Constant Headaches: Why You Have a Headache Every Day

Why do I have a headache every day?

Doctors use the term chronic daily headache for a headache on 15 or more days a month, for more than three months.¹ It is not rare. A worldwide analysis put the proportion of adults with headache on 15 or more days a month at 4.6 per cent.²

It is a description, not a diagnosis. The useful question is which type of headache is behind it.

The main types of constant headache

Chronic migraine

Headache on at least 15 days a month, with migraine features on at least eight of them, such as throbbing, nausea, and sensitivity to light and sound. It affects about 2 per cent of people, and usually develops gradually, with attacks becoming more frequent over months or years.³ See migraine symptoms.

Chronic tension-type headache

A pressing, band-like ache on both sides of the head, mild to moderate, without the vomiting or strong light sensitivity of migraine, that is present on most days.¹ See tension headache.

Medication overuse headache

Taking pain medicines for headache too often can make headaches more frequent and turn an occasional headache into a daily one. It affects between 1 and 2 per cent of the population, and it is more common in women and in people who also have depression, anxiety or other long-term pain.⁴

It is defined as headache on 15 or more days a month in someone who has taken headache medicines on 10 to 15 or more days a month, depending on the type, for over three months.¹ Treatment starts with understanding what is going on and cutting back, with your doctor’s help.⁴

New daily persistent headache

An uncommon type that starts abruptly, often in someone without a history of frequent headaches, and doesn’t let up. People can often name the exact day it began. It needs a medical assessment to rule out other causes.⁵

Other things that keep headaches going

• Poor sleep and sleep apnoea. Sleep apnoea causes headaches on waking, on most days of the week.⁶ See waking up with a headache and sleep apnoea
• Caffeine. Both large amounts and withdrawal can cause headaches.⁶ In a population study, high caffeine intake was a modest risk factor for developing daily headaches⁷
• Jaw clenching and teeth grinding. See TMJ and jaw pain
• Neck problems. See neck pain
• Stress, anxiety and low mood. Depression is one of the strongest predictors of episodic migraine becoming chronic⁸
• Not drinking enough water, and skipped meals⁶

Who is at risk?

A systematic review found that the factors most strongly linked with migraine becoming chronic were already having frequent headaches, depression, and frequent use of headache medicines.⁸ In an American population study, obesity was also linked with the onset of daily headaches.⁹

The same study carried good news. Daily headache is not a life sentence. Within a year, more than half of the people who had it had dropped back below that level.⁹

Could it be a brain tumour?

This is the fear behind many visits to the doctor, and the numbers are reassuring. In a British study of primary care records, the chance that a headache with no other symptoms was due to a brain tumour was 0.09 per cent, or less than 1 in 1,000. The authors concluded that headache alone carries too small a risk to justify a scan at the first visit.¹⁰

Tumours usually announce themselves with something else as well: a seizure, weakness, confusion, memory loss or a change in vision.¹⁰ Most people with daily headaches and a normal examination don’t need a brain scan. Your doctor will look for the warning signs below to decide.

What you can do

• Keep a headache diary for a month. Note the days, the features, and every dose of pain relief. It is the most useful thing you can take to an appointment⁶
• Count your medicine days. Aim for no more than two or three days a week
• Steady your caffeine. Reduce gradually to avoid withdrawal headaches
• Keep sleep and meals regular, and drink enough water⁶
• Move. Regular exercise helps prevent migraine and eases neck and shoulder tension
• Ask about prevention. For chronic migraine and chronic tension-type headache there are preventive treatments, both medicines and non-medicine approaches, that reduce how often headaches occur

See also how to get rid of a headache.

When to get urgent help

Call triple zero (000) or go to an emergency department for:⁶

• A sudden, severe headache
• A headache with fever, vomiting, a stiff neck, confusion or a change in vision

When to see a doctor

See your doctor if headaches are frequent or you often need pain relief for them.⁶ Go sooner if a headache:^6,11

• Is new and has been getting steadily worse over weeks
• Is different from any headache you have had before
• Wakes you from sleep, or is worse lying down, coughing or straining
• Began after a head injury
• Comes with weakness, numbness, trouble speaking or a seizure
• Is new and you are over 65, pregnant, or have cancer or a weakened immune system

References

1. . Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cephalalgia. 2018;38(1):1-211.
2. Stovner LJ, Hagen K, Linde M, et al. The global prevalence of headache: an update, with analysis of the influences of methodological factors on prevalence estimates. J Headache Pain. 2022;23(1):34.
3. Schwedt TJ. Chronic migraine. BMJ. 2014;348:g1416.
4. Diener HC, Dodick D, Evers S, et al. Pathophysiology, prevention, and treatment of medication overuse headache. Lancet Neurol. 2019;18(9):891-902.
5. Yamani N, Olesen J. New daily persistent headache: a systematic review on an enigmatic disorder. J Headache Pain. 2019;20(1):80.
6. healthdirect. Headaches.
7. Scher AI, Stewart WF, Lipton RB. Caffeine as a risk factor for chronic daily headache: a population-based study. Neurology. 2004;63(11):2022-7.
8. Buse DC, Greisman JD, Baigi K, et al. Migraine Progression: A Systematic Review. Headache. 2019;59(3):306-338.
9. Scher AI, Stewart WF, Ricci JA, et al. Factors associated with the onset and remission of chronic daily headache in a population-based study. Pain. 2003;106(1-2):81-9.
10. Hamilton W, Kernick D. Clinical features of primary brain tumours: a case-control study using electronic primary care records. Br J Gen Pract. 2007;57(542):695-9.
11. Do TP, Remmers A, Schytz HW, et al. Red and orange flags for secondary headaches in clinical practice: SNNOOP10 list. Neurology. 2019;92(3):134-144.