Chronic Daily Headache

Chronic daily headache (CDH) is a type of headache disorder characterized by the occurrence of headaches on 15 or more days per month, with the headaches lasting for at least 4 hours per day.

Types of Chronic Daily Headaches

• Tension-type chronic daily headache: This is the most common type of CDH and is characterized by a dull, aching pain on both sides of the head.
• Migraine-type chronic daily headache: This type of CDH is characterized by throbbing or pulsating pain, usually on one side of the head, and may be accompanied by sensitivity to light and sound.
• Chronic cluster headache: This is a rare type of CDH that is characterized by severe, one-sided pain around the eye and temple area.
• Hemicrania continua: This is a rare type of CDH that is characterized by continuous, one-sided pain on one side of the head.

Causes and Risk Factors

The exact cause of chronic daily headache is not fully understood, but several factors may contribute to its development, including:

• Genetics: Family history may play a role in the development of CDH.
• Stress and anxiety: Stress and anxiety can trigger or exacerbate headaches.
• Sleep disorders: Sleep apnea, insomnia, and other sleep disorders may contribute to CDH.
• Medication overuse: Overuse of pain medications, particularly those containing caffeine or barbiturates, can lead to medication-overuse headache (MOH), a type of CDH.
• Other medical conditions: Certain medical conditions, such as sinusitis, temporomandibular joint disorder, and cervical spine disease, may contribute to CDH.

Symptoms

The symptoms of chronic daily headache can vary depending on the type of headache, but common symptoms include:

• Head pain: The primary symptom of CDH is head pain, which can range from mild to severe.
• Fatigue: Many people with CDH experience fatigue and a lack of energy.
• Sensitivity to light and sound: Some people with CDH may experience sensitivity to light and sound, particularly during migraine-type headaches.
• Nausea and vomiting: Nausea and vomiting can occur, especially during migraine-type headaches.

Diagnosis

The diagnosis of chronic daily headache is based on a combination of medical history, physical examination, and diagnostic tests. The International Headache Society (IHS) has established criteria for the diagnosis of CDH, which include:

• Headaches occurring on 15 or more days per month
• Headaches lasting for at least 4 hours per day
• No evidence of another underlying condition that could be causing the headaches

Treatment and Management

The treatment and management of chronic daily headache depend on the type of headache, its severity, and the individual's medical history. Treatment options may include:

• Medications: Pain-relieving medications, such as triptans, ergots, and opioids, may be prescribed to manage acute headaches.
• Preventive medications: Medications, such as beta blockers, anticonvulsants, and antidepressants, may be prescribed to reduce the frequency and severity of headaches.
• Lifestyle modifications: Stress management techniques, such as relaxation therapy, biofeedback, and cognitive-behavioral therapy, may help reduce stress and anxiety that can trigger or exacerbate headaches.
• Alternative therapies: Alternative therapies, such as acupuncture, massage, and chiropractic care, may be helpful in managing chronic daily headache.

Prognosis

The prognosis for chronic daily headache varies depending on the individual's response to treatment and their overall health. With proper treatment and management, many people with CDH can experience significant improvement in their symptoms and quality of life.