Treatment of Chronic Headache: Modern Approaches and Methods
Dr. Amr Hosny is a Board Certified, Harvard trained, Interventional Spine Specialist, who helps patients relieve their pain, recover from injury, and get back to their normal lifestyle without surgery, as fast as possible. After completing his residency at St. Luke’s Roosevelt Hospital Center, Columbia University in... more
Chronic headache (CHP) is a condition that causes constant or recurring headaches over a long period. This can significantly reduce a person's quality of life, affecting their performance, sleep, and general well-being. Chronic headache is not an independent disease but a simultaneous symptom of various conditions.
Diagnosis of chronic headache
The diagnosis of chronic headache includes several stages that allow the doctor to accurately determine the nature of the pain and prescribe appropriate treatment. The first and most important step is taking a history, where the doctor gathers information about the pain's type, duration, intensity, and causative factors. The doctor will also be aware of symptoms such as nausea, vomiting, or photophobia.
A physical examination can help identify possible muscle tension, tender areas, or other issues. The doctor examines the patient's head, neck, and shoulders to assess the condition of these areas.
A neurological examination includes tests of reflexes, hearing, coordination, and other nervous system functions. This step is important to rule out neurological diseases that can cause chronic headaches.
Imaging studies such as MRI or CT scans may be ordered to rule out organic abnormalities such as tumors, aneurysms, or structural changes in the brain. These studies provide detailed images of brain and neck structures.
Methods for treating chronic headaches
Chronic headache treatment is to relieve symptoms and prevent new attacks. This may include medication, physical therapy, lifestyle changes, and psychological support.
Medications
Medical treatment for chronic headaches may include pain relievers, antidepressants, anticonvulsants, and beta blockers. Pain relievers such as non-steroidal anti-inflammatory drugs (NSAIDs) are used to relieve acute pain attacks. However, it is important not to use them too often, as they can cause medication-related headaches.
Antidepressants such as amitriptyline can be effective in reducing the frequency and intensity of headaches, especially if they are accompanied by stress or depression. Anticonvulsants can also be used to prevent migraines and other types of chronic headaches.
Beta-blockers can help reduce the frequency of migraine attacks by stabilizing blood levels. In some cases, botulinum toxin injections are used to prevent chronic migraines, especially when other treatments have not been effective.
Physical therapy
Physical therapy plays an important role in the treatment of chronic headaches, especially if they are related to muscle tension or problems in the cervical spine. Massaging the neck relieves muscle tension and improves blood circulation, thereby relieving pain.
Neck and back exercises strengthen the muscles and improve spinal mobility, which can reduce the frequency and intensity of headaches. Electrical stimulation uses electrical impulses to relieve pain by stimulating nerves and muscles.
Psychological support
Psychotherapeutic methods are also of great importance in the treatment of chronic headaches, especially if they are associated with psycho-emotional factors. Cognitive behavioral therapy (CBT) helps patients change negative thoughts and behaviors that can lead to pain.
Relaxation techniques such as meditation, breathing exercises, or yoga can help reduce stress and tension, which can reduce the frequency of pain attacks. With biofeedback, patients can monitor physiological processes such as muscle tension or heart rate that help manage pain.
Lifestyle changes
Lifestyle changes are also important in treating chronic headaches. Regular and adequate sleep helps prevent headaches. It is recommended to go to bed and get up at the same time, avoid daytime sleep, and monitor the quality of night sleep.
A healthy diet with all the necessary vitamins and minerals is important. Foods that can trigger headaches, such as caffeine, chocolate, and alcohol, should be avoided. Regular physical activity improves general well-being and reduces stress levels, thereby reducing the frequency of headaches.
Prevention
It is important to control the triggers that can lead to attacks to prevent chronic headaches. Keeping a headache diary can help you identify and avoid such triggers. Regular medical examinations are important to monitor the condition and adjust the treatment in a timely manner.
