11 Oct What Causes Continuous Headache for Days?
New daily persistent headache (NDPH) is a type of a headache occurring in individuals who do not have a history of a frequent headache. NDPH causes a continuous headache for days. This can lead to a headache that causes constant pain. With a continuous headache that lasts for days, the patients often find it difficult to function in daily life.
NDPH is often headache that lasts for more than 15 days each month for more than 3 months. These headaches can result in lost days at work, recurrent, intractable pain that is of a persistent nature, and a headache that also is associated with nausea and vomiting. NDPH affects around 0.5-1% of the general population.
Only two population clinical studies have been performed due to NDPH. In these studies, researchers found that the peak onset of daily persistent headache was in the 2nd and 3rd decades of life. In addition, the female to male ratio was 2.6:1. In one study, 42% of patients reported that they remembered the exact day of the onset of a headache. In addition, 46% recalled the specific trigger or stressful life event that brought on the headache.
Causes of Continuous Headaches
There are several theories related to the causes of persistent daily headaches. If you have headaches every day and are tired, consider one of these possible causes:
- Viruses – Several clinical studies have shown that constant headaches or NDPH are linked to viruses, such as the herpes simplex virus, cytomegalovirus, and Ebstein Barr virus.
- Past history of a headache – In a large study regarding NDPH, researchers found that 38% of participants had a past history of episodic migraines or tension-type headaches. Another study showed that 25% of patients had a history of headache disorders. Half of study participants had a family history of frequent headaches.
- Cervical spine joint hypermobility – This is thought to be a contributing factor to NDPH. The headaches spur from the continuous pain.
- Inflammation – In the nervous system, infection and inflammation can contribute to constant headaches.
- Triggers – Too much caffeine, alcohol, and certain foods may contribute to daily headaches. In addition, emotional stress is known to cause persistent headaches.
Treatment Options
If you are suffering from a new daily persistent headache (NDPH), or if you have a recurring migraine or a tension-type headache, you may want to consider these treatment options:
- Medications – Certain antidepressants and anticonvulsants are used to suppress persistent headaches. In addition, abortive agents are used to stopping the headaches, such as Imitrex and Amerge. For severe pain, the doctor may prescribe an opioid analgesic or tramadol.
- Trigger point injections – Along the posterior spine, the trigger points can be injected to stop/prevent headaches. This is done using an anesthetic (lidocaine or bupivacaine). In addition, the trigger points can be deactivated, which means the pain stops.
- Botox injections – For chronic migraines, Botox is used. The doctor injects the neck, forehead, and other regions using botulinum toxin type A.
- Sphenopalatine ganglion block – This involves insertion of a catheter through a nostril to instill a blocking agent onto the sphenopalatine ganglion nerve bundle. The medication will stop pain signal transmission.
New daily persistent headache (NDPH) is a chronic headache developing in a person who does not have a past history of headaches. A headache begins acutely and reaches its peak within 3 days. It is important to exclude secondary causes, particularly headaches due to alterations in cerebrospinal fluid (CSF) pressure and volume. A significant proportion of NDPH sufferers may have intractable headaches that are refractory to treatment. The condition is best viewed as a syndrome rather than a diagnosis. A headache can mimic a chronic migraine and chronic tension-type headache, and it is also important to exclude secondary causes, particularly headaches due to alterations in CSF pressure and volume. A large proportion of NDPH sufferers have migrainous features to their headache and should be managed with treatments used for treating migraine. A small group of NDPH sufferers may have intractable headaches that are refractory to treatment.
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