Understanding Chronic Migraine

Recognize the symptoms and risk factors for chronic migraine

More than 4 million American adults live with chronic migraine, and those numbers grow each year. Receiving an accurate diagnosis is the first step in understanding your chronic migraine and finding a treatment plan that provides the relief you deserve. If you’re trying to prevent your episodic migraine from worsening, or if you suspect your migraine attack frequency may qualify as chronic, read on to learn more about your symptoms, your risk factors, and when it’s time to speak with a headache specialist.

What is Chronic Migraine?

Migraine is not just a headache. Head pain in migraine attacks is typically accompanied by symptoms like nausea, aura and a heightened sensitivity to light, sound and odor. Whether a migraine is chronic or episodic is defined by the frequency of headache episodes. The diagnostic criteria for chronic migraine is more than 15 headache days per month, with at least 8 that include migraine features, for more than three months. Chronic migraine often appears in people whose less frequent, episodic migraine has worsened: “Chronic migraine and episodic migraine are truly on a spectrum of disease,” said Dr. Amaal Starling, Assistant Professor of Neurology at the Mayo Clinic.

Risk Factors for Chronic Migraine

Studies estimate that about 2.5% of people with episodic migraine will transition to chronic migraine each year. There are several risk factors that can increase the likelihood of migraine progression. High frequency of headache attacks, especially poorly treated headache attacks, is a common risk factor, especially as it can lead to medication overuse. Dr. Starling says frequent reliance on medication to abort headaches is “a prominent risk factor for the conversion and progression of episodic to chronic migraine.” Other risk factors include obesity, snoring, caffeine use and untreated depression and anxiety.

Signs Your Migraine May Be Chronic

The primary sign that your migraine is progressing is an increase in the frequency of migraine attacks. Maintain a daily headache diary to keep track of the exact number of days per month that you experience a headache, and the symptoms and behaviors that precede it. If you consistently have two or more headaches each month, and you’re not receiving preventive treatment, it’s time to find a headache specialist to explore your prevention options. The human brain doesn’t always adjust well to new situations and will start to normalize more frequent migraine attacks and pain, leading to the progression of migraine.

Reducing Your Risk

The best way to prevent your migraine from progressing is to address your risk factors early. Talk to your doctors and address factors you can control, like your overall health. Eating well and exercising regularly can combat some migraine symptoms and is key to avoiding obesity, a potent risk factor for chronic migraine. Starling recommends patients also keep an eye on the number of prescription and over-the-counter medicines they are taking.

If you live with chronic migraine, you are not alone. The resources you need to manage your migraine are at your fingertips, as are millions of people who understand exactly what you’re going through. Connect instantly with patients in our online support group, and find a headache specialist near you using our directory to devise a treatment plan that works for you.

To learn more about chronic migraine, The American Migraine Foundation created this infographic to explain chronic migraine including the signs of progression and next steps to take.