Daily Headaches and Migraines? A Deep Dive Into the Facts
Do you have a pounding, crippling headache every single day? If so, your first thought may be that you have daily migraines. You might particularly be convinced of this if your symptoms are a close fit for those of the typical migraine.
Many patients who believe that they have daily migraines treat them as such, and they take a prescription medication for migraines such as Imitrex as often as possible in order to try to mitigate them.
Can migraines be daily headaches? Or are migraines only headaches that you get occasionally?
I have noticed that there is a lot of contradictory information on this topic. As such, it seemed like a question that was worthy of an article.
I cannot provide a definitive answer to this question because of all the contradictory information. But I can at least let you know about the evidence for and against the idea of the migraine as a daily headache.
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Some Doctors Say “No,” Migraines Are Not Daily Headaches
I have found doctors who definitively say that migraines are never daily headaches. For an example, consider this article by a neurologist named Dr. Allan Bernstein. The article focuses specifically on the potential to overuse the prescription drug Imitrex for migraines.
The article states in large letters, “A MIGRAINE is NOT a DAILY HEADACHE.”
It goes on to state, " It is by definition an episodic event. Migraine headaches occur once a month or once a week, but generally not every single day. People who are using Imitrex 15, 20, 30 times a month may be treating their fear of migraine as much as they are treating migraine. They may be treating the wrong headache.”
This would seem to be a pretty straightforward answer to the question, at least at first glance.
But this is just one resource. And I have found that as I have dug deeper into other reliable sources that I have found other answers to this question.
For example, if we turn to the Office of Women’s Health, “The pain can last a few hours or up to one or two days. Some people get migraines once or twice a week. Others, only once or twice a year.”
So, we already have a second reputable source contradicting the first. There is a significant difference between once a week and twice a week, especially when we are talking about debilitating pain.
Now, let us consult with another reputable source: The Migraine Research Foundation. This page states the following:
“While most sufferers experience attacks once or twice a month, more than 4 million people have chronic daily migraine, with at least 15 migraine days per month.”
Okay, now we have an actual statistic regarding people who have migraines practically every other day.
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4 million is quite a large number of people for Dr. Allan Bernstein to have disregarded entirely in such large letters.
It is possible that I was taking Bernstein more literally than intended, but if I have, other people have as well.
A person who is in crippling pain each day and desperately in search of answers is likely going to have a tendency to take things at face value.
But if any of those 4 million people with chronic migraines had read that page, they might have made the assumption that they were not suffering from migraines all.
That might've led them in an improper treatment direction.
Is It Possible That You Can Have a Migraine Every Day?
So now that we have established that migraines can happen quite frequently, let's talk a little bit more about chronic daily migraine.
The Migraine Research Foundation has an entire page dedicated to this condition, which you can view here. The foundation focuses on medication overuse as a cause for chronic daily migraine. It would seem that this particular situation is reversible, as the foundation does say that there is a "way out of this cycle" by reducing medication use.
Is Medication Overuse The Only Possible Cause for Chronic Daily Migraine?
This leads to the next obvious question. Are there other potential causes of chronic daily migraine?
After all, you might be reading this article thinking, “I definitely have this type of intense daily head pain … but it started without me overusing (or even using) any medications at all.”
One thing I noticed while reading the previously linked page from the Migraine Research Foundation is this statistic:
- 85% of chronic daily migraine sufferers are women.
It seems hard to believe that this is a meaningless coincidence—that women are that much more prone to overusing headache medications than men.
This would seem to suggest that there are other physiological factors which could contribute to chronic daily migraine.
The next article that I found in my search for answers is a journal article titled “Estrogen and chronic daily headache."
The article abstract states, “Estrogen exerts a strong influence on episodic headaches, such as migraine and tension-type headache. A relationship between sex hormones and chronic daily headache (CDH) is less well established.”
This seems to both clarify and (at first glance) muddy the waters. First of all, the abstract clearly states that migraines can be impacted by hormones involved with menstrual cycles.
But secondly, it mentions “chronic daily headache” as something other than migraine.
What Is a “Chronic Daily Headache?”
It turns out that this is a blanket term referring to experiencing headaches 15 or more days out of any given month, as defined here by Johns Hopkins.
Johns Hopkins includes the following list on that page:
- Hemicrania continua
- Idiopathic intracranial hypotension
- Mixture of types (most commonly migraine and tension)
So this too ends up confirming the existence of daily migraines.
This page also talks about daily headaches which stem from the overuse of medications. But it goes on to define another type of chronic daily headache. As the page explains:
“An extremely difficult to treat — and all too common — type of CDH is a transformed migraine. This is a migraine that over time becomes more and more frequent, blurring together until there is a 24-hour-a-day continuous background headache with occasional superimposed, more severe migraine symptoms. A transformed migraine headache acts more like a chronic pain syndrome than a migraine in terms of its poor response to typical migraine drugs. Some researchers believe that years of chronic, frequent migraines can cause permanent scarring or other changes in the brain, creating this type of intractable CDH that may not be curable.”
So we have identified a couple of factors which could be involved with chronic daily migraines and which do not involve medication overuse:
- Brain changes resulting from frequent migraines
But there are still other possible factors which I have identified:
- Regular long migraine attacks
- Triggers that cannot be removed
Now I will elaborate on each of these.
Let’s turn to WebMD. This resource says, “Migraines can last from 4 hours to 3 days, and sometimes longer.”
So, we know that you can have a migraine that can last for 3 or more days. We also know you can get episodic migraines twice a week.
There are only 7 days in a week. So if you get slammed with two of these on average each week, and they each happen to last 3-4 days … you’re not going to get much (or any) relief.
This too, it seems, could turn a migraine into a daily headache—even if the events are technically episodic.
Now, let’s talk about triggers that are impossible to entirely remove. For this, we’ll reference this study, published in 2018.
The paper states, “Myofascial trigger points are prevalent in both migraine and tension-type headache, but the role they play in the pathophysiology of each disorder and to which degree is unclarified.”
Don’t know what a myofascial trigger point is? It’s another word for a muscle knot. But if you have myofascial pain syndrome, your trigger points are chronic.
Myofascial pain syndrome and trigger points are not well-understood at this point in time. But we do know that they refer pain to the head and face, including to many of the same areas where migraines are typically experienced.
This is a subject which I have written about at length in my article “Trigger Points and Migraines."
According to the American Migraine Foundation, "Trigger points within muscles of the head, neck, and shoulders can cause headache by themselves, and this type of condition is often called myofascial pain. In addition, trigger points can be present in patients with migraine, tension-type, post-traumatic, and other headache disorders, and can be worsening or perpetuating factors for the underlying headache condition.”
To make matters worse, new research shows that migraines themselves can lead to tense muscles.
That means that if you have migraines, they can feed right into your trigger points, making your myofascial pain syndrome worse.
The reason that I have brought up trigger points and have just discussed them at some length is because it would appear that they themselves are migraine triggers. And unfortunately, they are not something that can easily be avoided since they are 1- located inside your body, and 2- are, by definition, frequently chronic and hard to get rid of.
So if you have a condition like myofascial pain syndrome, those trigger points could remain active in your body for months at a time, spawning frequent migraine episodes and also creating a backdrop level of pain which may be constantly present.
While I have referred to research while talking about myofascial pain syndrome as well as the effects of hormones on migraines, I am also speaking from experience regarding both of these internal triggers.
I can tell you for a fact that these triggers, if present on a constant level, can lead to constant migraine pain.
What Can You Do about Chronic Daily Migraines?
If you find yourself experiencing migraines on a daily basis—or even the sense of one continual migraine—what can you do?
It is admittedly a pretty dire circumstance. But once you are aware that you may have migraines, you can start taking steps toward hopefully alleviating some of your pain.
A situation like this usually will not have a quick fix available. That is something to steel yourself for before you attempt to tackle the problem.
There is also not a sure-fire cure which will work for all daily migraine sufferers. But based on my experiences and research, I can at least give you some pointers to help you get started.
- Do see a doctor, and be incredibly crystal clear about the fact that your pain is a problem that needs to be solved. This is something which healthcare practitioners often cannot figure out by themselves, even if it seems obvious to you. This is particularly likely if you have a flat affect. So do not attempt to be stoic. The only way to get chronic pain treated is to make it abundantly clear that you cannot function well without some kind of intervention.
- Keep a log. You should keep a daily log about your headaches with as much detail as possible. This fills two purposes. The first is that it gives you data to work with as you attempt to figure out treatment ideas. The second is that it gives you evidence to show to your insurance provider if they demand to see it (which might happen).
- Investigate a range of possible headache types. While you are looking into the possibility that you have daily migraines, you should also check into the possibility that you might have other types of daily headaches as well (i.e. tension headaches, myofascial headaches, cervicogenic headaches, and so forth). In fact, it is quite likely that you do, considering the close relationship between migraines and tension in the neck. As different headaches have different treatment protocols, you will want to attack your pain on as many fronts as possible.
- Learn your triggers (experimentation may be necessary). Another important step in treating your migraines is going to be to identify your triggers. In the beginning, this will be quite difficult if your levels of pain are more or less constant. Over time, however, as you look up possible triggers and experiment with adding or removing them, you may be able to start perceiving patterns that spike your pain. This will teach you what to avoid or try to mitigate. Even internal triggers like hormone levels and trigger points can be treated to some degree.
- Do try painkillers. Whether your headaches are constant or frequent and episodic, do not shy away from giving painkillers a try. This goes beyond just getting temporary relief. Acute pain which is not treated effectively can transform into chronic pain. Chronic pain which is not effectively treated can metamorphose into intractable pain. You want to prevent this to the best of your ability, even if you are already at the chronic daily level.
- Do not assume you are screwed if your pain is already intractable. Even though you will read about frequent headaches transforming into intractable, constant pain, this is not the only direction things can go in. This is something which I can attest to from experience, as my pain began out of the blue and was initially intractable. Now it is of the chronic episodic variety. This has been the result of hard work on my part combined with some good fortune.
- Consider taking an herbal supplement. Did you know that herbal treatments such as butterbur, boswellia and Vitex can help reduce migraine frequency and severity? Find out more in our Essential Guide to Treating a Migraine Wwith Natural Supplements.
- Start exploring home therapies for migraines. There are home treatments that you can try for migraines which go beyond medication. Some ideas include cold therapy, a TENS unit, caffeine, dark, quiet environments, sleep (if you can get it) and so forth.
- Consider alternative therapies. Depending on the exact nature of your headache issues, a chiropractor, acupuncturist or massage therapist could provide you with significant help.
- Find something psychologically to hold tight to. Finally, you are in for a long, gruelling fight—and there is no point beating around the bush. You will need to find some way to bolster your psychological health. For some people, this could involve therapy, medication, or relaxation strategies. For others, another approach might be in order. For me, it was the simple determination to get my life back and pure hatred for my agony. That was what kept me going. The point is, whatever works for you, grab hold of it.
Conclusion: Migraines Can Be Daily Headaches, But You Can Fight Back
So can migraines be daily headaches? As millions of unfortunate persons can testify, the answer is “yes.” If you hear otherwise, do more research, and you will find plenty more resources that back up the existence of daily migraines.
We have gone over a few possible explanations for why migraines might be a daily occurrence, and we have also talked about treatment ideas.
If you are in the throes of crushing agony every single day, you can feel like your life is over (I sure did).
But there are a lot of things you can try. If you are thorough and diligent and you stick with your logs and your treatments over a period of weeks or months, you hopefully will start to see some gradual improvements.
A journey of years to reach a point of functioning is no easy thing to commit to, but take it from someone who has walked that path and is still on it—the relief and the ability to reconnect with your life and what you love is absolutely worth it.