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Getting a headache every now and then is common. Many common everyday things can trigger headache pain. For example, not drinking enough fluids, inconsistent intake of caffeine, lack of sleep, or stressful situations. But if you have frequent headaches or chronic headaches, that may point to something else going on.

What Are Chronic Headaches?

Chronic headache is not a specific type of headache. It’s an umbrella term for many types of frequent or ongoing headaches.

What is a chronic daily headache (CDH)?

The International Headache Society defines CDH as 15 or more headache episodes per month for at least three months.

Risks for chronic headaches

Chronic or frequent headaches affect up to 4% of people worldwide, according to the National Library of Medicine/StatPearls. In the United States, 39 million people live with chronic headaches. Women are three to five times more likely than men to experience frequent headaches.

Headaches, including chronic headaches, occur most often between teenhood and your 50s.

Causes of chronic headaches

Some chronic headaches are primary: They relate to a specific headache disorder.

Primary chronic headaches can include both short-term and long-term headaches. Short-term headaches last fewer than four hours. Long-term headaches last more than four hours.

Some chronic headaches are secondary: You develop these headaches as a result of something else, including:

• Central nervous system (CNS) infections.
• Increased pressure in your skull — also called intracranial pressure.
• Intracranial tumors.
• Medication overuse headache (MOH).
• Metabolic abnormalities.
• Post-traumatic, structural, or vascular problems.

Some people may have frequent headaches for more than one reason.

Common conditions that cause frequent headaches

Some common conditions that can cause chronic headaches include:

• COVID-19. Chronic headache is one of the symptoms of so-called long COVID syndrome. Also called “long COVID headache,” it can feel like a migraine or tension headache.
• Hormonal changes in women. This includes hormonal changes during puberty, menstruation, pregnancy, and menopause.
• Ischemic stroke. Following ischemic stroke, it’s common to have moderate to severe chronic tension-type headaches. That’s according to a 2020 systematic review and meta-analysis published in Neurology.
• Sleep disorders, including insomnia and sleep apnea.
• Traumatic brain injury (TBI), such as from a concussion or accident. You may develop a chronic headache right away, or it may take up to a year after your TBI, according to a 2023 literature review published in the Journal of Clinical Medicine. And you may still have frequent headaches even after five years of receiving a TBI.

Types of chronic headaches

According to the National Library of Medicine, there are five main subtypes of chronic headaches:

Chronic migraine headache

People with chronic migraine have a headache that occurs on 15 or more days in a month for more than three months. And they also have migraine features on at least eight or more days in a month.

Chronic tension-type headache

People with chronic tension headaches have pain on both sides of their head. Unlike migraine pain, the pain doesn’t pulsate and doesn’t have any other symptoms.

Medication overuse headache (MOH)

Using over-the-counter and prescription pain medicine too often can cause rebound headaches. The medical term is medication overuse headache.

Hemicrania continua

This type causes ongoing, varying pain that almost always occurs on the same side. Most people with hemicrania continua have attacks of increased pain three to five times per 24-hour cycle.

New daily persistent headache (NDPH)

NDPH occurs suddenly and does not go away within 24 hours of starting. This type of chronic headache is rare.

Keeping Track of Your Headaches

If you develop frequent headaches, it’s important to keep track of your headache patterns. This can help your doctor figure out what’s causing your chronic headache pain. Here’s what to write down in a headache diary:

• Day and time the pain started.
• How long the headache lasted.
• How much you slept.
• What were you doing and where were you before the headache started.
• What you ate and drank over the past 24 hours.
• What helped the headache pain or made the headache stop.
• What other symptoms, if any, did you have with the headache.

Preventing Headaches

You can’t always prevent a stressful situation. But there are some things you can do to prevent frequent headaches. For overall headache prevention, maintain a healthy lifestyle, including:

• Avoid or limit alcohol. For men that means two alcoholic drinks at most per day. For women, one drink at most per day.
• Avoid getting dehydrated. You can stay well hydrated by drinking more water and other fluids. You can also eat foods that are fluid-rich, such as fresh melons or cucumbers.
• Get enough sleep. Adults should aim for at least 7 hours.
• Know your triggers and avoid or manage them.
• Learn to manage stress.
• Quit smoking.

Common headache triggers

Different people have different things that can trigger their headache pain. Common headache triggers include:

• Alcohol use.
• Bright lights and loud noises.
• Certain foods, including aged cheese, smoked meats, and fermented or pickled foods.
• Certain odors or perfumes.
• Dehydration.
• Exercise or over-exertion.
• Hormonal changes.
• Lack of sleep.
• Skipping meals.
• Smoking.
• Stress.
• Too much caffeine.
• Too much screen time.
• Weather changes.

When Should You See A Doctor For Frequent Headaches?

Make an appointment or call your doctor or other health care provider for frequent headaches if:

• You are older than 50.
• You have blurry vision.
• Your scalp is tender.
• Your headache patterns or pain changes
• You have a severe, “thunderclap” headache.
• You take pain medicines more than three days a week.
• Treatments or at-home remedies that used to work no longer help.
• Rapid tiring of your jaw when you chew your food.
• Your headaches get worse when lying down.
• You have side effects from medication (if you are taking blood thinners).
• You have underlying medical conditions, such as cancer or HIV.
• You are taking birth control pills and have migraine headaches.
• You are pregnant or could become pregnant. You should not take certain headache medicines during pregnancy.

Your doctor can help figure out what’s causing your chronic headache. They can also provide a treatment plan and lifestyle changes to help you prevent and manage chronic or frequent headaches.

When Are Headaches an Emergency?

Some headaches are signs that something is seriously wrong. You should call 911 or an emergency number if:

• You develop a sudden headache or a severe headache that feels explosive.
• You are having “the worst headache of your life.”
• You have speech, vision, or movement problems, especially if you never had these symptoms with a headache before.
• You have a loss of balance or weakness, especially if you never had these symptoms with a headache before.
• You have a fever along with your migraine or any other headache.