Headache 15 or More Days a Month? You Might Have Chronic Migraine

This article is for people who are living with chronic migraine, or anyone who wants to learn more about chronic migraine. The goals of this activity are to improve ability to engage in shared decision-making with their doctor and healthcare team about what chronic migraine is and about their treatment options.

You will learn about:

• What chronic migraine is

• Why it’s important to see a doctor for chronic migraine

• Treatment options for chronic migraine

• Questions to ask your doctor and healthcare team about chronic migraine

Migraine is more than just a bad headache.  It’s a medical condition that causes severe headaches that happen often or last a long time.

There are different diagnoses of migraine, that are based on how often headaches and migraines happen.

A specific diagnosis of “chronic migraine” is when someone has at least 15 headache days a month, with at least 8 of those days involving migraines .

The symptoms of chronic migraine are similar to other migraine conditions – they are different for each person but may include things like:

• Throbbing head pain (a pounding feeling in your head)

• Nausea or vomiting

• Auras (seeing flashing lights, colors, lines or shadows)

• Being bothered by lights, sounds, touch and smells

With chronic migraine, your migraines may last for hours or even days, and make it very difficult to do your daily activities. It is important to see a doctor and create a plan to help prevent or treat your migraines.

There are 2 main types of medicines for chronic migraine:

1. Preventive medicines:

These are taken regularly to prevent migraines from starting and make them less painful if they do happen.  They are available with prescription and can include:

• Angiotensin II receptor blockers (ARBs)

• Antiseizure medicines

• Antidepressants

• Beta-blockers

• Botulinum toxin injections

• Calcium channel blockers (CCBs)

• CGRP-targeted therapies: pill-based and injectable options

2. Acute/rescue medicines:

These are taken to help you feel better once a migraine starts. They can include:

• Over-the-counter medicines, like pain-relievers such as nonsteroidal anti-inflammatory drugs (NSAIDs)

• Prescription medicines

In addition to the medicine options, there are also some useful non-medicine treatment options for chronic migraine, such as:

• Procedures: nerve stimulation, transcranial magnetic stimulation (TMS), and acupuncture

• Psychotherapy (talk therapy): help with stress and anxiety, which can both cause migraines and make them worse

• Lifestyle changes: getting enough sleep, eating well, exercising, and managing stress can help prevent migraines

To get a treatment plan that will work best for chronic migraine, work together with your doctor. 

Before your doctor’s visit: 

• List your symptoms, when they happen, what makes them worse (foods, smells, sounds, etc.)

• Bring your medicines/vitamins, or take a photo of the medicines for reference  

• Write down your questions 

During the visit: 

• Bring a family member or friend for support and to remember details 

• Share the truth about how migraines are impacting your day-to-day life 

• Speak up if the doctor uses terms or words you don’t understand

• Ask your doctor if you don’t understand the reason that they are recommending a medicine or a test

• What are the possible triggers for my migraines?

• What are the best treatment options for me?

• What lifestyle changes can help my symptoms?

• How often should I follow up to track my progress?

• What’s the best way to track my symptoms at home?

Congratulations!

You have successfully completed the program Headache 15 or More Days a Month? You Might Have Chronic Migraine.

View Additional Materials on this topic that you may find useful

What Is Chronic Migraine - American Migraine Foundation

When migraine turns chronic – NIH

Helping family and friends understand migraines - NIH