Chronic Daily Headache: What is the cause? (2014 Am Fam Physician review)

What is the definition of chronic daily headache?

Chronic daily headache is defined as the presence of a headache on 15 days or more per month for at least 3 months.

What are the causes?

The most common types of chronic daily headache are chronic migraines and chronic tension-type headaches. If a red flag for a secondary cause of headache is present, magnetic resonance imaging (MRI) of the head should be performed.

All patients should be asked about medication overuse, which can increase the frequency of headaches. Patients who overuse medications for abortive therapy for headache should be encouraged to stop the medications entirely and consider prophylactic treatment.

How to treat it?

Several prophylactic treatments for chronic daily headache can reduce headache frequency and severity, as well as improve overall quality of life.

Nonpharmacologic treatments include relaxation techniques, cognitive behavior therapy, acupuncture, osteopathic manipulation, and cervical exercises.

Pharmacologic therapies include amitriptyline, gabapentin, onabotulinumtoxinA, propranolol, tizanidine, topiramate, and valproate.


Chronic Daily Headache: Diagnosis and Management. Yancey JR1, Sheridan R2, Koren KG1. Am Fam Physician. 2014 Apr 15;89(8):642-648.

Image source:, public domain.

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