Treating the Underlying Causes of Chronic Migraine

Headache disorders have recently been ranked worldwide as the second leading cause of years lived with a disability,¹ with migraine headache recognized globally as one of the highest contributors to disability for those under 50 years of age.² Chronic migraine, specifically, has been noted as the most common type of daily headache seen by headache specialists. Chronic migraine often occurs as a typical progression from episodic migraine (less than 15 headaches per month) and displays its own unique physiology.³

Approximately 2% of the global population experience chronic migraine, with a higher frequency noted for women. About 3% of those who have episodic migraine progress to chronic each year.³

Clinical, neurophysiologic, and functional imaging studies have suggested that alterations can occur in the brains of patients with chronic migraine compared to episodic migraine.³ Also compared to episodic migraine, patients with chronic migraine experience higher rates of co-morbidities, including impaired sleep, anxiety and depression, and gastrointestinal disorders,³ all of which can greatly impact quality of life.

One challenge in the treatment and prevention of migraine is that the underlying etiology is not clear. A range of migraine triggers has been noted; however, if the exact cause for an individual is not known, this may create difficulty in selecting an appropriate treatment intervention.

The issue is, why are they getting the migraines? What is causing them to be chronic? -Robert Rountree, MD, IFM educator