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Neurological Treatments For Persistent Headaches

Headaches & Migraines

Headaches are common - nearly everyone experiences one from time to time. And while most headaches do not pose a serious health concern, chronic daily headaches or headaches that come on suddenly or with particular intensity might be a sign of a more significant neurological issue.

Migraines are a specific type of headache that can be severe and debilitating in nature and affect more than 12 percent of the U.S. adult population. When migraines are recurring, that's when patients typically seek out help from a neurological specialist.

There Are Many Types Of Headaches

While it can sometimes be hard to identify, chronic headaches can fall into many categories including:

Migraine Headaches

Notable by their length and intensity. Can last for hours or days with an intense throbbing sensation on one side of the head.

Tension-Type Headaches  From Muscle Tension

The most common type of headache, caused by muscle contractions in the neck or shoulders in response to stress or anxiety.

Occipital Neuralgia

A rare neurological condition with shooting, throbbing or burning pain at the base of the head spreading along the scalp.

Chronic Daily Headaches

Short or long in duration, chronic daily headaches occur 15 days or more a month, for longer than 3 months.

Cervicogentic Headaches

Unilateral pain starting at the neck radiating around to the forehead, eyes and ears, can be due to a fall, whiplash or arthritis.

Hypnic Headaches

Called "alarm clock headaches" because they occur nightly at the same time, waking you up. Most common in older women.

Medication Overuse Headaches (MOH)

Caused by taking headache medication too frequently for more than 3 months to relieve ongoing symptoms of a primary headache.

Post Traumatic Concussion Headaches

Often short term and associated with mild brain injury, this type can include trouble with balance, memory and sleep.

Cluster Headaches

Usually identified by severe pain on one side of the head, including behind the eyes. Can persist daily for weeks or months.

Premenstral Headaches

Can happen before or during a menstrual cycle with throbbing pain, light sensitivity, and nausea due to a drop in estrogen hormone.

Systemic Illness Headaches

Headaches caused by a systemic illness related to a vascular, infectious or inflammatory disorder such as lupus or meningitis.

Phases Of A Migraine Headache

Migraine attacks can happen in four stages, but everyone's migraine is different. You might only go through a few of them.

Premonitory Phase

Aura Phase

Headache Phase

Postdrome Phase

Nonpainful symptoms hours or days before

  • unexplainable mood changes

  • food cravings

  • stiffness of the neck

  • frequent yawning

  • constipation or diarrhea

  • sensitivity to light, sound, or smells

Sensory disturbances before or during the attack

  • flashing lights

  • zigzagging lines

  • blurred vision

  • blind spots that expand over time

  • speech problems

  • comprehension issues

  • cognitive difficulties

Intense throbbing pain with environmental sensitivity

  • nausea

  • vomiting

  • ringing in ears

  • neck or shoulder pain

  • sensitivity to light

  • sensitivity to sound

  • irritable

After the migraine headache subsides

  • weakness

  • confused

  • feeling unwell/drained

  • difficulty concentrating

  • dizziness

  • numbness

  • "hungover"


Diagnosing Chronic Headaches

A physical exam and other scans may be performed to rule out any other health issues that can present similarly to migraines and headaches. If you have a family history of migraines or have had several or severe episodes, you will likely be referred to a neurologist who specializes in various brain conditions including migraines.

If you've been relying heavily on over-the-counter pain meds for your headaches, it's important to know that overuse can actually make migraines worse in the long run. It may even make you unresponsive to various treatment options. 

Doctor in Scrubs Reading Notes.webp
Image by Alexandr Podvalny

Treatment Options for Chronic Headaches

Finding what works for you is key. Over-the-counter pain relievers and lifestyle changes like exercise and a healthy diet can be great at keeping migraines at bay. But for those tougher headaches where these aren't enough, there are prescription medications that might be a good fit.

Medications come in two flavors. There are ones that target a migraine when it strikes, and others that try to prevent them altogether, or at least make them less frequent and severe. Your doctor can help you decide which option is right for you.

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