Chronic migraines are severe, throbbing headaches that usually affect only one side of the head. They involve attacks lasting 3 to 72 hours, with or without aura.
These headaches occur on at least 15 days per month and continue for more than 3 months. Over time, a person’s occasional migraines can become more frequent and intense, eventually developing into chronic migraine.
This may happen because of the excessive use of pain relievers taken to ease headache pain. Chronic migraines do not have a cure, but symptoms can improve with treatment recommended by a neurologist.
Main symptoms
The main symptoms of chronic migraines are:
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Severe headaches that do not go away for more than 15 days and continue for longer than 3 months
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Poor sleep quality
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Insomnia
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Body aches
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Irritability
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Anxiety
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Depression
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Changes in appetite and mood
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Nausea or vomiting
Photosensitivity can also occur, which means the eyes become sensitive to light from lamps, sunlight, or even phone and computer screens, making a chronic migraine attack worse.
Sensitivity to sound, known as hyperacusis, may happen as well. According to the National Institute of Neurological Disorders and Stroke, migraine symptoms often include increased sensitivity to both light and sound.
Exercise or even simple movements, such as squatting, going up stairs, or going down stairs, can also make headaches worse during a chronic migraine attack.
Online symptom quiz
Chronic migraines are a type of migraine. To check how likely it is that you have migraines, select the symptoms that apply to you:
This test is only meant to serve as a guide. It is not intended to give a diagnosis and does not replace an appointment with a neurologist or primary care provider.
Confirming a diagnosis
A healthcare provider diagnoses chronic migraines by assessing a person’s symptoms and how long the headaches have been occurring.
In some cases, imaging tests such as a CT scan or MRI may be ordered to rule out other neurological problems.
Possible causes
The causes of chronic migraine are still not fully understood. However, some factors are known to contribute to this condition, such as:
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Self-medicating with excessive use of pain relievers
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Problems with the bones, joints, or muscles
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Mental health conditions, such as depression or anxiety
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Excessive intake of caffeine and related products
Chronic migraines may also be associated with obstructive sleep apnea and obesity.
According to the National Institute of Neurological Disorders and Stroke, migraines affect adult women more often than men, and regular overuse of headache medicines can worsen headache attacks or cause new headache symptoms.
Treatment options
Treatment for chronic migraines should be recommended by a neurologist and usually includes both medicines to treat migraine attacks when they happen and medicines to help prevent future attacks.
For acute treatment, a doctor may recommend pain relievers or triptans, depending on the person’s symptoms and medical history. For prevention, treatment may include medicines such as topiramate or valproic acid medicines, and botulinum toxin type A (Botox) may also be used, especially in adults with chronic migraines that are difficult to control.
Newer preventive options may also be considered, including CGRP-targeting therapies, which are now considered a first-line option for migraine prevention. These treatments may be recommended based on migraine frequency, prior treatment history, cost, insurance coverage, and individual response.
However, some home remedies may also be used to support chronic migraine treatment, such as sunflower seeds.
In addition, to improve treatment benefits, reduce symptoms, and help prevent chronic migraine attacks, it is important to exercise regularly, eat healthy foods, maintain an ideal weight, manage stress, and consider relaxation techniques, physical therapy, acupuncture, and talk therapy.