Constant Headache – Causes of Persistent, Continuous Headaches

What is a Constant Headache?

A headache is one of the more common symptoms experienced in life and is usually episodic. Constant headaches are considered as any head pain that does not subside for weeks or months. It can vary from severe pain to a dull ache. It may appear episodic but careful assessment will reveal that it is continuous (constant, persistent, non-stop, neverending). The the pain intensity may subside, although not resolve, for a period of time (hours or days) and then return to the full intensity.

These headaches may respond to analgesics (partial or complete pain relief), however, this does not change the nature of the headache – constant, continuous, persistent.

What is a Chronic Daily Headache?

A constant headache is not necessarily chronic in nature. Any headache, episodic or persistent, that lasts for a period of 3 months or more may be considered as chronic.

The term chronic daily headache is technically used for these types of headaches and the pain will usually be present for at least 15 days or more in a month. In order to conclusively diagnose a case of a chronic daily headache, it is advisable to keep a headache diary (record the frequency, possible trigger factors, day of menstrual cycle, pain intensity from 1 to 10 and duration) for a period of 3 to 6 months.

Clinical Significance of a Constant Headache

Any person suffering with a constant headache for a period of time may become frustrated. The continuous pain, range of tests and investigations and regular change in medication or the dosage can become tiresome. Questions arise as to whether a diagnosis is being missed or the focus on one possible cause is leading the clinician astray. Many medical practitioners will attribute a constant headache to psychological causes (depression, anxiety or imaginary) which leaves many a patient unsatisfied with the diagnosis.

A persistent headache without any neurological symptoms, no other obvious signs and symptoms or a lack of significant clinical findings of other disorders is unlikely associated with any serious medical disorder. Repeat tests, investigations and clinical evaluations by more than one medical practitioner is always recommended. This ensures that any developing condition is not missed either as a result of negative or inconclusive findings initially or due to a practitioner’s skill, or lack thereof.

A diagnostician may be required to work with your general practitioner and medical specialists (neurologist, physician, psychiatrist) in order to find the cause of the constant headache. Long term pain management may be the only option in dealing with a constant headache in some cases.

Causes of a Constant Headache

A continuous headache with no other significant signs or symptoms may be due to a number of causes. Associated features of the condition may be missed by the patient or practitioner or may appear at a later stage in the condition.

The conditions discuss below may account for constant headaches that have persisted for weeks or months, with NO signs and symptoms that would indicate a specific condition (neurological or other) and NO significant findings upon tests and investigations.

Tension-Type Headache

The most common cause of a constant headache is a tension-type headache (commonly referred to as tension headaches).  This type of headache may persist for weeks and in some cases, even for months. If it persists for more than 3 months, it may be considered as a chronic daily headache, or more specifically as a chronic tension-type headache.

While the trigger factors for tension-type headaches are common among sufferers, the exact cause is unknown. Two theories continue to persist about the possible cause :

  1. Increased muscle tension (head, neck and/or back muscles) as a result of overuse, strain or posture. Neck muscle spasm (also referred to as cervical muscle spasm) accounts for a large number of cases and the use of muscle relaxants, physical therapy and neck exercises appears to reduce the severity and temporarily resolve these type of headaches. It is possible that the muscle tension may not be a cause but a common feature found in most cases of tension-type headaches.
  2. Changes in brain hormones – serotonin, endorphins and other chemicals – for unknown reasons. These cases respond well to serotonin agonists like triptan, which was traditionally used for migraines and cluster headaches. The use of tricyclic antidepressants and selective-serotonin reuptake inhibitors prove to be effective in preventing a recurrence of these constant headaches. This does not mean that every case of a tension-type of headache is due to depression, anxiety, stress or other psychological causes.

NB : Excessive use of analgesics, particularly those containing codeine, will worsen this type of headache.

New Daily Persistent Headache

This is new category for primary headaches and is one of the types of chronic daily persistent headaches. It has features of migraines and tension-type headaches. The onset is sudden (over days, not minutes) and can persist for months, if not longer. There is some evidence to suggest that new daily persistent headaches may be linked to rebound headaches.

Rebound Headaches

These are headaches as a result of overuse of pain relieving medication. It is a vicious cycle as the sufferer tends to use analgesics in order to relieve the headache thereby perpetuating the pain. Other drugs like ergotamine which is used for migraines may also be responsible for rebound headaches.

Any chronic use of analgesics that is stopped for up to a week will often lead to improvment of the headache in a case of rebound headaches. The easy availability of OTC and scheduled analgesics plays a significant role in the increase of these type of headaches as the sufferer is often unable to understand the benefits of stopping analgesics or cannot tolerate the pain (headache) and has to use an analgesic.

Chronic Medication Headache

In these cases, a headache may be a side effect of a drug used to manage a chronic condition. The pain will persist until the medication is discontinued or replaced with other drugs.

Raised Intracranial Pressure

Any space-occupying pathology, whether a mass lesion (tumor, cyst) or fluid (cerebrospinal or edema), is referred to as raised intracranial pressure. When there is no mass present but raised intracranial pressure is due to poor drainage of CSF, this is known as idiopathic intracranial hypertension.

Raised intracranial pressure is often associated with a severe, sudden headache and serious neurological and other signs or symptoms like vomiting. However, this is not always the case especially in an instance where the increase in pressure is gradual (rising pressure). At times, a constant headache may be the first and only symptom present for a period of time before other signs and symptoms of raised intracranial pressure are evident.

There are certain features of a headache due to raised intracranial pressure :

  • Mild or dull headache which is continuous but responds well to analgesics.
  • Constant headache which is worse in the morning and improves through the day.
  • Pain worsens with bending forward, coughing and straining.

A sudden severe headache or ‘thunderclap’ headache is more likely due to a subarachnoid hemorrhage.

Facial Pain with Headache

There are a number of causes of head pain (head ~ face + cranium) but the most common causes include :

  • Temporomandibular TMJ dysfunction (jaw pain)
  • Dental pain
  • Sinusitis
  • Post-herpetic neuralgia
  • Atypical facial pain

Sometimes facial pain may be absent in these cases with just a headache persisting.

NB : Trigeminal neuralgia causes short episodes (not constant) of severe pain that is of a sudden onset.

CSF Leak and Post-Concussion Syndrome

CSF leak may be a slow leak of cerebrospinal fluid from a tear in the dura (outermost layer of the meninges surrounding the brain and spinal cord). Other symptoms like fluid from the ears and a runny nose may also be present. Trauma is a common cause.

Post-concussion syndrome may persist for prolonged periods after head trauma. Constant headaches may be present.

Age-Related Headache

This is more commonly seen in patients over the age of 60 years old. Giant cell arteritis, post-herpetic neuralgia, glaucoma and psychogenic causes should be investigated.

Hemicrania Continua

Although rare, hemicrania continua may be the cause of a continuous, one-sided headache and facial pain. The condition may be continuous, with daily headaches, or remitting, where the headache may last for up to 6 months.

In the latter form, there may be pain-free periods for weeks or months and then the headache recurs. Other signs and symptoms, usually one-sided, may often be present and it is common where this chronic condition is mistaken for other neurological and infectious causes of headaches.

Migraines

While this term is used loosely for severe and/or constant headaches, a migraine is usually not persistent. There may be repeat episodes (intermittent) but a continuous headache for days or weeks is unlikely a migraine type of headache.

It is possible for migraine sufferers to experience other types of headaches which may be longer lasting between migraine attacks. This contributes to the perception of a continuous migraine lasting for weeks or months. Chronic migraine or transformed migraine are not usually responsible for persistent headaches lasting for weeks or months which do not subside.

Hypertension Headache

The debate surrounding the link between high blood pressure (hypertension) and headaches have been persisting for decades. Not every hypertension patient will experience headaches as a result of the high blood pressure. Refer to Headache and Hypertension (Medscape).

Other Causes

There are other causes of a constant headache with no other signs and symptoms evident.

  • Cervicogenic headaches
  • Occipital neuralgia
  • Brain aneurysms – ‘leaking’ aneurysms
  • Female hormone disturbances
  • Depression or anxiety
  • Abuse – physical, sexual, emotional
  • Alcohol abuse
  • Narcotic drug addition
  • HIV/AIDS

Other Points to Consider

  • The presence of a fever should warrant further investigations for infections, particularly viral, where there is secondary headaches. Tropical infections should always be considered if there is a history of or onset after overseas travel.
  • Neurological conditions (or signs and symptoms) may present with secondary headaches and further investigations are necessary. Also refer to Headaches and Dizziness and Headache, Nausea and Vomiting.
  • Children complaining of headaches, whether constant or episodic, should always warrant further investigation. Children usually complain of abdominal pain, not headaches, as an attention-seeking mechanism.
  • Headaches in other chronic conditions like diabetes are a common feature.
  • Loss of weight, lack of appetite, fatigue and/or malaise with continuous headaches should not always be passed off as depression, even in the light of social and/or emotional circumstances. Many chronic and terminal conditions may present with only these signs and symptoms for long periods of time.

Causes of Chronic, Constant Severe Headache

  • Somatisation disorder: psychological problems may result in true or imaginary severe headache and other complaints
  • Temporal arteritis is an inflammation of the temporal artery. Symptoms include:
    • Chronic one-sided headache and extreme tenderness
    • Low-grade fever
  • Carotidynia is an inflammation of the carotid artery with (1):
    • One-sided throbbing pain and tenderness in the neck and head
  • Brain tumor or cystsymptoms may develop slowly over several months and may include:
    • Recurrent headaches, worse in the morning
    • Abnormal sensations and muscle weakness on one side of the body
    • Personality changes may develop slowly over several months
    • Slurred speech, vision disturbance or other neurological symptoms
  • Brain aneurysm, even if not ruptured, can cause:
    • Constant, moderate or severe headache
    • Nausea or vomiting
    • Blurred vision
    • Drooping eye

Severe Headache in Small Children

Causes of severe headache in small children include:

  • Citrullinemia – a genetic disorder of metabolism of amino acids. Symptoms include (2):
    • Severe headache, sleepiness, poor appetite, seizures
  • Hydrocephalus- a collection of the fluid that surrounds the brain due to a birth defect or as a complication of an infection, tumor, trauma. Symptoms:
    • Rapidly growing head
    • Eyes that seem to gaze downward
    • Prominent fontanelles
    • Irritability
    • Constant severe headache

 

  • Robert

    i surely experience a painful headache every morning & it manifests it self around the right hand side of my head. the eye even releases tears. the vain swells but after several hours it varnishes. i experience that unbarerable pain daily. i request for your help

  • Dr. Chris

    Hi Robert

    Cluster headaches are usually one-sided, with a pain behind the eye and causes tearing. It usually lasts less than an hour and tends to occur in the early hours of the morning. The exact causes of cluster headaches are unknown but it is more common in people who are heavy smokers and drink large quantities of alcohol.

    There are many other causes of headaches, some of which can be aggravated or begin upon waking. The two most common causes of mornings headaches is a headache due to :
    1. Muscle spasm, particularly of the neck. It tends to be worse in the morning due to your sleeping position (‘sleeping badly/awkwardly’) and a lot depends on neck support during sleep – number of pillows, type of pillow/neck support and even your mattress. Of couse, this does not always cause the headache – you may have significant muscle spasm possibly from your work situation and it tends o aggravate after sleep.
    2. Hay fever and sinusitis are two conditions that tend to aggravate in the morning. This is associated with allergies and since the bed is an area which has many allergens (dust, house dust mite, wool, etc), the conditiosn aggravate due to the prolonged exposure (8 hours of sleep without moving) to the allergen. Repeated sneezing upon waking in the morning, watery eyes and a ‘nasally’ tone to the voice may also be present.

    There are other causes related to changes in blood pressure, blood sugar levels, sleep apnea and so on which may cause morning headaches. You should see a doctor about your morning headaches so that the necessary tests can be undertaken to determine the cause and then take the necessary steps to try to remedy these causes. Refer to Head Pains Diagnosis.

    In terms of muscle spasm, a good, ergonomically designed pillow can help along with other methods of neck support (speak to a physical therapist or chiropractor). Immobilizing the neck during the day may also be useful, especially if you have severe cervical muscle spasm.

    If sinusitis or hay fever seems to be the cause, your doctor will prescribe the relevant medication to manage these conditions. Switching to pillows made with hypoallergenic materials, changing bed lined regularly, flipping your mattress over at least every 3 days and removing woollen objects (fluffy blankets, stuffed toys and even carpets) can be helpful.

    Your doctor will be in the best position to advise you accordingly.

  • Kate

    Hi there,

    I am constantly getting headaches each day im in the office. I work in a office with no windows and generally only have 3 breaks a day 2 x 10 minutes 1 x 30 minutes where i tend to get out of the office and start to feel a bit better.

    I have lately had a slight sick feeling under my tounge but nothing happens.

    I take around 12 Nurofeon Zavance a week and have tried to stop taking them as i know it cant be good for me.

    Do you have any suggestions what this could be caused from and something to prevent this?

    I’m scared i may have a brain tumor or other wise just need glasses.

    Let me know

    Thanks Kate

  • Jan Modric

    Kate,

    do you get any relief during weekend or on days when you are not in the office? Can you describe the “sick feeling under the tounge” in more detail? Bad air, strong or weak light, eye straining can all cause headache. Skipping meals, low blood sugar can aggravate headache. Refraction errors would cause blurred vision (hard to read letters, either near or distant).

  • Jynger Benadum

    I think I’ve had a constant headache for about a month now. I get headaches quite a bit, but never had anything like this before. (Headaches seem to run in my family..) For the most part it’s a dull ache that’s just enough to bother me, and sometimes it gets so severe that I can’t leave my bed. I only get a day or a few hours here and there headache-free, then it’s back again. I’ve given up on taking medication. I would take an excedrin, and the headache would be back 2 hours later.

  • Dr. Chris

    Hi Jynger Benadum

    Despite your history of headaches, it it advisable at this point to consult with your doctor given this rather long episode. It is important to identify trigger factors and any action that aggravates or eases the headache. This information will prove useful to your doctor. At this point in time, it is advisable to see a neurologist if you have not already done so. Excessive use of the type of medication that you frequently take for a headache may also be responsible so speak to your doctor rather that constantly using any medication unless it has been prescribed for chronic use by your doctor.

  • Dr. Chris

    Hi Kate

    It is very possible that this is related to your environment if you find that you headache eases when you step out of the office or on weekends. Anything from cleaning chemicals used in the office environment, to the carpets or even the air conditioning could be a trigger.

    What needs to be isolated here is if you are experiencing any other symptoms with your headache like nasal congestion or a runny nose, redness or itching of the eyes and so on. This may provide some indication as to the possible cause and your doctor may be able to treat it accordingly thereby reducing these headaches.

  • kenady

    hello I just turned fifteen and I’ve been having mostly a similar problem as jynger I think it might be a month now that I’ve had this. as soon as I wake up I get the headache as a dull pain and throughout the day it spikes up to a severe pain where I can’t concentrate on even the smallest things. today is my third day I’ve had to get pulled out of school from the pain being so bad. I’ve never had this before. I have a doctors appointment tomorrow at three but it seems too long and the pain is not subsiding. I have stopped pain medication because it doesn’t seem to work which frustrates me the pain never really subsides till I am asleep of course since I’m not conscious even though it is pretty difficult to go to sleep with the pain I am having. I really hope I can get to the bottom of this and stop the pain. any information will be great. thanks much, kenady

  • Dee

    I have been very worried about my mother’s constant headaches, it is never ending and she takes over the counter medication on a daily basis. She has been to the doctor more times than I can remember and every time they tell her it’s sinus and the proceed to give her the same meds over and over agian. Thing is it never seems to help with the pain.
    She went to a specialist yesterday to do a sinus scan and it came out clear, or so he says. She says that her nose feels blocked and that the pain subsides a bit when she takes off her glases. Any help will be great at this point as she has now finaly given up. Can it be a tumor???

  • Dr. Chris

    Hi Dee

    A tumor is always a possibility but rather than getting ahead of yourself, consider additional investigations like a CT/MRI. A tumor should not be the first condition suspected unless other, more common causes have been excluded. Despite common beliefs, a headache is not an early sign of a tumor. If it was the cause, at this point other signs and symptoms would also be evident, apart from just the headaches. But as stated previously, it is a possibility.

    Daily use of OTC medication, even non-opioid analgesics, can be dangerous and cause liver and kidney damage. Your mother should see an ENT specialist (otolaryngologist) to confirm/exclude any sinus or related nasal problems. She should also consult with a neurologist about her headaches. Without further evaluation and the necessary diagnostic investigation, it would be anybody’s guess as to the possible cause.

  • Ninu

    Hi,
    Three weeks ago, I started getting a consistent headache that varies in intensity – sometimes a dull ache but at times extremely unbearable. I woke up with a headache after a night of some emotional trauma and while the emotional episode went away and is no longer an issue, the headache hasn’t gone away. It started in the top middle part of my head but it’s migrated to the sides… I RARELY used to get headaches, maybe once every several months I’d get a slight headache that may have been related to tension so this is a new thing for me that has become quite bothersome and sometimes affects my lifestyle. I’ve been to the doctor and she prescribed a migraine medication. After reading your article, I thought to begin keeping a headache diary. I’m just frustrated because I certainly do not want to be on headache medication. I’ve had an MRI that came out with nothing. Is there another test that the doctors should be doing?
    Thank you for your help!
    Ninu

  • Dr. Chris

    Hi Kenady

    As you have read above, there are various causes of a constant headache. However, in young girls like yourself, some of the more common causes, apart from migraines, includes iron-deficiency anemia (heavy blood loss), low blood sugar levels (due to poor dietary habits and excessive dieting), eye strain or visual disturbances and cervical (neck) muscle spasm. Of course, hormonal disturbances may also be a possibility and if you notice that the pain tends to aggravate prior to your period along with other signs and symptoms of PMS, then this may be a more likely causes. It is also more pronounced in girls/women with irregular periods, painful periods and heavy menses. Magnesium supplements may be helpful in cases associated with PMS and painful menses. There could be other causes, some of which are quite serious, but first these should be considered. Your doctor will do the necessary tests to try to identify the cause.

  • Dr. Chris

    Hi Ninu

    Firstly,, a headache diary is a good idea. Secondly, stress of any sort tends to result in neck, head and back muscle spasm. This is the most common cause of headaches as you will read above. You won’t know that these areas are painful until you have a doctor assess your muscles and range of motion. Repeat sessions of physical therapy will help ease the muscle spasm and relieve the headaches.

    Yes, there are many causes of headaches but in such a short term case, muscle spasm should have been verified and attended to. In fact your doctor should have referred you to a physical therapist anyway (considering the MRI is clear) for manual therapies on the back and neck which could have helped the situation. I am not saying that your headaches are definitely due to this cause but it is the most common and from what you report, it was not considered. You should see a neurologist as well. He/she will advise you on RELEVANT tests to consider rather than going for unnecessary investigations. There are many tests that could be conducted but these are only considered if your doctor has a suspicion of some condition and needs to confirm/exclude it. This does not mean that every headache sufferer needs to go for these tests.

    You should see a neurologist at this point. Speak to your doctor about a referral.

  • Ian Simpson

    hey dr. chris i wake up every morning with a very clear head but at the end of the day i have a throbbing headache. i have had this for a bout 7 days now and i was wondering if you had any explenation

  • Dr. Chris

    Hi Ian

    Possibilities are endless. Considering that it is short term and occurring towards the end of the day, it could be related to fatigue, muscle tension, poor posture and inadequate nutrition. These are the causes that have to first be considered and excluded before considering any other more serious causes. A lot also depends on your history. At this point, it is advisable to consult with your doctor.

  • blake

    im 22 and have been experiencing consistent headaches daily for about 2 to 3 months. I was in a car wreck a couple years back and recently did some wake boarding seeming to heat up my old injury again. Ive been to the chiropractor serveral times and it doesnt seem to help. The headache seemes to start in the area where the neck joins to the back of the head but can be other places as well. What would you suggest doing?

  • Dr. Chris

    Hi Blake

    You should see a neurologist at this point. Given your history, it is possibly your recent activities have aggravated an old injury. Further investigation like X-rays, an MRI, etc would be necessary to identify any problems that were missed previously (if you had undergone a full examination). While it may be due to muscle related problems, which are the more common causes, it is still important to exclude any severe disorders.

  • Elizabeth

    Hi,

    I’m a 27 year old female and have had a constant headache for about a year. I went to the doctor 3 months ago to find answers, he did a large variety of blood tests and also a CT Scan but found nothing. Tried a food journal- nothing seems to trigger it or contribute to it. I have even given up caffeine for 6 months. No change.

    Last month I just randomly had a whole month with no headache. I don’t know why. But it was great! But it came back again a couple of weeks ago when my period started.

    I’m tired and can’t seem to find a solution. Any ideas?

  • Elizabeth

    Also, the headache is right between my eyes, along my eyebrows and center forehead which suggests sinuses. But i’m completely clear- the doctor ruled out anything sinus related.

  • Dr. Chris

    Hi Elizabeth

    Many types of chronic headaches do go for short periods where it totally resolves only to return a short while later. As you have mentioned, this latest onset seems to be related to your period so that is something that needs to be considered as well. While a food journal is helpful, it is also a good idea to record incidents that precede the onset of the headache. This may give you a better idea of what is going on. Any concomitant symptoms would also assist with a diagnosis. Speak to your doctor and try to see a physical therapist as well. One of the more common causes of a constant headache is cervical muscle spasm (neck) and of course anemia has to also be considered if you have any menstrual irregularity. Eye strain and nasal problem should also be further investigated.

  • Anelle

    Hi, I’m a 37 yr old female and I’ve had constant headaches for over a year now. Initially they seemed and were diagnosed as migraines and I was prescribed antidepressant medication, which didn’t help…and felt my doctors just assumed they were migraines. In the last six months they have increased in severity and I do not go a day without so type of headache. They come at any time of day, and pain varies from on top of head to specific areas on either sides to pain towards back …
    And pain can. Be dull and constant to severe and qiuck.I have kept a diary and I don’t see anything specific that triggers them. I once read about rebound headaches so for months now I only take ibuprofen when the pain is too severe. I suggested to my neurologist to take a CT but. He says medication should be first option. I’m discouraged by him, and don’t know what to do.

  • Dr. Chris

    Hi Anelle

    A CT should be considered at this point but of course a lot depends on your doctor’s assessment and the information he has gathered which you may have not revealed here or not be aware of. If you are not happy with the treatment you are receiving, then you can seek a second opinion from another doctor or neurologist. This is the next step.

  • Gustavo

    Hello: Can anybody write me in spanish? my english is not good enough to write you about my constant headache.

  • gloria

    Hi, I’m 18 and I’ve been experiencing headaches EVERY single day since the Summer of 2010. It’s January now and my headache pain has only gotten worse with time. The pain is in the back of my neck and the back of my head, sometimes in my temples, but never facially painful. I know that it’s not a good thing, but I take 3 Motrin pills about 3 times a day, totaling up to about 9 or 10 pills in one day, every day. I’ve also gone from using the family bottle of Motrin to buying my own OTC bottle of Motrin containing 100 pills, and finished it in a month. My mom saw on the news that pain relievers can make headaches worse, so I stopped taking them for about 2 weeks, but my pain never lessened. I don’t know what to do, and I’m really afraid that I may have a brain tumor because of how excessively I take medicine for my pain. A headache every day just doesn’t seem normal to me. My parents want to take me to the doctors to get checked out, but I’m so used to being sent home with pills that don’t ever work for me.
    Answers to narrow my fear would be great,
    Gloria*

  • Tricia

    Hello,
    I am 22 years old and I cannot get rid of my headaches. They came on suddenly about 8 months ago. I’d never had bad headaches before but all of the sudden I had them every day. I feel sick to my stomach and I get moody. I’ve been to my doctor and she has my on topomax but they still come every day in the afternoon no matter how much she has changed or upped my medicine. I was given a CT that came up clean when I first told her and a sinus scan that was also clean. No food seems to trigger it and my eyes are 20 20. I’ve ruled out everything I can but I still don’t have an answer. I don’t want to take the narcotics I’ve been given because they make my stomach sick and I can’t function well. Do you have any idea what could be causing this? or better yet how to get rid of it??

  • Dr. Chris

    Hi Gloria

    You have to stop with the excessive use of the painkiller in question. A simple Google search will revel just how dangerous this can be. There is no way of knowing for sure what the cause may be unless you see a doctor. Try to see a neurologist if possible.

    If you are going to start with your family doctor (GP) then try to go back for follow up visits and so on, so that you doctor can take this step by step. Remember that given your age group and lack of other symptoms, your doctor may not consider additional investigations like a CT scan or MRI immediately and start you off on medication.

    But if you are not responding to medication (which can only be ascertained by returning to your doctor at the prescribed times for a follow up) then further steps will be taken. Irregular visits or changing doctors frequently does not help your doctor build up a case history. See a doctor immediately.

  • Dr. Chris

    Hi Tricia

    There are numerous causes of recurrent headaches. It would be advisable that you see a neurologist at this point. Also take not if it is related to eating – not specific foods – but hunger, etc. Headaches often triggered by low blood sugar levels tend to start at this time of the day. In addition, neck muscle spas, tends to aggravate at this time especially if you have spent the day working at a computer and so on. Your doctor will be able to advise you further.

  • nicolemarie

    Hi,

    I have had a constant headache for the last 7 years. I was in a car accident where a schoolbus ran into the drivers side of my car. It threw me over the console and I had muscle damage, a concussion, but nothing more. I went to the chiropracter for over a year, physical therepy, but I have a birth defect where the fifth vertebrae in my neck is fused on one side and I am diabetic. They told me after a year there was nothing more they could do for me. I have been in pain ever since. It is unbearable. My neck is messed up, my upper back is messed up, leading to this terrible pain in the back of my head that eventually ends up in the front of my head in my temples. Nothing helps. I am thinking about botox, but my insurance doesn’t cover….help!

  • Dr. Chris

    Hi Nicolemarie

    You may be describing a cervicogenic headache and long term physical therapy should help if your therapist is working alongside your doctor in managing the condition. Neck and upper back muscle spasm is still one of the leading causes of a headache and once again physical therapy has a lot to offer here along with medication. I would advise that you first start off by seeing a neurologist who can assess your condition and manage it over a period of time. The insurance aspect is always a difficult issue and it boils down to personal finances on which we cannot really comment. Try not to start off with one practitioner, and then stopping or hopping over to the next practitioner, when you do not get the results that you expected in the short term. Proper long term management is the key here. Also speak to your physical therapist about the safety and manner in which you can do neck stretching exercise daily. As simple as this sounds, it followed properly, it can make a massive difference over the long term. Also consider immobilizing your neck as often as possible with a brace/collar, using an ergonomically designed pillow and so on. Your therapist will be able to advise you further.

  • Sash

    I want to start of by saying I am fit, eat healthy and workout everyday for an hour, until the other day. I switched up my workout from the evening to morning. I took my regular pre-workout pills and started my workout with 30 pushups. I didn’t even get to 30 when all of a sudden I got this huge intense throbbing headache I could also feel it in my right eye sort of. So I slowly finished my workout and even cut it to 45minutes. Then a day later when I got lucky at a party and was about to engage in sex, this headache slowly crept up and intensified the more closer to climax I got. WTH is going on?