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Chronic Migraines

Chronic migraines are frequent headaches that happen 15 or more days each month. They can cause more than head pain, including nausea, light sensitivity, and vision changes. Getting the right diagnosis and treatment plan can help reduce how often they happen and how much they affect your daily life.

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Overview

What Are Chronic Migraines?

Chronic migraines are diagnosed when someone has headaches 15 or more days a month for at least three months, and at least eight of those days have migraine symptoms. Unlike occasional migraines, chronic migraines can interfere with work, family life, and everyday routines.

Migraine pain is often throbbing and may affect one side of the head. Some people also experience nausea, vomiting, and sensitivity to light and sound. Others experience visual changes called aura, such as flashing lights or blind spots. Chronic migraines are considered a brain disorder that changes how the body processes pain.

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Common Types of Chronic Migraines

Chronic migraines can look different from person to person. Understanding the type of migraine you have can help guide treatment.

Chronic Migraine Without Aura

Frequent headaches with typical migraine symptoms, but no warning signs before the pain begins. The pain is usually moderate to severe and may get worse with movement.

Chronic Migraine With Aura

Includes temporary symptoms before or during the headache, such as flashing lights, blind spots, or tingling in the face or hands.

Medication Overuse Headache

Can develop when migraine medications are taken too often. This may lead to rebounding headaches and more frequent pain.

Hemiplegic Migraine

A rare type of migraine that can cause temporary weakness on one side of the body. Because it can look like a stroke, medical evaluation is important.

Vestibular Migraine

Often it causes dizziness, balance problems, or a spinning feeling. Head pain may or may not be present.

Menstrual-Related Chronic Migraine

Linked to hormone changes during the menstrual cycle. Migraines may become more frequent or more intense around this time.

What Causes Chronic Migraines

Chronic migraines usually develop from a mix of genetic factors, brain sensitivity, and environmental triggers. Changes in brain chemicals, including serotonin and CGRP, play an important role in how migraines start and continue.

Genetics

If migraines run in your family, you may be more likely to develop them.

Hormonal Changes

Shifts in estrogen levels during menstruation, pregnancy, or menopause can trigger migraines.

Stress

Emotional or physical stress is a common trigger and may increase how often migraines occur.

Sleep Disruption

Poor sleep, irregular schedules, or sleep disorders can make migraines more frequent.

Dietary Triggers

Some people are sensitive to certain foods or drinks, including alcohol or aged cheeses.

Neurological Sensitivity

People with chronic migraines often have a nervous system that is more sensitive to pain signals.

Treatments That Remedy Chronic Migraines

Managing chronic migraines often involves more than one approach. A treatment plan may include preventive medication, medicine taken during attacks, lifestyle changes, and sometimes in-office procedures. The goal is to reduce both the number of migraines and how severe they are.

Preventive Medications

Daily prescription medications can help lower the number of migraine days each month. These may include beta blockers, anti-seizure medications, or newer CGRP-targeting treatments.

Acute Migraine Medications

Taken at the start of a migraine to reduce pain and shorten the attack. These include triptans, gepants, and anti-inflammatory medications.

OnabotulinumtoxinA Injections

Also known as Botox, this treatment is FDA-approved for chronic migraine prevention. Injections are given every 12 weeks in specific areas of the head and neck.

CGRP Monoclonal Antibodies

These medications block a protein involved in migraine pain. They are usually given by injection once or every few months.

Neuromodulation Devices

Non-invasive devices use electrical or magnetic signals to help calm overactive pain pathways.

Lifestyle and Behavioral Therapy

Managing stress, improving sleep, staying hydrated, and working with a therapist trained in cognitive behavioral therapy can help reduce triggers and improve coping skills.

Related Concerns to Chronic Migraines

Chronic migraines often occur alongside other conditions. Treating these can improve overall migraine control.

Tension-Type Headaches

These can happen at the same time as migraines and may complicate treatment.

Anxiety and Depression

Mood disorders are more common in people with chronic migraines and may worsen symptoms.

Temporomandibular Joint Dysfunction

Jaw tension or clenching can trigger or worsen head pain.

Cervicogenic Headaches

Neck problems or muscle strain can contribute to chronic head pain.

Sleep Disorders

Conditions such as insomnia or sleep apnea can make migraines worse.

Hormonal Imbalances

Thyroid problems or other hormone changes may influence migraine patterns.

Frequently Asked Questions

Diagnosis is based on how often headaches occur, what symptoms are present, and your medical history. Imaging tests are only used if another condition needs to be ruled out.

There is no permanent cure, but many treatments can significantly reduce how often migraines happen and how severe they are.

OnabotulinumtoxinA is FDA-approved for chronic migraine prevention and has been shown to be safe when given by a trained provider.

Some treatments begin to help within a few weeks, while others may take several months for full results.

If headaches occur more than 15 days per month or regularly disrupt your daily life, it is reasonable to seek evaluation from a qualified provider.

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Sources & studies

The information presented on this page is supported by data and insights from the following trusted sources:

Headache Classification Committee of the International Headache Society (IHS)

This publication provides the formal diagnostic criteria for chronic migraine, including the requirement of 15 or more headache days per month for at least three months. It serves as the global standard for classification and diagnosis of migraine disorders.

Dodick DW et al. OnabotulinumtoxinA for treatment of chronic migraine: results from the PREEMPT clinical program

This Phase 3 clinical trial evaluated the safety and efficacy of onabotulinumtoxinA injections for chronic migraine prevention. Results demonstrated a statistically significant reduction in headache days compared to placebo, supporting its FDA approval for chronic migraine.

Goadsby PJ et al. Trial of erenumab for episodic migrain

This randomized clinical trial examined the role of CGRP monoclonal antibody therapy in migraine prevention. Findings support the effectiveness of CGRP pathway targeting in reducing migraine frequency and severity.

Lipton RB et al. Migraine prevalence, disease burden, and the need for preventive therapy

This epidemiological study outlines the prevalence and disability burden associated with migraine in the United States. It highlights the substantial impact of frequent migraines on quality of life and work productivity.

Ashina M. Migraine pathophysiology and emerging therapeutic targets

This review article summarizes current understanding of migraine neurobiology, including altered sensory processing and CGRP involvement. It provides context for modern preventive therapies and evolving treatment strategies.

All sources are reviewed for accuracy and credibility to ensure the content remains reliable and up to date.

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