Why Do I Keep Getting Headaches Every Day?

While the exact trigger for chronic headaches can be elusive, some factors are believed to be significant contributors, including:

1- Trigeminal Nerve Activation: Chronic headaches can be linked to malfunctions in the trigeminal nerve, responsible for relaying feeling sensations from your face and head to your brain.

2- Muscle Tension: Tightening of head and neck muscles creates tension that often leads to headache pain.

3- Hormonal Changes: Fluctuations in hormone levels, such as estrogen, are linked to certain headache types, particularly migraines, which are more prevalent in women.

4- Genetic Predisposition: Our genes can influence how susceptible we are to developing chronic headaches, including migraines.

5- Environmental and Lifestyle Factors: Headaches can also be triggered or worsened by lifestyle and environmental factors:

• Stress
• Sleep Irregularities
• Dietary Habits
• Physical Strain
• Weather Changes
• Emotional Factors

Dr. Miguel Ley Nacher follows a streamlined process:

1- Medical History

• Assessment: Your doctor will ask about your headache patterns (frequency, duration, location, and type).
• Triggers: They’ll explore if headaches coincide with specific activities or times of day.
• Symptoms: Any accompanying symptoms, such as nausea, sensitivity to light or sound, or visual disturbances, will be noted.
• Family History: Information on family members experiencing similar headaches, particularly migraines, will be discussed.
• Medications: Your current medications, including over-the-counter remedies, will be reviewed.

2- Physical Examination

• Focused Examination: The doctor will perform a physical exam to check for signs of underlying conditions contributing to headaches.
• Neurological Assessment: This may include testing reflexes, sensation, and muscle strength to evaluate nerve function.

3- Diagnostic Testing

• Imaging: CT scans or MRIs may be ordered to rule out structural issues like tumors or abnormalities.
• Laboratory Tests: Typically reserved for cases where an infection or another medical condition is suspected based on symptoms.

4- Differential Diagnosis

• Ruling Out Secondary Causes: Conditions such as infections (meningitis, encephalitis), sleep disorders (like obstructive sleep apnea), seizures, traumatic brain injury, or exposure to toxins will be considered and evaluated accordingly.

Treating Chronic Headaches

Chronic headaches, whether they are tension-type headaches, migraines, or cluster headaches, can significantly impact daily life and require personalized treatment approaches. 

Here’s a detailed look at various treatment options available, categorized into medications, non-medication therapies, and lifestyle changes:

1- Medications

Medications play a crucial role in both preventing and treating constant headaches. Your doctor will recommend specific medicines based on the type and severity of your headaches:

Preventive Medications:

• Tricyclic Antidepressants: Such as amitriptyline and nortriptyline, not only prevent headaches but can also help manage associated anxiety or depression.
• Antiseizure Medications: Examples include gabapentin and topiramate, which effectively prevent migraines and other chronic headaches.
• Beta-Blockers: propranolol and metoprolol, have shown promise in reducing how often and how severe migraines and tension headaches occur.
• Monoclonal Antibodies: Newer treatments like erenumab, fremanezumab, and galcanezumab precisely target calcitonin gene-related peptides to prevent migraine attacks.
• Other Medications: Calcium channel blockers like verapamil or mood stabilizers like lithium may be used to prevent cluster headaches.

Acute Treatment Medications:

• Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Headaches on the milder side can often be managed with common pain relievers like ibuprofen and naproxen.
• Triptans: Specifically designed for migraines, medications like sumatriptan and rizatriptan target the issue at its source. They achieve this by constricting blood vessels and blocking the pathways that transmit pain signals.
• Ergot Derivatives: Like dihydroergotamine, which can be effective for treating migraines and cluster headaches.

2- Non-Medication Therapies

In addition to medications, non-medication therapies can complement treatment plans and improve overall headache management:

Therapy:

• Cognitive Behavioral Therapy (CBT): Helps individuals understand and cope with chronic headaches’ emotional and psychological impacts.
• Support Groups: Chronic headaches can feel isolating, but support groups can connect you with others who understand. Here, you’ll gain emotional encouragement and share coping mechanisms to navigate daily life.
• Biofeedback: Biofeedback utilizes monitoring tools to track functions like muscle tension and heart rate. This feedback loop empowers individuals to learn how to manage these responses and potentially prevent headaches.  

Nerve Stimulation:

• Occipital Nerve Stimulation: Involves electrical impulses targeting the occipital nerves to alleviate migraine pain.
• Vagus Nerve Stimulation: This can effectively treat cluster headaches by modulating pain pathways.

Acupuncture: 

• Thin needles are inserted at targeted points on the body, promoting relaxation and potentially reducing headaches.

Massage: 

• It helps reduce muscle tension and promotes relaxation, potentially alleviating tension headaches.

Supplements: 

• Butterbur and feverfew are herbal supplements showing promise in reducing how often and how severely migraines strike for some people.

3- Lifestyle Changes

Making lifestyle adjustments can also contribute significantly to managing constant headaches:

• Identifying and Avoiding Triggers: Certain foods (e.g., processed meats, aged cheese), strong odors, or environmental factors (e.g., bright lights, loud noises).
• Ensuring adequate and consistent sleep hygiene can help prevent headaches.
• Eating meals regularly and staying hydrated can prevent hunger and dehydration headaches.
• Techniques such as mindfulness, relaxation exercises, or yoga can reduce stress levels and minimize headache triggers.
• Engaging in physical activity boosts endorphin levels and enhances overall well-being, which may contribute to reducing the frequency of headaches. Both can trigger headaches in susceptible individuals, so moderation or avoidance may be beneficial.
• Smoking can exacerbate headaches and other health conditions, so quitting can lead to overall improvement in health.