Tips to Live By

Help for Chronic Headaches

Oct. 22, 2019

According to the World Health Organization, one in 20 adults has a headache every day. For some people, headaches are a mild annoyance. But for others, they can have serious effects on quality of life.

Dr. Carisa Liew, a neurologist with Houston Methodist, wants headache sufferers to know that an effective therapy plan can help.

“It’s a misconception that it’s okay to just live with headaches,” she says. “They’re a major cause of missed time at work and school and can affect many areas of your life.”

Understanding the different types of headaches

People can be affected by different types of headaches, and each one has its own symptoms and happens for different reasons. The most common types of headaches include:

Cluster headaches: A cluster headache is a rare condition that affects fewer than 1% of adults. It is characterized by a sharp, severe pain that is often only on one side of the head. It is very painful but only lasts a short time — usually about 45 to 90 minutes. It may cause nasal congestion, watery eyes and flushing of the forehead and face on the same side as the headache. It can cause a sudden onset of pain that may awaken you from sleep.

Migraines: A migraine is characterized by a throbbing, severe pain that lasts from four hours to three days. Nausea, vomiting and sensitivity to light, noise and smells can also accompany the pain. Migraines may be preceded by what is called a migraine aura: visual or other symptoms associated with the onset of a migraine. 

Tension headaches: A tension headache wraps around the head and is dull and achy. It is the most common type of headache. It can cause pressure or tightness (non-throbbing pain) and tends to come on later in the day. While it does not usually cause nausea or vomiting, it can be related to stress and fatigue.

Dr. Liew frequently sees patients exhibiting another type of headache: a medication-overuse headache, also known as a rebound headache.

“Many patients develop worsening headaches over time partially due to the too-frequent use of pain medications,” she says. “If you take pain medication for headaches often, and the headache returns, you might be experiencing a medication-overuse headache.”

Your doctor can help you manage the dosages and frequency of any prescription and over-the-counter medications you take to avoid medication overuse. (Related: Why Do I Keep Getting Headaches?)

Video: Why do migraines happen?


Specialized treatment can lead to better headache relief

When it comes to headaches, finding the right treatment for your unique symptoms is vital. A neurologist is trained to identify your headache and offer treatment options customized to each patient, such as:

  • BOTOX® injections
  • Cranial nerve blocks
  • Dietary supplements
  • Infusions
  • Noninvasive medical devices 
  • Over-the-counter and prescription medications 
  • Physical therapy
  • Psychological techniques


Before your appointment, it’s a good idea to keep a headache diary for several weeks, jotting down details about each headache’s onset. It may offer important clues as to what may be triggering your headaches — a significant step in preventing the pain.

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