-guide/diagnosing-and-treating-chronic-daily-headaches?srsltid=AfmBOoqwt8Dcd1t7XkbLi0YcvhrJ8KR27RPBKJ7kDvjv_eIqgO1dvDC_
Sleep disturbances, particularly snoring, are more common in patients with chronic daily headaches. […] Individuals with chronic daily headaches tend to have high medication use, as documented by many authors. In fact, it is estimated that approximately one third of chronic daily headache patients overuse medicines. […] Treatment approaches will then vary based on the type of primary headache which has become chronic.
#31 10 Most Common Causes of ChronicÂ DailyÂ Headache | National Headache Institute
https://nationalheadacheinstitute.com/blog/10-most-common-causes-of-chronic-daily-headache/
If you suffer from chronic daily headaches, you know how much they can affect your life. Chronic headaches make going about your daily activities agonizing, no matter what type of chronic headache you have. But what causes chronic headaches? […] Chronic stress can lead to other chronic conditions such as anxiety or depression, both of which can cause chronic daily headaches. Chronic stress can also cause tension in the muscles of the neck which can cause tension-type headaches. […] Ironically, taking medication for chronic headaches can actually cause the recurrence of them. This type of headache is known as a rebound headache and is most often caused by taking certain medications daily to relieve headaches and then stopping them abruptly. […] Sleep is like the reset button for your brain. It âresetsâ the sodium-potassium pumps in the brain that generate action potentials which cause the neurons to fire. If you are suffering from insomnia, the reset is interrupted and can lead to headaches.
#32 Causes and Triggers of Chronic Daily Headaches
https://www.ehacstl.com/blog/1186736-causes-and-triggers-of-chronic-daily-headaches/
Stress and the resulting emotional disorders can be considered as some of the main causes of CDH. Therefore, long-term stress, anxiety, and depressive disorder are endorsed by both the American Headache Society and the National Headache Foundation as potential influencers to increase both the intensity and frequency of headaches. Stress causes tension of muscles, including muscles that are covered, and enables the brain to heighten the perception of pain thus elongating headaches. […] Another factor that has been identified to be a cause of chronic daily headaches is sleep, especially if it is insufficient and/or of poor quality. Lack of sleep or nap at the wrong time may alter the patients pain tolerance and make them prone to headaches. According to the National Headache Foundation, primary sleep disorders include insomnia, sleep apnea, and shift work disorder which causes chronic headache disorders.
#33 Never Too Young For Chronic Headaches in Teenagers
https://americanmigrainefoundation.org/resource-library/never-too-young-for-chronic-headaches/
Controlling headache pain is a very difficult problem for patients. Analgesics that are typically effective for an episodic migraine are not very effective for chronic migraine or chronic daily headaches. […] Identifying specific trigger factors for chronic daily headache is difficult because the headache is daily, often â24/7.â However, important environmental factors do play a role in these headaches. […] School absence is a significant problem. […] Sleep disturbances are very common and occur in approximately two-thirds of patients. […] Patients will frequently complain of dizziness, particularly with standing. […] Follow-up should be scheduled on a routine basis with your doctor until symptoms come under satisfactory control. […] Natural history studies have shown that chronic daily headache can resolve in many children although the symptoms may last months to years.
#34 10 Most Common Causes of ChronicÂ DailyÂ Headache | National Headache Institute
https://nationalheadacheinstitute.com/blog/10-most-common-causes-of-chronic-daily-headache/
Obesity is becoming an epidemic in our country and is the cause of many chronic health problems such as diabetes, high blood pressure, and heart disease. But it can also cause chronic daily headaches. […] The caffeine in coffee, black tea, or soda can cause headaches as well. If you drink caffeine regularly or have several cups of coffee a day, you have an increased risk of developing chronic daily headaches. […] If hit too hard, the brain can bounce in the skull causing a concussion which can lead to chronic headaches. Any injury to the brain itself can also result in chronic headaches. […] Blood clots that form in or near the brain called cerebral venous sinus thrombosis, or CVST, can also cause chronic headaches. […] Infectious diseases such as meningitis can increase intracranial, or spinal pressure can also be a cause of chronic daily headaches. […] The two most common neuralgias are trigeminal and occipital neuralgia, both of which can cause chronic headaches.
#35 10 Most Common Causes of ChronicÂ DailyÂ Headache | National Headache Institute
https://nationalheadacheinstitute.com/blog/10-most-common-causes-of-chronic-daily-headache/
Obesity is becoming an epidemic in our country and is the cause of many chronic health problems such as diabetes, high blood pressure, and heart disease. But it can also cause chronic daily headaches. […] The caffeine in coffee, black tea, or soda can cause headaches as well. If you drink caffeine regularly or have several cups of coffee a day, you have an increased risk of developing chronic daily headaches. […] If hit too hard, the brain can bounce in the skull causing a concussion which can lead to chronic headaches. Any injury to the brain itself can also result in chronic headaches. […] Blood clots that form in or near the brain called cerebral venous sinus thrombosis, or CVST, can also cause chronic headaches. […] Infectious diseases such as meningitis can increase intracranial, or spinal pressure can also be a cause of chronic daily headaches. […] The two most common neuralgias are trigeminal and occipital neuralgia, both of which can cause chronic headaches.
#36 Diagnosing and treating chronic daily headaches | Medmastery
https://www.medmastery.com/guides/headaches-clinical-guide/diagnosing-and-treating-chronic-daily-headaches?srsltid=AfmBOoqwt8Dcd1t7XkbLi0YcvhrJ8KR27RPBKJ7kDvjv_eIqgO1dvDC_
Chronic daily headaches are defined as headaches which occur at least 15 days or more per month for at least three months, regardless of the underlying headache etiology. […] Diagnosis of chronic daily headaches can be further complicated by secondary factors, such as medication overuse, post traumatic headache, cervicogenic headache, and other more serious causes such as arterial dissection, tumor, and intracranial hypotension from a cerebrospinal fluid leak or pseudotumor cerebri. […] Chronic daily headache is more common in individuals of lower income and / or less education. […] Obesity is a risk factor for chronic daily headache, for unknown reasons. […] A history of migraine and depression is frequently found in those who suffer from chronic daily headaches. […] Those that suffer from chronic daily headaches also tend to report associated stressful life events including death in the family or illness, moves, job changes, marital status changes, and child-related issues.
#37 Top 7 reasons you have a headache – Harvard Health
https://www.health.harvard.edu/diseases-and-conditions/top-7-reasons-you-have-a-headache
Stress can cause tight muscles in the shoulders and neck, which often leads to tension headaches. […] Alcohol is a common migraine trigger. For some people, a few ounces of red wine are all it takes to provoke a headache, although any kind of alcohol can be a trigger. […] Environmental factors such as bright light, smoke, humidity, intense scents, or cold weather are associated with migraine headaches. […] Changes in estrogen levels are associated with migraines in women, and women suffer from migraines more often than men. […] A lack of sleep is associated with migraines and tension headaches.
#38 Chronic Tension Headache: Causes and Treatment
https://patient.info/brain-nerves/headache-leaflet/chronic-tension-headache
Chronic tension headache is a condition where you have a tension headache on at least 15 days every month for at least three months. The cause of chronic tension headache is often not clear. […] The cause of the tension headaches is not always clear, and may be more than one thing. These include: Tension in the muscles at the back of the head, neck and shoulders, caused by muscle contractions. Stress. Tiredness and lack of sleep. Hunger. Eye strain. Drinking too much caffeine and alcohol. Dehydration. […] Many chronic tension headaches develop for no apparent reason and are not caused by other conditions. […] Some research suggests that genetics may be a factor. Some people may inherit a tendency to be more prone to develop tension headaches than others when stressed or anxious.
#39 Headache | Better Health Channel
https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/headache
Stress is thought to trigger our bodys fight or flight response, which is characterised by shallow breathing, faster heart rate and raised blood pressure, and greater amounts of stress chemicals such as adrenaline. […] Stress can cause or worsen a headache in a number of ways, including: tightening the muscles, particularly of the upper back, shoulders, neck and head; lowering a persons tolerance to pain; reducing the effects of medications such as pain-relievers; reducing the levels of endorphins, which are the bodys natural pain-relieving chemicals. […] Many infections of the nose, throat and ear can cause headache. […] Depending on the disorder, treatment can include medications such as antibiotics, decongestants or antihistamines. […] According to some studies, what we eat and when we eat it can play a significant role in headache.
#40 Chronic Daily Headache: Diagnosis and Management | AAFP
https://www.aafp.org/pubs/afp/issues/2014/0415/p642.html
The most pervasive secondary cause of chronic daily headache, medication overuse, often coexists with a primary headache syndrome. […] After other secondary causes have been ruled out, the clinical history helps determine what type of primary headache is present. […] The most common complications of chronic daily headache, other than those related to untreated pain, are medication-induced adverse effects. […] Education about headache from medication overuse is essential.
#41 Chronic daily headaches
https://pmc.ncbi.nlm.nih.gov/articles/PMC3444216/
MOH is the most common headache to present in the specialist headache clinic and an estimated 1-1.5% of the population suffers from this condition and accounts for 50-80% of patients presenting to a tertiary headache clinic. […] The exact aetiology and pathophysiology of primary NDPH remains unclear. […] NDPH is highly refractory to currently available treatments particularly one with pronounced migrainous features; there is an unmet need for research in to better treatments. […] Chronic tension type headache (CTTH) is a featureless bilateral headache occurring on 15 days or more in a month for more than three months. […] Unlike the episodic variety, CTTH is thought to be secondary to a central sensitization process whereby repeated painful stimuli over years causes dorsal horn neuron sensitisation. […] The pathophysiology of HC is not well identified although a vascular aetiology, pupillometric changes, and pain pressure threshold hypothesis have been investigated.
#42 Diagnosing and treating chronic daily headaches | Medmastery
https://www.medmastery.com/guides/headaches-clinical-guide/diagnosing-and-treating-chronic-daily-headaches?srsltid=AfmBOoqwt8Dcd1t7XkbLi0YcvhrJ8KR27RPBKJ7kDvjv_eIqgO1dvDC_
Sleep disturbances, particularly snoring, are more common in patients with chronic daily headaches. […] Individuals with chronic daily headaches tend to have high medication use, as documented by many authors. In fact, it is estimated that approximately one third of chronic daily headache patients overuse medicines. […] Treatment approaches will then vary based on the type of primary headache which has become chronic.
#43 Patient education: Headache causes and diagnosis in adults (Beyond the Basics) – UpToDate
https://www.uptodate.com/contents/headache-causes-and-diagnosis-in-adults-beyond-the-basics/print
Chronic daily headache is not a type of headache but a category that includes frequent headaches of various kinds. […] When a headache is present for more than 15 days per month for at least three months, it is described as a chronic daily headache. […] Most people with chronic daily headache have migraine or tension-type headache as the underlying type of headache. […] Some people with frequent headache use headache medications too often, which can lead to „medication-overuse headaches.” […] Medication-overuse headache may occur in people who have frequent migraine, cluster, or tension-type headaches, which leads them to overuse pain medications. […] Overuse of any number of pain medications can increase the risk of developing medication-overuse headaches.
#44 Headache – Functional Neurological Disorder (FND)
https://neurosymptoms.org/en/symptoms/common-associated-symptoms/headache/
The majority of people with chronic daily headache have a history of other headaches, usually migraine. When a series of migraines leads on to chronic daily headache it is sometimes called transformed migraine. […] There does seem to be a link between stress and these sorts of headache. Stress makes this headache worse and the headache causes stress, both because it’s painful but also because it can be worrying. […] In recent years we have recognised that using painkillers such as codeine and paracetamol can actually make chronic daily headache worse. You have probably already discovered that regular painkillers only take the edge off the pain and don’t work well. In fact it is worse than that, these painkillers often cause a rebound headache when they wear off. Over time this can make the headache gradually worse.
#45 Chronic Headaches – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK559083/
Secondary chronic daily headaches include medication overuse, CNS infection, CNS hematomas, intracranial tumor, raised intracranial pressure, low-pressure headache, vasculitis, aneurysms, and cerebrospinal fluid (CSF) leak. […] Medication overuse headaches share much of the pathophysiology of migraine and tension headaches as functional and structural changes in the central nervous system. Changes in the serotonergic neuromodulatory system and upregulation of vasoactive and pro-inflammatory mediators also contribute. […] Some studies have theorized a potential genetic risk as to the etiology of the development of MOH.
#46 Chronic daily headaches | Beacon Health System
https://www.beaconhealthsystem.org/library/diseases-and-conditions/chronic-daily-headaches?content_id=CON-20370872
By definition, chronic daily headaches occur 15 days or more a month, for longer than three months. True (primary) chronic daily headaches aren’t caused by another condition. […] The causes of many chronic daily headaches aren’t well-understood. True (primary) chronic daily headaches don’t have an identifiable underlying cause. […] Conditions that might cause nonprimary chronic daily headaches include: Inflammation or other problems with the blood vessels in and around the brain, including stroke, Infections, such as meningitis, Intracranial pressure that’s either too high or too low, Brain tumor, Traumatic brain injury.
#47 10 Most Common Causes of ChronicÂ DailyÂ Headache | National Headache Institute
https://nationalheadacheinstitute.com/blog/10-most-common-causes-of-chronic-daily-headache/
Obesity is becoming an epidemic in our country and is the cause of many chronic health problems such as diabetes, high blood pressure, and heart disease. But it can also cause chronic daily headaches. […] The caffeine in coffee, black tea, or soda can cause headaches as well. If you drink caffeine regularly or have several cups of coffee a day, you have an increased risk of developing chronic daily headaches. […] If hit too hard, the brain can bounce in the skull causing a concussion which can lead to chronic headaches. Any injury to the brain itself can also result in chronic headaches. […] Blood clots that form in or near the brain called cerebral venous sinus thrombosis, or CVST, can also cause chronic headaches. […] Infectious diseases such as meningitis can increase intracranial, or spinal pressure can also be a cause of chronic daily headaches. […] The two most common neuralgias are trigeminal and occipital neuralgia, both of which can cause chronic headaches.
#48 New Daily Persistent Headache (NDPH): Symptoms & Treatment
https://my.clevelandclinic.org/health/diseases/24098-new-daily-persistent-headache-ndph
You can also have NDPH as a secondary effect of another medical condition that directly affects your brain or central nervous system. […] Some examples of this include: Subarachnoid hemorrhage (bleeding into the subarachnoid space between your brain and an outer membrane; this often begins very suddenly with a thunderclap headache), Low cerebrospinal fluid (CSF) pressure, usually from a CSF leak in your skull or around your spinal cord, High CSF pressure that causes a headache, Post-injury headache (such as from a concussion or traumatic brain injury), Medication overuse (especially for medications that treat headaches or migraines), which can cause rebound headaches.
#49 Chronic Headaches – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK559083/
Secondary chronic daily headaches include medication overuse, CNS infection, CNS hematomas, intracranial tumor, raised intracranial pressure, low-pressure headache, vasculitis, aneurysms, and cerebrospinal fluid (CSF) leak. […] Medication overuse headaches share much of the pathophysiology of migraine and tension headaches as functional and structural changes in the central nervous system. Changes in the serotonergic neuromodulatory system and upregulation of vasoactive and pro-inflammatory mediators also contribute. […] Some studies have theorized a potential genetic risk as to the etiology of the development of MOH.
#50 Why Am I Suddenly Getting Headaches Every Day?
https://www.verywellhealth.com/why-am-i-getting-headaches-every-day-all-of-a-sudden-8662518
Swelling or bleeding in or around the brain are medical emergencies that require immediate medical attention. […] Bleeding in and around the brain or blood clots that stop blood flow to parts of the brain can all cause headaches. […] Why daily headaches occur is not well understood. However, what is known is that they can be triggered by numerous factors, such as stress, tension, food, hormonal changes, sleep, and more.
#51 Chronic daily headaches | Beacon Health System
https://www.beaconhealthsystem.org/library/diseases-and-conditions/chronic-daily-headaches?content_id=CON-20370872
By definition, chronic daily headaches occur 15 days or more a month, for longer than three months. True (primary) chronic daily headaches aren’t caused by another condition. […] The causes of many chronic daily headaches aren’t well-understood. True (primary) chronic daily headaches don’t have an identifiable underlying cause. […] Conditions that might cause nonprimary chronic daily headaches include: Inflammation or other problems with the blood vessels in and around the brain, including stroke, Infections, such as meningitis, Intracranial pressure that’s either too high or too low, Brain tumor, Traumatic brain injury.
#52 New daily persistent headache | Great Ormond Street Hospital
https://www.gosh.nhs.uk/conditions-and-treatments/conditions-we-treat/new-daily-persistent-headache/
We do not fully understand the exact cause of NDPH. Some, but not all, reports suggest that the onset of NDPH can be triggered by certain events. The underlying cause of NDPH is poorly understood, with some research indicating either inflammation or the bodys immune system being involved in triggering NDPH. Other studies suggest that viruses or upper respiratory infections (rhinitis, pharyngitis) may occur before the headache starts. However, understanding the potential role of viral or other infection in NDPH requires further research. […] NDPH, like other primary headaches, may be also linked to mental health conditions such as anxiety and panic disorders. In fact, a third of children with chronic headaches will have associated problems like anxiety disorders or depression.
#53 New Daily Persistent Headache (NDPH): Symptoms & Treatment
https://my.clevelandclinic.org/health/diseases/24098-new-daily-persistent-headache-ndph
NDPH has two main forms, primary and secondary. […] Primary NDPH: Healthcare providers and experts often call this idiopathic NDPH, meaning experts cant determine why its happening. […] Secondary NDPH: This is when NDPH happens in connection with or because of another condition or disease, most commonly a viral illness. […] Experts don’t know exactly why NDPH happens, but they suspect certain events and circumstances are possible triggers. […] Going through stressful events is a common feature for people who develop NDPH. […] One such key type of trigger is having an infection. […] People often develop NDPH while they have a viral or bacterial infection, including: Epstein-Barr virus (a key cause of mononucleosis, or just mono), Salmonella, E. coli, Dengue fever, COVID-19, Meningitis or encephalitis.
#54 10 Most Common Causes of ChronicÂ DailyÂ Headache | National Headache Institute
https://nationalheadacheinstitute.com/blog/10-most-common-causes-of-chronic-daily-headache/
Obesity is becoming an epidemic in our country and is the cause of many chronic health problems such as diabetes, high blood pressure, and heart disease. But it can also cause chronic daily headaches. […] The caffeine in coffee, black tea, or soda can cause headaches as well. If you drink caffeine regularly or have several cups of coffee a day, you have an increased risk of developing chronic daily headaches. […] If hit too hard, the brain can bounce in the skull causing a concussion which can lead to chronic headaches. Any injury to the brain itself can also result in chronic headaches. […] Blood clots that form in or near the brain called cerebral venous sinus thrombosis, or CVST, can also cause chronic headaches. […] Infectious diseases such as meningitis can increase intracranial, or spinal pressure can also be a cause of chronic daily headaches. […] The two most common neuralgias are trigeminal and occipital neuralgia, both of which can cause chronic headaches.
#55 New daily persistent headache | Great Ormond Street Hospital
https://www.gosh.nhs.uk/conditions-and-treatments/conditions-we-treat/new-daily-persistent-headache/
We do not fully understand the exact cause of NDPH. Some, but not all, reports suggest that the onset of NDPH can be triggered by certain events. The underlying cause of NDPH is poorly understood, with some research indicating either inflammation or the bodys immune system being involved in triggering NDPH. Other studies suggest that viruses or upper respiratory infections (rhinitis, pharyngitis) may occur before the headache starts. However, understanding the potential role of viral or other infection in NDPH requires further research. […] NDPH, like other primary headaches, may be also linked to mental health conditions such as anxiety and panic disorders. In fact, a third of children with chronic headaches will have associated problems like anxiety disorders or depression.
#56 New daily persistent headache – Wikipedia
https://en.wikipedia.org/wiki/New_daily_persistent_headache
New daily persistent headache (NDPH) is a primary headache syndrome which can mimic chronic migraine and chronic tension-type headache. […] The cause of NDPH is unknown, and it may have more than one etiology. NDPH onset is commonly associated with an infection or flu-like illness, stressful life event, minor head trauma, and extra cranial surgery. […] The pathophysiology of NDPH is poorly understood. Research points to an immune-mediated, inflammatory process. Cervical joint hypermobility and defective internal jugular venous drainage have also been suggested as causes. […] Post-infectious origins have been approximated to make up anywhere between 30 and 80% of NDPH patients in different studies. […] NDPH as an inflammatory, post-infectious manifestation indicates a potential meningoencephalitis event in NDPH patients. […] NDPH has been reported in Hashimoto’s encephalopathy, an immune-mediated type of encephalitis.
#57 Headache that won’t go away: Causes and treatments
https://www.medicalnewstoday.com/articles/326091
A traumatic brain injury (TBI), or concussion, can lead to many long term complications, such as the development of new or worsening headaches. […] Up to 23% of people develop a persistent headache following a stroke. […] Persistent headaches are among the most common symptoms following a mild TBI, according to a recent article in the journal NeuroRehabilitation. […] Moderate or severe TBIs can cause lingering headaches that do not go away or worsen over time.
#58 10 Most Common Causes of ChronicÂ DailyÂ Headache | National Headache Institute
https://nationalheadacheinstitute.com/blog/10-most-common-causes-of-chronic-daily-headache/
Obesity is becoming an epidemic in our country and is the cause of many chronic health problems such as diabetes, high blood pressure, and heart disease. But it can also cause chronic daily headaches. […] The caffeine in coffee, black tea, or soda can cause headaches as well. If you drink caffeine regularly or have several cups of coffee a day, you have an increased risk of developing chronic daily headaches. […] If hit too hard, the brain can bounce in the skull causing a concussion which can lead to chronic headaches. Any injury to the brain itself can also result in chronic headaches. […] Blood clots that form in or near the brain called cerebral venous sinus thrombosis, or CVST, can also cause chronic headaches. […] Infectious diseases such as meningitis can increase intracranial, or spinal pressure can also be a cause of chronic daily headaches. […] The two most common neuralgias are trigeminal and occipital neuralgia, both of which can cause chronic headaches.
#59 Headaches – Types, Causes, Symptoms, Diagnosis, Treatment
https://www.webmd.com/migraines-headaches/migraines-headaches-basics
You have this type of headache 15 days or more a month for longer than 3 months. Some are short. Others last more than 4 hours. Its usually one of the four types of primary headache: […] Doctors aren’t sure why this type of headache starts. Some people find it strikes after an infection, flu-like illness, surgery, or stressful event. […] Chronic daily headaches can result from a blow to the head. Rarely, they can be a sign of a more serious medical problem. […] Headaches, which can show as pressure or sharp pain in the head or face, vary widely in their type, intensity, location, and how often they happen. Common types include tension headaches, migraines, cluster headaches, chronic daily headaches, and sinus headaches. There are many causes of headaches, including stress, illness, environmental factors, genetics, changes in sleep patterns, and what you eat.
#60 Headache that won’t go away: Causes and treatments
https://www.medicalnewstoday.com/articles/326091
A traumatic brain injury (TBI), or concussion, can lead to many long term complications, such as the development of new or worsening headaches. […] Up to 23% of people develop a persistent headache following a stroke. […] Persistent headaches are among the most common symptoms following a mild TBI, according to a recent article in the journal NeuroRehabilitation. […] Moderate or severe TBIs can cause lingering headaches that do not go away or worsen over time.
#61 Chronic daily headaches | Beacon Health System
https://www.beaconhealthsystem.org/library/diseases-and-conditions/chronic-daily-headaches?content_id=CON-20370872
By definition, chronic daily headaches occur 15 days or more a month, for longer than three months. True (primary) chronic daily headaches aren’t caused by another condition. […] The causes of many chronic daily headaches aren’t well-understood. True (primary) chronic daily headaches don’t have an identifiable underlying cause. […] Conditions that might cause nonprimary chronic daily headaches include: Inflammation or other problems with the blood vessels in and around the brain, including stroke, Infections, such as meningitis, Intracranial pressure that’s either too high or too low, Brain tumor, Traumatic brain injury.
#62 New Daily Persistent Headache (NDPH): Symptoms & Treatment
https://my.clevelandclinic.org/health/diseases/24098-new-daily-persistent-headache-ndph
You can also have NDPH as a secondary effect of another medical condition that directly affects your brain or central nervous system. […] Some examples of this include: Subarachnoid hemorrhage (bleeding into the subarachnoid space between your brain and an outer membrane; this often begins very suddenly with a thunderclap headache), Low cerebrospinal fluid (CSF) pressure, usually from a CSF leak in your skull or around your spinal cord, High CSF pressure that causes a headache, Post-injury headache (such as from a concussion or traumatic brain injury), Medication overuse (especially for medications that treat headaches or migraines), which can cause rebound headaches.
#63 New Daily Persistent Headache: Symptoms, Causes & Treatments
https://www.denveruppercervical.com/new-daily-persistent-headache
There are, however, a few known root causes and risk factors for NDPH. Determining which applies to you is important as it allows you and your provider(s) to target the root cause of your pain. […] Causes and risk factors of NDPH: Decreased spinal fluid pressure that leads to spinal headache, Increased spinal fluid pressure that leads to pseudotumor cerebri, Bleeding around the brain, Blood clot in the brain (AKA cerebral venous sinus thrombosis), Medication overuse, Intracranial hypertension, Lumbar puncture, such as an epidural anesthesia or steroid shot, Epstein-Barr virus or another flu-like illness, Meningitis, Surgical procedure, Head trauma, A stressful life event. […] According to a 2016 clinic-based study by Dr. Todd Rozen published in Headache, more than 50% of patients cannot identify an NDPH trigger. […] How common is NDPH? Actually, NDPH is rare. A landmark study published in Cephalalgia shows that only 0.03% of Norway’s general population experienced NDPH, and that the average age is 35 years old.
#64 Chronic daily headaches | Beacon Health System
https://www.beaconhealthsystem.org/library/diseases-and-conditions/chronic-daily-headaches?content_id=CON-20370872
By definition, chronic daily headaches occur 15 days or more a month, for longer than three months. True (primary) chronic daily headaches aren’t caused by another condition. […] The causes of many chronic daily headaches aren’t well-understood. True (primary) chronic daily headaches don’t have an identifiable underlying cause. […] Conditions that might cause nonprimary chronic daily headaches include: Inflammation or other problems with the blood vessels in and around the brain, including stroke, Infections, such as meningitis, Intracranial pressure that’s either too high or too low, Brain tumor, Traumatic brain injury.
#65 Learn the most common causes of daily headaches
https://www.osfhealthcare.org/blog/common-causes-daily-headaches/
A stressful workweek can sometimes cause headaches that occur several days in a row. […] For individuals with daily headaches that do not subside, a more serious cause may be to blame. […] In some cases, chronic headaches may stem from a brain tumor â benign or malignant. […] While most headaches are not due to brain tumors, when they are, they require expert treatment.
#66 Learn the most common causes of daily headaches
https://www.osfhealthcare.org/blog/common-causes-daily-headaches/
A stressful workweek can sometimes cause headaches that occur several days in a row. […] For individuals with daily headaches that do not subside, a more serious cause may be to blame. […] In some cases, chronic headaches may stem from a brain tumor â benign or malignant. […] While most headaches are not due to brain tumors, when they are, they require expert treatment.
#67 10 Most Common Causes of ChronicÂ DailyÂ Headache | National Headache Institute
https://nationalheadacheinstitute.com/blog/10-most-common-causes-of-chronic-daily-headache/
Obesity is becoming an epidemic in our country and is the cause of many chronic health problems such as diabetes, high blood pressure, and heart disease. But it can also cause chronic daily headaches. […] The caffeine in coffee, black tea, or soda can cause headaches as well. If you drink caffeine regularly or have several cups of coffee a day, you have an increased risk of developing chronic daily headaches. […] If hit too hard, the brain can bounce in the skull causing a concussion which can lead to chronic headaches. Any injury to the brain itself can also result in chronic headaches. […] Blood clots that form in or near the brain called cerebral venous sinus thrombosis, or CVST, can also cause chronic headaches. […] Infectious diseases such as meningitis can increase intracranial, or spinal pressure can also be a cause of chronic daily headaches. […] The two most common neuralgias are trigeminal and occipital neuralgia, both of which can cause chronic headaches.
#68 Why Am I Suddenly Getting Headaches Every Day?
https://www.verywellhealth.com/why-am-i-getting-headaches-every-day-all-of-a-sudden-8662518
One in 20 adults has a headache every day or nearly every day. […] It’s estimated that only about 10% of headaches have a known cause, although contributing factors can trigger daily headaches. […] Emotional stress and muscle tension around the head and neck are both common triggers for tension headaches. […] Changes in estrogen levels associated with menstrual cycles are related to migraines in women, especially in perimenopause. […] Drinking alcohol, having too much or too little caffeine, not eating enough, or eating certain foods can each trigger headaches in some people. […] Sleep problems, especially not getting enough sleep, are known to trigger migraines, tension headaches, and cluster headaches. […] Colds, the flu, or a sinus infection can all cause headaches. […] Certain medications can trigger headaches.
#69 Headache that won’t go away: Causes and treatments
https://www.medicalnewstoday.com/articles/326091
A persistent headache can result from an injury or a structural problem in the spine, such as arthritis. It can also affect people who have migraine or have had a stroke. The overuse of pain relief drugs can also cause a headache that does not go away. […] Migraine, head injuries, and medication misuse can cause head pain that lasts for several hours or days. […] Intractable migraine, also known as status migrainosus, is a severe migraine headache that lasts for longer than 72 hours. […] Rebound headaches tend to occur on a recurring basis. The International Headache Society (IHS) describe a rebound headache as one that occurs on 15 or more days per month in people with a preexisting primary headache disorder and a history of medication overuse. […] Cervicogenic headaches are secondary headaches that result from structural problems in the head, neck, and spine.
#70 Chronic daily headaches
https://pmc.ncbi.nlm.nih.gov/articles/PMC3444216/
The definition of CM is not universally accepted and there is lack of consensus among professionals on its application in clinical practice. […] Progression from episodic to chronic migraine is seen in 6% in the population-based and 14% in clinic-based studies. […] Co-morbidities such as anxiety, depression and co-existent pain are more common and 76% – 95% of patients report recognisable triggers. […] It is postulated that patients with CM have a high and more persistent cortical excitability than those with EM. […] The recognition and management of CM poses considerable challenge to primary care physicians. […] The disorder generates more referrals to secondary or tertiary care and accounts for more emergency care visits than the episodic form. […] The IHS used the term medication overuse headache (MOH) in their 2nd edition of classification (ICHD-II, 2004), although this was revised with details of various sub-types by Silberstein in 2005.
#71 Headache | Better Health Channel
https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/headache
Different causes of diet-related headache include: fluctuations in blood-sugar levels, caffeine withdrawal, food additives, naturally occurring chemicals in foods. […] If a person has difficulties with their vision, such as long-sightedness, they tend to squint and strain their eye muscles in order to better focus their vision. […] Medications are designed for a particular target in the body, such as a diseased organ. […] However, they can also affect other areas in the body. […] Oral contraceptives can cause headache as an unwanted side effect. […] Hormone replacement therapy also known as menopause hormone therapy makes headaches worse for some women. […] Suggestions for reducing the risk of medication-induced headache include: Follow the dosage directions on the label; Don’t mix prescription medications with drugs such as alcohol; Avoid dependence on painkillers; Report any side effects or unusual symptoms to your doctor immediately.
#72 Chronic daily headaches
https://pmc.ncbi.nlm.nih.gov/articles/PMC3444216/
Chronic Daily Headache is a descriptive term that includes disorders with headaches on more days than not and affects 4% of the general population. […] Chronic migraine, chronic tension-type headache, new daily persistent headache and medication overuse headache accounts for the vast majority of chronic daily headaches. […] The primary CDH is divided into short and long duration. […] Many risk factors have been identified that predict the development of CDH, in particular CM, some of which are modifiable. […] The term CDH is mainly referred to the primary headache disorder, although secondary CDH must be excluded. […] Medication overuse headaches (MOH), essentially a secondary headache disorder commonly accompany the primary headache disorders and are described with them. […] The concept of high frequency migraine has been in the literature for a long time with terms such as transformed migraine, mixed headache syndrome and evolutive migraine.
#73 Diagnosing and treating chronic daily headaches | Medmastery
https://www.medmastery.com/guides/headaches-clinical-guide/diagnosing-and-treating-chronic-daily-headaches?srsltid=AfmBOoqwt8Dcd1t7XkbLi0YcvhrJ8KR27RPBKJ7kDvjv_eIqgO1dvDC_
Chronic daily headaches are defined as headaches which occur at least 15 days or more per month for at least three months, regardless of the underlying headache etiology. […] Diagnosis of chronic daily headaches can be further complicated by secondary factors, such as medication overuse, post traumatic headache, cervicogenic headache, and other more serious causes such as arterial dissection, tumor, and intracranial hypotension from a cerebrospinal fluid leak or pseudotumor cerebri. […] Chronic daily headache is more common in individuals of lower income and / or less education. […] Obesity is a risk factor for chronic daily headache, for unknown reasons. […] A history of migraine and depression is frequently found in those who suffer from chronic daily headaches. […] Those that suffer from chronic daily headaches also tend to report associated stressful life events including death in the family or illness, moves, job changes, marital status changes, and child-related issues.
#74 Living With Chronic Daily Headaches – PMIR Medical CenterAccessibility ToolsIncrease TextDecrease TextGrayscaleHigh ContrastNegative ContrastLight BackgroundLinks UnderlineReadable FontReset
https://paininjuryrelief.com/living-with-chronic-daily-headaches/
Chronic daily headaches describe a cluster of chronic conditions that cause headaches on more than 15 days a month, for at least three months in a row, with various causes and associated risk factors. […] While causes vary widely and primary headache conditions have no understood or clear cause, there are identifiable risk factors associated with recurring and chronic headaches. Nonprimary chronic daily headaches (i.e., caused by a separate condition) may occur because of a stroke, head injury, infection, intracranial pressure, and more. But primary headaches are usually associated with: Stress, Excessive caffeine (or caffeine sensitivity), Medication overuse, Sex (females are statistically more susceptible to chronic daily headaches), Anxiety and depression, Obesity, Poor quality of sleep, Other types of chronic pain (arthritis, rheumatoid or otherwise; fibromyalgia; chronic fatigue syndrome, and more).
#75 Diagnosing and treating chronic daily headaches | Medmastery
https://www.medmastery.com/guides/headaches-clinical-guide/diagnosing-and-treating-chronic-daily-headaches?srsltid=AfmBOoqwt8Dcd1t7XkbLi0YcvhrJ8KR27RPBKJ7kDvjv_eIqgO1dvDC_
Chronic daily headaches are defined as headaches which occur at least 15 days or more per month for at least three months, regardless of the underlying headache etiology. […] Diagnosis of chronic daily headaches can be further complicated by secondary factors, such as medication overuse, post traumatic headache, cervicogenic headache, and other more serious causes such as arterial dissection, tumor, and intracranial hypotension from a cerebrospinal fluid leak or pseudotumor cerebri. […] Chronic daily headache is more common in individuals of lower income and / or less education. […] Obesity is a risk factor for chronic daily headache, for unknown reasons. […] A history of migraine and depression is frequently found in those who suffer from chronic daily headaches. […] Those that suffer from chronic daily headaches also tend to report associated stressful life events including death in the family or illness, moves, job changes, marital status changes, and child-related issues.
#76 Chronic daily headaches
https://pmc.ncbi.nlm.nih.gov/articles/PMC3444216/
The definition of CM is not universally accepted and there is lack of consensus among professionals on its application in clinical practice. […] Progression from episodic to chronic migraine is seen in 6% in the population-based and 14% in clinic-based studies. […] Co-morbidities such as anxiety, depression and co-existent pain are more common and 76% – 95% of patients report recognisable triggers. […] It is postulated that patients with CM have a high and more persistent cortical excitability than those with EM. […] The recognition and management of CM poses considerable challenge to primary care physicians. […] The disorder generates more referrals to secondary or tertiary care and accounts for more emergency care visits than the episodic form. […] The IHS used the term medication overuse headache (MOH) in their 2nd edition of classification (ICHD-II, 2004), although this was revised with details of various sub-types by Silberstein in 2005.
#77 Chronic migraine – The Migraine TrustVisualV1 – SearchVisualV1 – CrossVisualV1 – Home VisualV1 – CrossVisualV1 – Arrow
https://migrainetrust.org/understand-migraine/types-of-migraine/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. […] Itâs not fully understood what causes chronic migraine. […] For a lot of people chronic migraine develops gradually with migraine attacks becoming more frequent over time. […] There are a number of medical conditions that can increase your tendency to have migraine. These include: depression, anxiety, other pain conditions such as Fibromyalgia, sleep apnoea, Postural orthostatic tachycardia syndrome (PoTS). […] Managing these can help with managing migraine and the effectiveness of migraine treatment.
#78 Chronic Daily Headache: Diagnosis and Management | AAFP
https://www.aafp.org/pubs/afp/issues/2014/0415/p642.html
Chronic daily headache is defined as the presence of a headache on 15 days or more per month for at least three months. The most common types of chronic daily headache are chronic migraines and chronic tension-type headaches. […] All patients should be asked about medication overuse, which can increase the frequency of headaches. […] Several prophylactic treatments for chronic daily headache can reduce headache frequency and severity, as well as improve overall quality of life. […] For patients with migraine, modifiable risk factors for progression to chronic migraine include obesity, medication overuse, stressful life events, snoring, caffeine overuse, and other causes of chronic pain. […] It is important to evaluate for red flags that may suggest a secondary cause of headache or a headache requiring more immediate evaluation.
#79 Never Too Young For Chronic Headaches in Teenagers
https://americanmigrainefoundation.org/resource-library/never-too-young-for-chronic-headaches/
Chronic daily headache presents a significant problem for many teenagers. For practitioners, patients, and their families, it is a challenging and frustrating entity to treat. […] Individuals with a diagnosis of chronic daily headache experience at least 15 headache days in 1 month for 3 consecutive months and show no additional signs of underlying organic pathology. This headache disorder tends to affect teenagers and adults more so than preteens. […] Most teenage patients with chronic daily headache have a history of episodic migraines. The transformation to chronic migraine may occur over weeks, months, or years. […] Approximately one-quarter of teenagers with chronic daily headache have no significant past headache history. In these patients, an infection such as mononucleosis or a minor head injury may incite a new daily persistent headache (onset within 3 days or less).
#80 Chronic migraine – The Migraine TrustVisualV1 – SearchVisualV1 – CrossVisualV1 – Home VisualV1 – CrossVisualV1 – Arrow
https://migrainetrust.org/understand-migraine/types-of-migraine/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. […] Itâs not fully understood what causes chronic migraine. […] For a lot of people chronic migraine develops gradually with migraine attacks becoming more frequent over time. […] There are a number of medical conditions that can increase your tendency to have migraine. These include: depression, anxiety, other pain conditions such as Fibromyalgia, sleep apnoea, Postural orthostatic tachycardia syndrome (PoTS). […] Managing these can help with managing migraine and the effectiveness of migraine treatment.
#81 Never Too Young For Chronic Headaches in Teenagers
https://americanmigrainefoundation.org/resource-library/never-too-young-for-chronic-headaches/
Patients with chronic daily headache can experience and complain about multiple types of headaches. Many have severe intermittent headaches that are migraine-like. […] Headache is not the only symptom of chronic daily headache. Frequent additional symptoms include dizziness, sleep disturbance, pain at other sites of the body (including neck pain, back pain, and abdominal pain), fatigue, difficulty in concentration, decreased mood, and increased anxiety. […] One of the roles of a headache specialist in treating these patients is to separate out chronic daily headache, which is a primary headache syndrome, from secondary causes of headache. […] Chronic daily headache is difficult to control. There are often no immediate answers or easy ways to the treatment and resolution of the pain. […] Preventive medications are traditionally used in episodic migraines to reduce the frequency of the migraine headaches. Occasionally, they may reduce the severity of the chronic daily headaches as well.
#82 New daily persistent headache | Great Ormond Street Hospital
https://www.gosh.nhs.uk/conditions-and-treatments/conditions-we-treat/new-daily-persistent-headache/
We do not fully understand the exact cause of NDPH. Some, but not all, reports suggest that the onset of NDPH can be triggered by certain events. The underlying cause of NDPH is poorly understood, with some research indicating either inflammation or the bodys immune system being involved in triggering NDPH. Other studies suggest that viruses or upper respiratory infections (rhinitis, pharyngitis) may occur before the headache starts. However, understanding the potential role of viral or other infection in NDPH requires further research. […] NDPH, like other primary headaches, may be also linked to mental health conditions such as anxiety and panic disorders. In fact, a third of children with chronic headaches will have associated problems like anxiety disorders or depression.
#83 Chronic Headaches – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK559083/
Secondary chronic daily headaches include medication overuse, CNS infection, CNS hematomas, intracranial tumor, raised intracranial pressure, low-pressure headache, vasculitis, aneurysms, and cerebrospinal fluid (CSF) leak. […] Medication overuse headaches share much of the pathophysiology of migraine and tension headaches as functional and structural changes in the central nervous system. Changes in the serotonergic neuromodulatory system and upregulation of vasoactive and pro-inflammatory mediators also contribute. […] Some studies have theorized a potential genetic risk as to the etiology of the development of MOH.
#84 Chronic Headaches – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK559083/
Secondary chronic daily headaches include medication overuse, CNS infection, CNS hematomas, intracranial tumor, raised intracranial pressure, low-pressure headache, vasculitis, aneurysms, and cerebrospinal fluid (CSF) leak. […] Medication overuse headaches share much of the pathophysiology of migraine and tension headaches as functional and structural changes in the central nervous system. Changes in the serotonergic neuromodulatory system and upregulation of vasoactive and pro-inflammatory mediators also contribute. […] Some studies have theorized a potential genetic risk as to the etiology of the development of MOH.
#85 Causes and Triggers of Chronic Daily Headaches
https://www.ehacstl.com/blog/1186736-causes-and-triggers-of-chronic-daily-headaches/
Patients with chronic daily headaches have been noted to abuse as well as overuse medication, especially analgesics and triptans. The American Headache Society reports that taking headache medications for too long will result in medication overuse headache where the effect of the medication is to make the headache get worse with time, frequently, and severely.
#86 Headache that won’t go away: Causes and treatments
https://www.medicalnewstoday.com/articles/326091
A persistent headache can result from an injury or a structural problem in the spine, such as arthritis. It can also affect people who have migraine or have had a stroke. The overuse of pain relief drugs can also cause a headache that does not go away. […] Migraine, head injuries, and medication misuse can cause head pain that lasts for several hours or days. […] Intractable migraine, also known as status migrainosus, is a severe migraine headache that lasts for longer than 72 hours. […] Rebound headaches tend to occur on a recurring basis. The International Headache Society (IHS) describe a rebound headache as one that occurs on 15 or more days per month in people with a preexisting primary headache disorder and a history of medication overuse. […] Cervicogenic headaches are secondary headaches that result from structural problems in the head, neck, and spine.
#87 Chronic Daily Headaches Symptoms & Causes | NHI
https://nationalheadacheinstitute.com/disorders/chronic-daily-headache/
Overuse of opiates, analgesics, and ergot-amines can go hand in hand with a chronic daily headache. […] Medication overuse can lead to what are called rebound headaches, which can lead to medication dependency. […] The most common history is of an episodic migraine converted to a transformed migraine through overuse of medication. […] Chronic headaches are not a symptom of another medical condition and can vary greatly in duration, usually around four hours. […] Chronic migraines develop from episodic migraines not accompanied by an aura and with moderate or severe episodes of throbbing pain on one part of the head. […] Chronic tension-type headaches can evolve from episodic tension headaches that are described as mild to moderate pressure-like pain. […] New daily persistent headaches are very similar in description to chronic tension-type headaches. […] Hemicrania continua is characterized by constant, moderate pain on the side of the head sometimes with intermittent moments of severe pain.
#88 Why Am I Getting Frequent Headaches? – Scripps Health
https://www.scripps.org/news_items/3239-why-do-i-get-frequent-headaches
Tension headaches, the most common type of headache, cause mild to moderate pain. They often present as a dull, constant pain felt on both sides of the head and have no other symptoms. […] These types of headaches are caused by tightening or tension in the muscles in the head, neck and scalp. They can be brought on by stress, noise, fumes and even long periods of watching TV or computer screens. […] Chronic tension headaches are much less common. […] Migraine is the most disruptive type of primary headache. It is often marked by a throbbing pain that is moderate to severe. […] Certain environmental factors are common triggers, such as sleep disruption, dehydration, skipped meals, some foods, hormone fluctuations and exposure to chemicals. […] Also known as rebound headaches, they are caused by an overuse of pain medications, such as aspirin, acetaminophen and ibuprofen.
#89 Chronic Daily Headache: Diagnosis and Management | AAFP
https://www.aafp.org/pubs/afp/issues/2014/0415/p642.html
The most pervasive secondary cause of chronic daily headache, medication overuse, often coexists with a primary headache syndrome. […] After other secondary causes have been ruled out, the clinical history helps determine what type of primary headache is present. […] The most common complications of chronic daily headache, other than those related to untreated pain, are medication-induced adverse effects. […] Education about headache from medication overuse is essential.
#90 Chronic Daily Headache | My Headache Doc | Houston Texas
https://myheadachedoc.com/headache-and-head-pain/chronic-daily-headache/
Patients with daily headaches or near daily headaches need a significant evaluation to determine if there is a systemic cause for which the daily headache is only a symptom. […] Once all secondary diseases are eliminated, then a physician is left with the considerations of the causes mentioned below. The following are just a few secondary causes of daily headache or near daily headache: Brain tumors, Meningitis (infection of the lining of the brain), Systemic infection, Some vitamins and herbs, Sleep apnea. […] A large number of patients with chronic daily headaches are taking daily pain medication therefore the issue of medication rebound becomes important. Headaches that are associated with the use of daily pain medication of any type (over the counter or prescription) will usually not get better without the patient discontinuing the daily pain medication.
#91 Headache – Functional Neurological Disorder (FND)
https://neurosymptoms.org/en/symptoms/common-associated-symptoms/headache/
Chronic Daily Headache is the commonest type of headache that is referred to a neurology clinic. It refers to a headache that is present most days, often for most of the day. Typically it has the following features: Constant pressing or bursting sensation, sometimes pounding. Can be all over head, on one side or sometimes in a small area. It is often variable but tends to get worse as the day goes on. Conventional painkillers only take the edge off the pain. […] Chronic headache is due to a volume knob turned up in the pain pathways in your brain. Stopping regular painkillers is not easy but can be a vital step on the road to recovery. […] Chronic Daily Headache is a complex phenomenon that probably has lots of different causes. Try thinking of the problem as a volume knob in your head that has been turned up too high.