What is Chronic Migraine?
Chronic migraine is a debilitating neurological condition characterised by headaches occurring on 15 or more days per month for at least three months, with at least 8 of those headache days having features of migraine.
Migraines are typically severe, throbbing headaches that may be accompanied by nausea, vomiting, and increased sensitivity to light, sound, or smells.
Chronic migraine can have a significant impact on quality of life, making it difficult to work, maintain social activities, and carry out everyday tasks.
Symptoms of Chronic Migraine:
- Frequent headaches lasting 4-72 hours
- Throbbing or pulsating pain, often on one side of the head
- Sensitivity to light, sound, and sometimes smell
- Nausea or vomiting
- Visual disturbances (aura) in some cases
- Dizziness or vertigo
Causes and Triggers:
While the exact cause of chronic migraine is not fully understood, it is thought to result from a combination of genetic, neurological, hormonal, and environmental factors. Several factors may contribute to its development, including:
- Genetic predisposition: A family history of migraines increases the likelihood of developing chronic migraine.
- Neurological factors: Chronic migraine is now recognised as a central sensitivity disorder and a primary pain disorder, causing pain pathways to become overactive and making the brain more responsive to migraine triggers.
- Triggers: Stress, hormonal changes, certain foods, poor sleep, dehydration, and environmental factors like bright lights or strong smells can trigger migraine attacks.
Management of Chronic Migraine:
Effective management of chronic migraine involves a combination of lifestyle adjustments, medications, and sometimes physical therapy.
Here are the main approaches used to manage the condition:
Lifestyle and Rehabilitation:
- Sleep management -consistent sleep patterns
- Stress management
- Dietary changes
- Good hydration
- Coping strategies (migrainetrust)
How Can We Help?
As pain specialists, we offer the following interventions for managing chronic migraine:
- Botox® for Chronic Migraine: Botox® has been shown to reduce the number of headache days by around 50% in many patients with chronic migraine. The benefits typically last 3–4 months, and treatment can be repeated if it remains effective.
- Occipital Nerve Blocks: Occipital nerve blocks involve the injection of a local anaesthetic and steroid around the occipital nerves, which supply the scalp. This can reduce inflammation and calm irritated nerves, providing temporary relief from headache pain in selected patients.
If you're experiencing chronic migraine symptoms, which are not controlled by medications, reach out to us for an assessment to explore the above two treatments options.
