The headache hit on Monday at around 3 p.m. It came out of nowhere, and you couldn’t escape the pressure, tightness and pain. But you’d never had much trouble with headaches in the past, so you shrugged it off. Then Tuesday rolled around, and it was back. Ditto on Wednesday. And Thursday.
If you have pain that appeared without warning and is now an unwelcome part of your everyday life, you may be suffering from New Daily Persistent Headache (NDPH).
Recognize Your Headache
NDPH sometimes shares symptoms (e.g., nausea or sensitivity to light) with other headache types, but it’s actually a variety all its own, says Katherine Carroll, MD, a neurologist at Chicago’s Northwestern Memorial Hospital.
One of the unique characteristics of NDPH is that it typically hits people with no real history of regular headache trouble, although occasionally NDPH sufferers have a history of migraine or tension headache. Unlike migraine, NDPH is an equal opportunity affliction—striking men and women of all ages—though it affects women slightly more frequently.
NDPH can show up at any time, day or night, and tends to reveal itself with feelings of pressure (instead of pounding or pulsing). It is a bilateral headache, meaning it occurs on two sides of the head at the same time (either front and back or right and left). The bilateral location can vary, but it usually stays put during each attack. The telltale sign is that the headache keeps coming back with a vengeance every day.
In some cases, physicians can pin the arrival of NDPH to a particular event. “There’s at times a history of viral illness or upper respiratory infection,” Dr. Carroll says. “Other times, it can just occur [for no apparent reason].”
Get a Diagnosis
For Cindy S.* of Chicago, a 43-year-old mother of four, the headaches started about six years ago, the day she gave birth to one of her children.
In the days following her hospital stay, she had persistent, painful headaches. She sought help from her primary care physician as well as a chiropractor, and tried a handful of medications, but with little success. At the worst point, she says, it was like the headaches were happening 24/7.
“I think the hardest thing is that it’s really hard on the family,” Cindy says. “The kids have to put up with Mom not feeling good, and they don’t understand why she’s not feeling good every day.”
Eventually, after plenty of trial and error, several CAT scans and MRIs, and a visit to a specialist at a Chicago headache clinic, Cindy was diagnosed with NDPH.
Dr. Carroll says patients like Cindy—those who have no prior history of headaches but suddenly have chronic pain—should talk to a doctor about getting a neurological workup. It’s important to rule out more serious conditions before moving forward with a treatment plan.
Find Relief
To tackle her pain, Cindy overhauled her diet, focusing on eating healthy foods like fruits and vegetables and avoiding common headache triggers. Even on the weekends, she made an effort to go to bed and wake up at the same times each day, a change she says provided a noticeable improvement in the severity and frequency of the headaches. She was also prescribed Topamax and Divalproex, two prophylactic (or preventive) medications approved for migraine.
Dr. Carroll says a range of medications, from prophylactic drugs to antidepressants, have been effective for treating NDPH. Some patients also find relief with relaxation exercises or biofeedback. But patience is key. It might take weeks, months or even years to see a noticeable difference.
Thanks to efforts to curb the pain, Cindy’s headaches are now an occasional, rather than an everyday problem.
“Most [headaches] do go away,” Dr. Carroll says, “but the timing and what caused them to go away varies.”
*Name changed
POP QUIZ
In a recent poll on Headwisemag.org, we asked, "Do you have daily headaches?" Here's how you responded:
