What are chronic headaches and what treatments are available?

Chronic headaches are defined as having headaches on at least 15 days per month for more than 3 months. There are a huge number of causes of chronic daily headaches, you know? The commonest cause tends to be migraine, though you can have things such as cluster headache as well. So, what we offer will depend on the syndrome that you have, but you can, in essence, break things down into four or five main areas. We will offer people lifestyle advice. We will give them drug treatments, and drug treatments can be thought in terms of either painkillers, you know, things that you take to get rid of the attack when you have it, or prevention whereby what you're trying to do is reduce the number of attacks that you're having. We also offer what we call transitional treatments. These are treatments that work quickly but don't work for very long. They're a nice way of bridging the treatment while we are waiting for a preventive treatment to work, and there are some oral drugs that you can take but there are also some injectable treatments that we can offer such as nerve blocks. Then, we also have stimulators, which can be non-invasive. Otherwise, there are handheld devices that patients can use, or we have the invasive stimulators. Of the non-invasive stimulators, there are stimulators used over the forehead, something called the Cefaly device. There is something that can be held over the neck called the gammaCore device or vagal nerve stimulation. And magnetic impulses that you can apply to the back of your head, you have something called transcranial magnetic stimulation. For people who have failed these oral drugs, injectable treatments, or electrical treatments, we will then offer them invasive treatments. And, over here we've got something called occipital nerve stimulation, another one called deep brain stimulation, and a third type called sphenopalatine ganglion stimulation. These are implantable devices that stimulate different parts of the pain architecture, or the pain network, that can be very useful in aborting or stopping the attacks.