Chronic daily headache is a common problem reported by children and adults. The causes are multiple. Treatment with dugs can make the problem worse rather than better. The best approach is to locate and remove the cause.
There are two common patterns of headache:
Migraine headaches are particularly severe "sick headaches."
Tension headaches are associated with increased neck, scalp, and facial muscle tone and tenderness. The muscle tension and soreness is an effect of the underlying biochemical cause of the pain and not a cause of it. Many patients have mixed headache patterns, with "tension" headaches occurring more often than their sick, migraine headaches.
Migraines can begin in children and affect females more than males. The average age of onset is 20 and most people have 15 to 20 years of headaches before they disappear. Estimates of migraine prevalence vary from a low of 18% in women and 6% of men in the US to 23% of women and 9% of men in Canada. The peak age for migraines is 35-45. It is likely that prevalence estimates are very low, are based on limited information and misdiagnosis of headache causes. New headaches starting after the age of 45 should not be considered migraine until all other causes have been ruled out. Some women have "premenstrual migraine" and only experience headaches days before and during their periods. In the past, fewer than half of migraine suffers sought help from their physicians. In Canada, it is estimated that 27 of 100 lost work days is due to migraine headaches at an annual cost of $500 million per year. (Family Practice Jan 12 1998;36)
71% of 75 neurologists reported having at least one migraine headache at some point in their life. This rate is much higher than the 12% lifetime prevalence reported in the general population, suggesting that migraines are being missed or wrongly diagnosed. One of the most common misdiagnoses appears to be sinus headache. Gladstone stated that: "Billions of dollars are spent in North America each year on over-the-counter (OTC) medications, sinus remedies, and alternative treatments for headaches, but for many, these treatments are ineffective or unsatisfactory. This is probably because most individuals don't know what type of headaches they have… There is very little education on headache in medical school, despite the fact that it is such a common condition." 65% of the neurologists reported tension-type headache in the preceding year, followed by migraine at 51%. When the authors surveyed medical students and family practice doctors, the prevalence of migraine in the past year did not exceed 32%. Conversely, medical students and family physicians were much more likely than neurologists to report sinus headache. Ninety-five percent of neurologists with migraines reported using OTC drugs. NSAIDs were the favored first choice agent for migraines. ( Anthony Brown. Migraines May Be More Common Than Previously Thought. Reporting from the 46th Annual Scientific Meeting of the American Headache Society in Vancouver, British Columbia, June 2004. The study was reported by J. Gladstone, from the Mayo Clinic in Scottsdale, Arizona.)
Kossoff suggested that over 50% of chronic daily headache is thought to be secondary to overuse of analgesics such as acetaminophen, aspirin, ibuprofen, naproxen, ergotamine, triptans, and caffeine. Withdrawal of the offending analgesic is a well-established treatment for medication-overuse headache.
Better than drugs... why not remove the original food causes of headaches?