What Are Chronic Migraines?

When it comes to headaches, the only thing worse than a migraine is a migraine that keeps coming back. Painful, exhausting, and sometimes fully debilitating, chronic migraine is a condition that afflicts a percentage of the population.^1,3 Chronic migraines are headaches that occur on 15 days or more per month for three months or longer, with a minimum of eight days per month being headaches with migraine symptoms.^1,2,3,4 The reality for chronic migraine sufferers is that days without headaches are less common than days with them.^1,2,3 Chronic migraines often start out as less-frequent episodes that develop into a chronic condition;³ in fact, between 2.5 and 3% of those that experience episodic migraines will develop chronic migraines every year.^1,3

Migraine headaches are recurring headaches that present moderate to severe levels of pain, and are often pulsing or throbbing and localized on one side of the head.⁷ Migraine headaches can be accompanied by symptoms like weakness or nausea and may cause sensitivity to light and sound.⁷ Research indicates that there are a number of potential migraine triggers, including stress, flashing lights, caffeine consumption, hormonal changes, and lack of sleep.⁷ As mentioned above, if a person experiences headaches on upwards of 15 days per month for three months or longer, with a majority of those headaches presenting migraine symptoms, their migraines are considered chronic migraines.^1,2,3,4

Causes

Although research is still being done, there are a few recognized risk factors that may influence the likelihood that a person will develop chronic migraines. These elevated risk factors include having a mood disorder like depression, caffeine overconsumption, experiencing frequent nausea, ongoing disrupted sleep, and overusing acute medication.^1,3 Overusing medication meant to target headache pain is an important risk factor to call out here. Often, those who suffer from headaches or episodic migraines will turn to medications with barbiturates or narcotics to help manage headache pain.³ Over-consuming prescription medications, as well as overusing over-the-counter pain relievers like non-steroidal anti-inflammatories and acetaminophen, can cause a person to develop chronic headaches due to medication overuse.³

Striking the right balance when it comes to treating migraines—both chronic and episodic—is critical. Episodic migraines that are improperly managed or untreated can turn into chronic headaches with periodic migraine symptoms.⁶ In order to avoid triggering chronic migraines due to acute medication overuse while simultaneously avoiding triggering the onset of chronic migraines due to under-management, talk to your doctor about developing a migraine treatment plan.^4,6

Treatment

The approach to treating chronic migraines has many similarities to the approach to treating episodic, less-regular migraines.¹ While there is no cure for migraines, there are a number of methods for pain relief you can try.⁷ Drinking plenty of fluids, closing your eyes and resting in a dark and quiet room, and placing something cool on your forehead like a cloth or ice pack are all ways to help manage migraine pain.^7,8

Taking pain-relieving medication during a migraine attack, known as acute treatment, or taking preventative pain relievers are also options to help manage or prevent migraine symptoms.⁸ As mentioned above, however, it’s important not to overuse acute medication, as this can result in more serious issues.^1,6 Talk to your doctor about pain relief medication options and how frequently you should be taking them for your headaches and migraines.

Long-Term Care

For migraine headaches that are an ongoing issue, it’s important to understand the options when it comes to long-term chronic migraine care. While studies are still ongoing, alternative medicine presents some nontraditional therapies that may help a person manage the pain that accompanies chronic migraines.

Nontraditional methods for managing chronic migraine pain include:

• Some vitamins, minerals, and herbal treatments^7,8
  High doses of vitamin B2 (riboflavin) have shown to help prevent migraine symptoms and/or reduce headache frequency. Some studies are testing the use of coenzyme Q10 supplements and magnesium supplements to help treat migraine symptoms, although research is still ongoing. Feverfew (Tanacetum parthenium) and butterbur are two herbs that have also indicated potential migraine symptom-relieving effects. Talk to your doctor or healthcare provider before trying any vitamin, mineral, or herbal supplements for chronic migraine relief.
• Acupuncture⁸
  Acupuncture treatments—the insertion of thin needles into strategic points of the body—have shown some evidence for being helpful in relieving headache pain.
• Cognitive behavioral therapy (CBT)⁸
  CBT is a type of psychotherapy that helps a person understand how the perception of pain can be influenced by thoughts and behavior. Some have found this therapy helpful in managing chronic migraines.
• Biofeedback^7,8
  Biofeedback is a relaxation technique that can help a person track and control physical responses to stress and has been shown to be helpful in relieving migraine pain.

Lifestyle Changes to Help with Migraines

Beyond these non-traditional treatment options, making lifestyle modifications can also prove effective in managing migraine pain. Here are some ways you can make changes to your day-to-day to help with migraines:

• Practicing stress management techniques. Schedule periods of time throughout your day that include relaxation strategies, such as taking slow, deep breaths, stretching, or even laying down in a dark, quiet room. These strategies can help alleviate stress, which could help prevent migraines.⁹
• Getting regular exercise. For example, you could incorporate at least 30 minutes of aerobic exercise 2 – 3 times a week such as running or biking. These types of exercises can help to reduce the frequency and/or severity of migraine.⁹
• Making sure to eat and sleep consistently. Do your best to eat meals on a regular basis, while avoiding trigger foods and medicines, and skipping any meals. Eating a good, healthy breakfast is a great way to start off your day. Also, ensure that regular sleep is a part of your daily routine, as a good night’s rest can help reduce the frequency of a migraine.⁹
• Trying hormone therapy if migraines are linked to your menstrual cycle. Estrogen level changes, especially rapid fluctuations in estrogen levels can trigger migraines.⁹
• Losing weight if you have obesity are a few ways to help prevent migraines.^5,7,8

We hope this article has helped you understand chronic migraines and their potential causes, symptoms, treatment, and long-term care options. For more information on migraines, check out our resources on migraine causes, migraine prevention, and migraine treatment.