Feel like you spend half the month waking up with a pounding headache without even touching a drop of your chosen tipple the night before? You’re not alone – up to 3 million people in the UK suffer from Chronic Daily Headache (CDH) and it turns out women are more at risk.
What Is Chronic Daily Headache?
“CDH, in its simplest terms, means experiencing a headache on more than 15 days a month for at least three months – in other words, struggling with a headache more often than not,” explains Mark Weatherall, Consultant Neurologist and Headache Specialist.
Not only do these headaches hit on a regular basis but they last longer than the average – CDH lasts for at least four hours at a time, making it a severely debilitating issue for sufferers.
The type of headache pain – a dull ache, throbbing, sharp, stronger on one side of the head – varies from individual to individual and can change from one week to the other so it’s not easy to make a blanket statement about the causes or treatments.
In terms of what’s actually happening during chronic pounders, Fayyaz Ahmed, Consultant Neurologist and Educational Officer to the British Association for the Study of Headache, explains: “The hypothalamus is an area of the brain directly involved with many daily functions such as sleeping, hunger, sexual arousal and circulation. We believe that people who experience frequent headaches have increased sensitisation in the hypothalamus that makes them prone to head pain.”
Why Are Women Most At Risk Of Chronic Daily Headache?
Sadly, us women are more likely to suffer. “As children, headaches are equally common in both sexes but after puberty, women suffer from CDH twice as much as men and most cases occur in a women’s fertile period between 20-50. This leads us to think female hormones may be an underlying cause of CHD.”
Given the known impact of hormones on the occurence and severity of head pain, it's to be presumed that the hormone-based contraceptive pill may exacerbate the development of migraines, and as such, CDH. In fact, some women find that their headaches improve when they take the pill, but others experience a worsening of symptoms. Studies suggest switching to a low dose pill (20 micrograms of oestrogen) or those containing newer types of progestogen may be the answer, but experts insist every individual is different, so it's best to work with your GP to find the pill that suits you best.
What Are The Different Types Of Chronic Daily Headache?
The causes or types of CDH typically fall into three camps: tension-type headache, rebound headache and chronic migraine. “Chronic migraine is the most common cause of CDH, where a person is already prone to experiencing episodic migraines and the head pain related with that becomes more frequent. The cause behind this isn’t currently known,” says Ahmed. “Tension headaches tend to affect both sides of the head with a painful sensation of tightening rather than throbbing.”
A rebound headache is arguably the most frightening cause but happily, is the one most tangibly solvable. Also known as medication overuse headache, it develops when an individual takes too much pain medication and CHD worsens as a result. “As many as 50% of CHD patients symptoms have developed or worsened due to the regular use of chronic headache that has developed or worsened with the regular overuse of analgesic drugs; taking simple analgesics (ibuprofen, aspirin) on more than 15 days every month or stronger ergots, triptans, opioids, or combination analgesics for more than 10 days every month,” says Weatherall. “Medication overuse may be driven by various psychological factors, including the natural desire to relieve pain and continue functioning, the fear of headache, obsessional drug-taking behaviours or mental health issues.”
What Treatment Is Available?
According to Weatherall, and it seems ironic, medication withdrawal can be very effective in reducing symptoms of CDH which has been caused by overuse. “Up to one-third of patients experience a significant improvement in their headaches, reverting to less frequent headaches. A further one-third of patients experience a reduction in the frequency or severity of their headaches. Even in patients who don’t see a marked improvement in their symptoms, reducing medication is still important as it allows previously discarded painkillers to regain their effectiveness.”
The expert view is that if you’re suffering, visit your GP. It’s important to learn what type of headache you’re suffering from and if it can be treated with medication. “Meanwhile, a lack of sleep and exercise can exacerbate symptoms, so try to focus on getting a good night’s sleep and work out on days that the pain isn’t too much to bear,” adds Ahmed.
6 Facts About Chronic Daily Headaches
** 1.** Headache disorders are among the most common disorders of the nervous system.
** 2.** At least 60% of sufferers of migraine or headache never consult their GP because they mistakenly think that nothing can be done to help them.
** 3.** Some headache medications include caffeine because it can be beneficial in reducing headache pain, but it can also aggravate pain. It’s good to monitor your intake to see if it’s a trigger.
** 4.** The classification system of headaches used by doctors and specialists during diagnosis is one of the longest and most complex in medicine.
** 5.** The World Health Organisation has classified headache as a major health disorder and has rated migraine amongst the top 20 most disabling lifetime conditions.
** 6.** Headache on 15 or more days every month affects 1.7–4% of the world’s adult population.
For more information follow these links tobash.com and migrainetrust.org
***Words by Victoria Joy. ***