Chronic Migraine: 7 Things to Know

Medically Reviewed By William C. Lloyd III, MD, FACS

Written By Ashley Festa on October 16, 2020

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  What to Know About Frequent and Chronic Migraine

  If you have frequent migraine headaches, you aren’t alone. More than 20% of people will experience a migraine at some time in their life. A smaller percentage of people—about 1 to 5%—experience 15 or more headaches a month. This condition is chronic migraine. Migraine at this frequency can feel like a constant headache—as some people have pain that lasts up to 72 hours. Women are much more likely to be affected by chronic migraine than men, often due to fluctuating levels of estrogen. Children and teenagers can also experience chronic migraine. Get the facts about chronic migraine and what affects migraine frequency, including the benefits of preventive migraine medicine.
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  1. Migraine symptoms vary from person to person.

  Some people have throbbing or pulsing pain on one side of their head, and others have pain on both sides. Sometimes migraines cause sensitivity to light or sound. Nausea, vomiting, weakness, and worsened pain when you move are also common migraine symptoms. Some people also experience what’s known as aura either before or during a migraine. Aura can include various disturbances in the nervous system, such as flashes of light, bright spots, or vision loss. You may feel weakness or have trouble speaking.
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  2. Taking too much medication can make migraine worse.

  Many types of medication to treat migraine is on the market, both over the counter and by prescription. But simply taking more medication to try to get rid of a single migraine won’t help and actually could make the headache worse. This is called a medication overuse headache, or more commonly, a rebound headache. In addition to taking too much medicine for an acute attack, regular, long-term use of some pain relievers can also cause rebound headaches in people who have chronic migraine (but not in people who regularly take pain relievers for other conditions, such as arthritis).
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  3. Too much caffeine can sometimes trigger migraine attacks.

  Even though caffeine is an ingredient in some pain relievers used to treat migraine attacks, the regular intake of caffeine is a risk factor for chronic migraine. For some people, having caffeine relieves the symptoms of an acute migraine attack, and it’s perfectly safe to treat a migraine this way if it works consistently. Otherwise, keep your daily intake of caffeine to less than 100 milligrams, which is about the amount in a single, six-ounce cup of coffee.
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  4. Certain foods may be causing your frequent migraines.

  It’s hard to know precisely what foods may trigger an individual’s migraines because everyone’s body is different. However, there’s evidence some foods in particular can either cause or lower the threshold for migraines. Aged cheeses, processed meats or other processed foods, chocolate, MSG, and alcoholic beverages, particularly wine, may be associated with migraine. Some people find some fruits, nuts, yeast, or fermented foods are what causes migraines for them.
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  5. Keeping a migraine diary may help you identify triggers.

  If you suspect you might have chronic migraine, it’s important to start keeping track of when you have headaches, what kind of headaches they are, and what you were doing or eating when you got the headache. Doctors diagnose someone with chronic migraine when the person has at least 15 headaches per month, eight of which have the characteristics of a migraine. Be sure to tell your doctor about every headache you have, not just those that are disabling. Also write down what you were doing or eating in the hours before you got the headache so you can try to narrow down activities or foods that trigger your migraines.
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  6. Preventive treatment options for chronic migraines might surprise you.

  Your doctor might suggest preventive medicine if your pain lasts more than 12 hours or pain relievers aren’t reducing your migraine symptoms. Some of these drugs were originally approved for other conditions, such as cardiovascular drugs, antidepressants and antiseizure medications. Biologic medicines that target a substance (CGRP) involved in migraine are another option for high-frequency or chronic migraine. Three have recently been approved and others are in the pipeline. Botox injections have also been found to help prevent chronic migraines. However, all of these medicines can come with side effects, so talk with your doctor about the pros and cons.
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  7. Some lifestyle changes may help reduce the frequency of your migraines.

  Lifestyle changes, exercise, and other complementary, non-medicinal treatments help reduce frequent migraines in some people. While there aren’t any universal migraine triggers, it’s best to stay hydrated and maintain a healthy weight to not increase your risk of migraines. Exercise is also great, but start out slow if you’ve never been on an exercise regimen before. Some good options to start with are yoga and tai chi because they are low-impact exercises. You may also want to try acupuncture, massage, hypnotherapy, or cognitive behavioral therapy to reduce migraine symptoms.

Chronic Migraine: 7 Things to Know About Symptoms & Treatment

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