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Chronic Daily Headache: Theory to Therapy
1Pain and Orthopedic Neurology, P.A., Charlotte Spine Center, 2001 Randolph Road, Charlotte, NC 28207, USA.
Current Review of Pain
|September 22, 2000
Summary
Chronic daily headaches often stem from brain stem processing issues, not serious illness. Management focuses on behavioral changes and avoiding medication overuse for better outcomes.
Area of Science:
- Neurology
- Pain Medicine
- Neuroscience
Background:
- Headaches are a common reason for seeking medical care in the US.
- While sometimes indicating serious illness, headaches frequently arise from primary disorders in brain stem nociceptive processing.
- Chronic daily headache can evolve from episodic types, often linked to medication overuse and disability.
Purpose of the Study:
- To review the pathophysiology and evolutionary mechanisms of chronic headache.
- To discuss revised classifications and nosology for headache disorders.
- To outline effective management strategies for chronic craniofacial pain.
Main Methods:
- Review of recent scientific and clinical observations.
- Integration of pathoanatomic models for persistent headache.
- Analysis of International Headache Society (IHS) classifications.
Main Results:
- Chronic headaches are often primary disorders of brain stem modulation.
- Understanding pathophysiology has led to proposed changes in headache classification.
- Persistent headaches can be explained by integrated pathoanatomic models.
Conclusions:
- Chronic daily headache is a complex syndrome often associated with medication overuse.
- Revised classifications reflect a better understanding of headache pathophysiology.
- Management should prioritize behavioral changes and avoiding medication overuse.
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