Chronic Headache: Causes, Symptoms, and Treatment
Medically reviewed by Sumiran Racherla, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Chronic Headache?
A neurologist, a doctor who treats brain and nerve conditions, often treats chronic headache when it is hard to control or the cause is unclear. A primary care doctor can often start the evaluation. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is chronic headache?
Headache is the most common form of pain.
Headaches differ in how often they happen and how much pain they cause. Some happen again and again, which is called episodic. Others last for days or weeks at a time, which is called chronic.
Migraine is another common cause of repeated headaches. It brings attacks of moderate to severe throbbing pain, often on one side of the head. Doctors sort headaches into groups. A primary headache happens on its own, while a secondary headache happens because of some other medical condition. Chronic tension-type headaches happen more often and can last from hours to days or constantly.
Symptoms
Pain can range from mild to severe. It may come with nausea or more sensitivity to noise or light.
A tension headache is the most common type of headache. Its pain may feel:
- Dull and pressure-like, not throbbing.
- Like a tight band around the head.
- All over the head, not in one spot or on one side.
- Worse in the scalp, temples, or back of the neck.
Tension headaches usually do not cause nausea or vomiting. The pain may last from 30 minutes to 7 days.
Causes and who gets it
Doctors do not know exactly why some people get tension-type headache. Research shows that genes, brain signals, and muscle tenderness play important roles.
Tension headaches happen when neck and scalp muscles become tense or contract. Stress, depression, head injury, or anxiety can set this off.
Common triggers include:
- Emotional stress and mental strain.
- Not enough sleep or poor quality sleep.
- Changes in eating and sleep patterns, and dehydration (not enough water in the body).
- Too much caffeine or caffeine withdrawal, and alcohol use.
Taking pain medicine more than 3 days a week may lead to rebound headaches. These are headaches that keep coming back because of overuse of pain medicine.
How doctors diagnose it
A doctor will review your medical and headache history and do physical and neurological exams. The doctor may then order tests to look for a specific cause.
These tests can include blood, urine, and fluid tests, a CT scan, an MRI, or an EEG.
A headache journal can help a doctor better diagnose the type of headache and find the best treatment. After each headache, write down the time of day, how bad it was, and how long it lasted.
Treatment
The first step is to find any health conditions that could be causing the headaches. Over-the-counter medicines like aspirin, ibuprofen, or acetaminophen can help with pain. Taking too much acetaminophen can damage your liver. Too much ibuprofen, naproxen, or aspirin can irritate your stomach or damage your kidneys.
Regular overuse of headache medicine can make headaches worse or cause new ones. A doctor can help make a plan for safe medicine use.
A doctor may suggest different prescription medicines depending on the type of headache. For tension headache, antidepressants can help. For migraine, a doctor may use medicines that ease pain as it happens or medicines that help prevent attacks.
Biofeedback, relaxation training, meditation, and cognitive-behavioral therapy can help people manage stress from headache. Massage may also help.
Getting enough sleep can help with headache pain. Exercise and a healthy diet can also help prevent headaches.
When to see a doctor
Talk with a doctor if headaches affect your daily life. Contact your provider if your headache pattern or pain changes. Also contact your provider if treatments that once worked no longer help or you need pain medicine more than 3 days a week. NINDS lists two or more headaches a week among the reasons to call or see a doctor right away.
Call 911 or go to the emergency room if you have the worst headache of your life, the headache starts very suddenly, or the headache comes with repeated vomiting.
Also call 911 if you have a high fever or stiff neck with the headache. Call 911 as well for problems with speech, vision, or movement, or loss of balance, especially if you have not had these symptoms with a headache before.
See a doctor right away for a headache that follows a brain injury or gets worse over days or weeks.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either kind of doctor can review your headache history and help you keep a headache journal. A doctor can also help make a plan for safe medicine use.
Common questions
What is the difference between episodic and chronic headache?
Episodic headaches happen repeatedly, while chronic headaches last for days or weeks at a time. If tension headaches are long-term, they can interfere with life and work.
Can taking pain medicine too often cause headaches?
Yes, taking pain medicine more than 3 days a week may lead to rebound headaches. Regular overuse of headache medicine can worsen headaches or cause new ones.
Can stress cause chronic headaches?
Yes, emotional stress is an important trigger for tension-type headache. Some people find relaxation exercises or meditation helpful.
Sources
- National Institute of Neurological Disorders and Stroke - Headache
- MedlinePlus - Tension headache
- MedlinePlus - Headache
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
