1. Treat the Underlying Disease or Condition
A headache is considered "chronic" if it occurs more than 15 days a month for at least 3 months. Many of these headaches are caused by underlying diseases and conditions, such as infections, problems with intercranial pressure, brain tumors, pinched nerves in the neck, problems with blood vessels in the brain or traumatic brain injuries. If these conditions can be treated successfully, the chronic headaches typically go away completely. It's important to get evaluated by a physician to see if the cause of your chronic headaches can be pinpointed and treated. For most chronic headaches, however, there is no underlying disease or condition.
2. Use Preventative Medications
Most treatment for chronic headaches uses preventative medications to alleviate pain. Tricyclic antidepressants are the most common drugs prescribed. Depression, anxiety and sleep disorders often accompany chronic headaches, and these drugs treat all of them. If the antidepressants don't work, selective serotonin reuptake inhibitors (SSRIs) may be helpful.
Beta blockers and some anti-convulsants are also used to treat chronic headaches preventatively. Beta blockers are a common preventative migraine medication, and they are sometimes used with antidepressants when treating chronic headaches. Nonsteroidal anti-inflammatory drugs (NSAIDs) are also prescribed on occasion for preventative treatments, particularly if your chronic headaches are caused by medication overuse and you are withdrawing from pain relievers. Injections of steroids and a numbing agent at a trigger point and nerve-blocking injections can also be used to prevent chronic headaches.
3. Avoid Medication Overuse
One of the main causes of chronic headaches is medication overuse. In such cases, episodic tension headaches or migraines can transform into chronic headaches, also called rebound headaches, if you consistently use pain relievers more than two or three times a week. This can be difficult to avoid if you suffer from frequent headaches, but varying the type of medication you use to treat acute headaches can reduce your risk of developing rebound headaches.
4. Keep a Headache Journal
Determine what triggers your headaches, and then avoid those triggers by keeping a headache journal. Note everything you do throughout each day, recording what you ate, when you slept, what you were doing when you got the headache, how the headache felt and how you tried to get rid of it. Over time, you may be able to point to certain common causes of your headaches and steer clear of them.
5. Make Lifestyle Changes
Living a more routine, healthy lifestyle can reduce chronic headaches for some people. This includes maintaining a regular exercise schedule, eating regular meals of nutritious foods, avoiding potential triggers, such as alcohol, cigarettes and caffeine, and maintaining a consistent sleep schedule. Relaxation and stress management strategies, including meditation, yoga and counseling, can help keep your mood even and prevent chronic headaches. Unfortunately, for some people there may be no reliable treatment for chronic headaches.
