A headache is one of the most common pain-related complaints that doctors see on a daily basis, alongside abdominal pain. We all suffer with a headache now and then. For some people it may just be an odd episode every few months or even years. For others, it is much more frequent and can sometimes even be a daily phenomenon. However, even with daily occurrences there are expectations that it will come and go, and worsen or ease at certain times of the day. In constant headaches, there is little to no relief even for short periods and the headache seems to never resolve.
Definition of Constant Headache
A constant headache cannot be clearly defined. It is not always the same as chronic headaches which could be constant but are often recurrent, in that it comes and goes, over a long period of time. The term constant can therefore be relative. For a person who suffers with the odd headache every now and then, any headache that last for more than a day may be considered constant to them. For people who have regular headaches, an episode that does not subside within a few days as is usually the case may then be considered constant.
In contrast, a chronic headache is defined as a headache that last for 15 days or more for at least 3 months. This is also known as a chronic daily headache. With a constant headache, the usual relieving factors may be not be of any help. The pain is non-stop and may even worsen. This type of persistent headache can affect life in various ways – from moods and concentration, to interpersonal relationship and even work. Even when or if the pain subsides, it does not resolve entirely and a person continues to experience a headache.
Causes of Constant Headaches
The causes of constant headaches are not significantly different from headaches that come and go. It is important to first consider the more common reasons for headaches and correct it, preferably without medication. If these causes are not the reason for the headaches then less common and sometimes more deadly causes needs to be investigated.
This is one of the most common causes of headaches. Head, neck and upper back muscle spasm occurs for various reasons. Usually it is related to poor posture and overuse of these muscles. Spasm and stiffness of the muscles is more frequently seen these days with long hours of computer use. It is also believed to be the cause of tension-type headaches although it is unclear whether it just a symptom of these type of headaches or the actual cause of it.
Changes in brain hormone levels to the point that it cause symptoms occurs for a number of different reasons. This includes serotonin, endorphins and other chemicals in the brain. These fluctuations in hormone levels is seen in various mental health disorders like depression and anxiety. Headaches are one of the symptoms seen in these conditions. However, these hormone changes may also be seen with headaches even in the absence of these mental health conditions.
Headaches related to the use of medication may occur for two reasons. Firstly a headache may be a side effect of the medication or an adverse drug reaction when drugs interact with each other. Second it may be what is known as a rebound headache. This is when overuse of medication used to treat headaches then causes headaches. It only happens with certain headache disorders. It is also important to note that withdrawal from strong medication like codeine can also present with headaches.
Eyestrain and headaches often present together and this is becoming more common due to the dependence and overuse of technology. While muscle spasm in the head, neck and upper back may also be present with eye strain and therefore be the cause of the headache, sometimes the entire problem related to the eye. Apart from long hours of staring at a fixed distance like a computer screen, the other ways that the eyes may be strained includes vision problems like nearsightedness, bright light without protective eye wear and incorrect spectacle prescriptions.
Psychological stress may be linked to anxiety and depression as well as changes in the hormone levels, all of which is known to cause headaches. It may also contribute to muscle spasm in the head, neck and upper back which are also common reasons for headaches. People who are stressed may not sleep or eat as they normally would and as is required by the body. As a result headaches may occur. Therefore psychological stress can cause headaches in a variety of ways.
One of the less widely considered causes of headaches is dehydration. Even very mild dehydration could lead to headaches. Consuming beverages like cola sodas, coffee and alcohol without sufficient water intake is some of the reasons why dehydration is more commonly seen these days. Apart from increasing the likelihood of muscle spasm, dehydration may also affect other processes in the body like the flow of blood to the brain which may then cause headaches.
Apart from OTC and prescription medication, it is not uncommon for substances like caffeine, alcohol and illicit drugs to be overused and abused. Caffeine and alcohol are diuretics which contributes to dehydration and therefore headaches. Overuse of these substances can cause headaches as do withdrawal symptoms when these substances are not used for a period of time. Alcohol and illicit substances can also have a significant effect on the brain hormones, another cause of headaches.
Once the above causative factors have been excluded, other conditions should be investigated as a possible cause of persistent headaches. It may require specialized diagnostic investigations like an MRI scan. These other conditions include:
- Hypertension (high blood pressure)
- Raised intracranial pressure
- Brain tumors
- Brain aneurysm
- CSF leak
- Nerve root compression (pinched nerve)
- Giant cell artertitis
The above conditions are mainly related to disorders and diseases within the head and neck. However, headaches may be seen with various other medical conditions where the main problem does not involve the head or neck. It is therefore important to consult with a medical professional.