Migraine and chronic pain: what is chronic migraine?

Chronic pain is pain that continues for weeks, months or even years. Migraine is one of the most common forms of chronic pain, especially chronic migraine, where you have headache on 15 or more days a month. It affects not only your physical wellbeing but also your mental health, and it is often underestimated by the people around you.

What is chronic pain?

Everyone has pain now and then, but when pain is present most of the time, it is called chronic pain. It can occur anywhere in the body. Living with constant or frequent pain affects sleep, mood, work and relationships, and it can be exhausting in ways that are hard to explain to others.

What is chronic migraine?

Chronic migraine is a severe form of migraine in which you have headache on at least 15 days a month, with at least 8 of those days having the features of migraine. Migraine is more than a headache: it is a complex brain condition that can severely limit daily life. The ongoing pain of chronic migraine often comes with other symptoms, such as nausea, sensitivity to light and sound, and difficulty concentrating, which makes it hard to function normally.

How does chronic migraine develop?

Chronic migraine often develops gradually. What starts as episodic migraine, with a few attacks a month, can become more frequent over time. Factors such as taking painkillers or other acute medication too often can contribute to this. When attacks become frequent enough, the diagnosis becomes chronic migraine.

What is the difference between episodic and chronic migraine?

The difference lies in the number of headache days. In episodic migraine you have headache on fewer than 15 days a month. In chronic migraine you are almost constantly in a cycle of pain and recovery, often with little time in between to feel fully well.

How does medication overuse affect chronic pain?

When attacks are frequent, it is understandable to reach for acute medication often. But taking painkillers on 15 or more days a month, or triptans on 10 or more days a month, can cause medication overuse headache and keep the cycle of daily pain going. If this sounds familiar, it is worth discussing with a migraine specialist rather than simply cutting down on your own.

Is there treatment for chronic migraine?

Chronic migraine can make you feel there is no way out, especially if you have lived with pain for a long time. Many people with chronic migraine feel hopeless and frustrated, because it is so hard to plan your life around the constant threat of an attack. But treatment can help.

Preventive treatment aims to reduce how often attacks happen and how severe they are. Our migraine specialists can offer the monoclonal CGRP inhibitors erenumab, fremanezumab and galcanezumab, and the gepants atogepant and rimegepant, all developed specifically for migraine. For the attacks you still have, triptans work best when taken early.

A headache diary can help too. Recording your headache days, your symptoms and the medication you take gives you and your migraine specialist a clear picture of how often attacks happen and whether treatment is working.

At your first consultation, a migraine specialist talks through your situation with you and makes a plan that fits your needs. The aim is fewer and milder attacks, so that you can take back control of your life.

How can The Migraine Clinic help?

Our migraine specialists understand that migraine is much more than a headache. You see them by video, without a GP referral. Not sure whether you have migraine? Take our free migraine test. Want to know more? Read about what migraine is and our preventive medication, or see how to start.