Warning Signs of a Persistent Headache

As a Pain Doctor will tell you: “nearly everyone has had headache pain, and most of us have had it many times. But if your headache is severe or unusual, you might worry about stroke, a tumour, or a blood clot. Fortunately, such problems are rare. Still, you should know when a headache needs urgent care, and how to control the vast majority of headaches that are not threatening to health” [1]

Signs of a Daily Persistent Headache

These headaches suddenly appear, and generally speaking, only affect those who do not have a headache history. Persistent headaches become constant within three days of the first headache. They:
• Frequently impact both sides of the head
• Generate a type of pain that feels like tightening or pressing (but not pulsating)
• Bring about mild to moderate pain
• Could include features of chronic tension-type headache or chronic migraine [2]

The Low-Down on Persistent Chronic Headaches

Unlike a particular category of headache, chronic (long-term) daily headaches incorporate an assortment of various headache subtypes.

“The constant nature of chronic daily headaches makes them one of the most disabling headache conditions. Aggressive initial treatment and steady, long-term management might reduce pain and lead to fewer headaches” [2], so booking an in-person or online appointment with a Pain Doctor who will devise a Personalised Treatment Plan, is the smart way to go

Chronic daily headaches refer to headaches that last for 15 days or longer per month (over a period of three months or more). Furthermore, there are long-lasting and short-lasting chronic daily headaches. The former last for over four hours [2]. Of note, Pain Doctors are able to treat both categories of headache. Treatment can include: tricyclic antidepressants, beta blockers, anti-seizure medications, NSAIDs, botulinum toxin (botox), and more.

Chronic daily headaches include:
• Long-term migraine
• Long-term tension-type headaches
• Having a new persistent headache that occurs every day
• Hemicrania continua (a persistent and chronic type of headache involving non-stop pain with varying degrees of severity. It always occurs on the same side of the head and face. Some people experience pain on both sides of their head) [2]

Warning Headache Symptoms You Should Report to a Pain Specialist
• Headaches which only start to develop after 50 years of age
• Experiencing a major change in your headache pattern
• Feeling an unusually intense headache
• Head pain which gets worse if you move or cough
• Headaches which become steadily worse
• Changes in mental function or personality
• Headaches which arise simultaneously with seizures, numbness, weakness, slurred speech, neurological symptoms (for example, visual disturbances), decreased memory or alertness, confusion, stiff neck, or fever
• Headaches which occur at the same time as a painful red eye
• Headaches which come about when you feel pain and tenderness close the temples
• Headaches after you have had blow to your head
• Headaches which stop you from carrying out your regular daily activities
• Headaches which suddenly appear, particularly when you’re sleeping, and get woken up by them
• Headaches in patients who are suffering from an impaired immune system or cancer [1]

Seek immediate medical care from your Pain Doctor if your headache:
• Has suddenly appeared, and feels severe
• Is accompanied by difficulty speaking, numbness, weakness, double vision, seizure, confusion, a stiff neck, or a fever
• Comes on after a head injury
• Becomes worse regardless of taking pain medication, and having sufficient rest [2]

[1]. Harvard Education (2020). “Understanding what causes headaches and finding treatments to relieve the pain”

[2]. Mayo Clinic (2024). “Chronic Daily Headaches.”