While headaches and migraines are an infrequent part of life for most people, they can become altogether too frequent for others. Up to 20% of people will be affected by migraines at some point in their lives, and up to 16 million people in the US alone have a migraine 15 days a month (1, 2). Treating chronic headaches and migraines can be tricky, and because there is no set treatment, many people go to the ER and are prescribed painkillers such as NSAIDs or opioids to simply deal with the pain (3). While there is no one cure, there are a number of therapies and treatments that functional medicine can provide to those suffering from chronic headaches.
What is the difference between a headache and a migraine? And when is it considered chronic?
Many people consider a migraine just a very bad headache, but it is more than that. A headache may be any type of pain or pressure in your head, usually occurs on both sides, and is often caused by other factors, such as muscle tension, stress, or sinus pressure (4). They can range from mild discomfort to severe pain and can last up to a week. While the type of pain and pressure can vary, headaches are usually characterized by a dull, throbbing ache (7).
A migraine, on the other hand, is always moderate to severe and is usually a sharp, pulsating pain. It is always accompanied by other symptoms, such as (1, 2, 4, 5):
Nausea or vomiting
Pain behind one ear or eye
Seeing floaters, flashing lights, or spots (usually before the migraine begins)
Temporary loss of sight or blind spots
General sensitivity to light, sound, or smell
Pain that worsens with physical movement or exertion
Numbness or tingling of hands, arms, face, lips, tongue, usually on one side of the body
Changes to bowel movements
Fatigue, abnormal energy, neck stiffness, or frequent urination (before migraine begins)
An increasing number of migraines over time
Migraines are most commonly known for affecting only one side of the head, but they can also be equally painful on both sides, or even at the front or back of the head (5). Women are twice as likely to have headaches and migraines as men, and they occur most commonly in those ages 18-44, according to the CDC (6).
While nearly a quarter of the population can report experiencing a headache or migraine within the past three months, both have to meet specific criteria to be considered chronic (1, 3, 7). Headaches must occur on at least 15 days per month for more than three months to be chronic, and 8 of those days must be migraines to be diagnosed with chronic migraines (1).
What causes migraines and headaches?
Headaches share the same risk factors as migraines (7). However, sinus pressure, muscle tension, inflammation or pressure in and around the brain, traumatic brain injury, and infections may also cause headaches (7).
The exact cause of migraines is not known, largely because there doesn’t seem to be one cause. The tendency to suffer from migraines has a genetic basis, but there are other internal and external factors that can trigger their onset (5). Commonly known risk factors for migraines include (1, 2, 7):
Depression, anxiety, and other mood disorders
Stressful or traumatic life events
Ongoing disrupted sleep patterns
Head or neck injury
Caffeine or alcohol
Eating certain foods, or irregular eating habits
Persistent, frequent nausea
Less commonly known causes of migraines and headaches include environmental toxins and mold. Unfortunately, exposure to both is a possibility anywhere that you may go.
One study found that the average person has 91 toxins in their blood and urine, since they come from so many sources (11, 12). Cigarettes, asbestos, burning wood or gas, unsafe drinking water, lead, and other chemicals are all sources of toxins that may cause headaches (11). Water damage in buildings is a common source of toxic mold formation, which can sometimes go without being noticed. These toxins are known to cause inflammation, disease, and death (13, 14).