Patients with chronic daily headache can experience complain multiple types of headaches. Many have severe intermittent headaches that are migraine-like. The severe headaches are described as throbbing, severe, crushing, knife-like, or hatchet-like. They are often associated with nausea, and avoidance of bright lights, loud noises and strong odors. For this more severe headache pain, sleep sometimes helps, but patients will still have persistent headache when they awaken. The frequency of these severe headaches varies with the individual. Severe episodes typically occur multiple times a week.
 
In addition, many patients have a continuous headache that is present "all the time". This continuous headache may wax and wane in severity, often worsening in the morning or at the end of the school day. The characteristics of the all-the-time headache pain are similar to the episodes of severe headaches, only much less intense.
 
Headache is not the only symptom in chronic daily headache. Frequent additional symptoms include dizziness, sleep disturbance, pain at other sites of the body (including neck pain, back pain, and abdominal pain), fatigue, difficulty in concentration, decreased mood, and increased anxiety. It is important to recognize and treat these symptoms as well.
 
One of the roles of a headache specialist in treating these patients is to separate out chronic daily headache, which is a primary headache syndrome, from secondary causes of headache. The evaluation for secondary causes of headaches includes a thorough history and physical exam, and consideration of a neuroimaging study, blood tests, and, in the occasional patient, lumbar puncture. In selected patients, tilt-table testing or sleep studies may also be of value.
 
Chronic daily headache is difficult to control. There are often no immediate answers or easy ways to the treatment and resolution of the pain. Many patients have had a sudden onset to their daily headache, and some can even point to a specific day when they transition from a headache-free life to an all-the-time headache. Unfortunately, it typically takes weeks to months to achieve headache control. The cornerstones of therapy are education, preventive medications, and attention to routine.

Complimentary and Alternative Treatments for Chronic Headaches
Many people find relief from chronic headache pain through complimentary and alternative treatments. Some of these include:
-- Yoga
-- Massage
-- Meditation
-- Acupuncture and acupressure
-- Aromatherapy
-- Hypnosis
-- Dietary Supplements