Troubleshooting constant headaches

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Almost everyone gets a headache from time to time. Some people, though, get them daily or almost every day. This problem is known as chronic daily headache. Women are twice as likely as men to have it.

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Headaches inflict their misery in a variety of ways, from a dull, steady ache to a blinding, throbbing pain. Nearly everyone has them at least occasionally, but an unfortunate few experience near-constant head pain. This report offers in-depth information on the most common kinds of headaches and the treatment strategies that work best for each, including a number of self-help and alternative techniques.

People with this condition get headaches every day or nearly every day for a prolonged period of time — for example, at least five days a week for a year or longer. Most often, chronic daily headache develops in people who used to get the occasional migraine, tension headache, or other type of headache. Sometimes chronic daily headache develops without any preamble or warning.

No matter how it originates, chronic daily headache is notoriously difficult to treat and, understandably, often produces anxiety and depression.

Getting control of chronic daily headaches often means weaning off regular use of pain relievers. Consider other methods to help ease headache pain, too. For example, try a cool compress on the forehead or a heating pad on tight muscles in the neck. You may want to ask your doctor to send you to a physical therapist. Techniques such as massage, ultrasound, and relaxation exercises may also help keep headaches at bay.

Preventive medications are a good choice for some people. Examples include a tricyclic antidepressant such as amitriptyline (Elavil) or nortriptyline (Pamelor, Aventyl), a beta blocker such as propranolol (Inderal) or nadolol (Corgard), or gabapentin (Neurontin). For some people who suffer with chronic daily headaches, other medications may be necessary. As with many chronic conditions, it is important to work closely with your doctor to find the preventive and treatment strategies that work for you.

For more on preventing and treating headaches, buy Headaches, a Special Health Report from Harvard Medical School.

4 ways to tame tension headaches

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A tension headache can put a damper on your day. This kind of headache usually develops in the afternoon, causing mild or moderate pain that may feel like dull tightness or a band of pressure. Tension headaches occur when neck, shoulder, and scalp muscles become tense. Some people experience tension headaches from time to time; others get them more often. While this type of headache is rarely debilitating, it can certainly make life miserable.

If you have frequent tension headaches (more often than once or twice a week), here are some strategies that can help you prevent them:

Pay attention to the basics. Get enough sleep, don't skip meals, and be sure to pace yourself to avoid stress and fatigue.
Relaxation techniques. Physical and psychological relaxation therapies can help stave off tension headaches, so long as you practice these techniques regularly. Physical approaches include applying a heating pad to your neck and shoulders to relax the muscles. Exercising these muscles also helps by strengthening and stretching them. Guided imagery exercises that help you focus your attention on various parts of your body in order to relax them and release tension and stress can also help.
Biofeedback. This relaxation technique requires special training but can help people avoid recurrent tension headaches. Typically, a therapist will attach electrodes to your skin to detect electrical signals from your neck and shoulder muscles. You then learn to recognize when you are becoming tense and practice ways to relax the muscles before they tighten so much that you develop a tension headache.
Medical approaches. Some people with tension headaches have very sensitive areas, known as trigger points, at the back of the neck or in the shoulders. Injecting a local anesthetic into these areas may eliminate the pain and prevent the headache from occurring again. There are also a number of medications that can help keep tension headaches at bay. If non-drug therapies aren't giving you the relief you need, talk with your doctor about the medication options that might be right for you.

For more information on preventing, diagnosing, and treating headaches, buy Headaches: Relieving and preventing migraines and other headaches, a Special Health Report from Harvard Medical School.

Headaches

Featured content:

•	Headache basics
•	Self-help and alternative strategies to ease headache pain
•	Tension headache
•	Migraine headache
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