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Preventive Medication, Stress Reduction May Help with Chronic Headache

Q. I’ve had chronic daily headaches for more than four years. I just cannot get relief. I have tension headaches that typically start at the same time each day. Recently, I’ve been having more and more nausea and visual problems. I fear I may have rebound headache from using ibuprofen nearly daily for so long.

I would like to know if there is an invasive but guaranteed method for eliminating head pain so I can have my life back. I’m doing a trial with an implant in my forehead, but I haven’t gotten the results I was hoping for. I am now hoping my doctor will allow me to try again with an occipital area implant.

A. If indeed you have tension headaches, I doubt that stimulation of a specific nerve will give you any lasting relief. Tension-type headaches are usually generalized all over the head, not localized to the area supplied by a specific nerve.

There is no guaranteed procedure that will eliminate head pain. Countless different procedures have been tried for many years, and none has yet proven successful. Most chronic headaches are due to biochemical dysfunction in the brain; stimulating a nerve or destroying a nerve in the scalp isn’t going to affect the abnormality going on in the brain cells.

The use of daily pain pills, such as ibuprofen, and especially those containing caffeine can be a cause of daily headache. You need to be on a preventive type of medication. The best choice for chronic tension-type headache is one of the antidepressants, such as amitriptyline. Seeking help in identifying and reducing stresses in your life may help reduce your headaches as well.

Robert S. Kunkel, M.D.

Emeritus staff

Former Director of the Headache Clinic

Cleveland Clinic Foundation

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