CDHDiagnosis & Treatment for Chronic Daily Headaches (CDH)

Overuse of Medication can Worsen Headache Pain

At New Jersey Headache Institute we often treat patients that suffer constant headaches, which are referred to Chronic Daily Headaches, or CDH. 

CDH, is used loosely to describe any recurring headache that occurs more than 15 times in a month and that is not associated with another disorder or disease. It encompasses chronic tension-type headaches (CTTH), chronic migraines (CM), and transformed migraines (TM). One of our specialities at New Jersey Headache Institute is to provide expert headache treatment for CDH.

It is believed that medication overuse is present in more than 80% of chronic daily headache cases, but they can develop without it. Transformed migraines and chronic migraines develop in patients with history of episodic migraines. The majority of patients are women who have suffered from migraines since their teens or twenties. Patients commonly experience an increase in headache frequency that develops over several months or sometimes years. 

At New Jersey Headache Institute we have sen that the occurrence of related symptoms like nausea, photophobia and phonophobia decreases as the chronic nature of the headache develops. Family history of headaches, anxiety, depression, bipolar disorders, panic disorders, alcohol abuse and fibromyalgia are common among patients with transformed migraines and chronic migraines. 

Among transformed migraines patients, 80% also have depression. Near daily chronic tension-type headaches tend to develop in patients who suffer from episodic tension-type headaches (ETTH) which occur fewer than 15 times a month.

If you are suffering from Chronic Daily Headaches, New Jersey Headache Institute can help. Contact us for an initial consultation.

Chronic tension-type headaches are diffuse and affect the posterior of the head and neck. Drug overuse is very common among chronic daily headache patients and is sometimes the cause of the condition. The most overused medications are analgesics, ergotamines and opiates. The overuse of medication produces a rebound headache. Over time a dependence to the medication develops. The most common pattern involves patients with episodic migraines that convert to transformed migraines through medication overuse.

Chronic Daily Headache Treatment May Include Behavioral Counseling

A treatment plan for a chronic daily headache patient must account for any associated psychological or behavioral conditions. This may call for psychotherapy and behavioral counseling and education.  

Lifestyle changes can be implemented, in particular exercise and sleep habits should be investigated. Preventative medications may could include beta blockers, calcium channel blockers, antidepressants and anticonvulsants. These can be prescribed individually or in combination depending on patient need. 

When medication overuse is the culprit, the priority is to discontinue use of the causative medication. Precautions should be taken for any withdrawal symptoms the patient may experience. A gradual withdrawal from the medication, stretched over several weeks, is the best approach to reduce withdrawal symptoms. During this withdrawal the need for anti-inflammatories, like NSAIDS or steroids, may arise.

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