Migraines vs. Chronic Migraines

Medically Reviewed by Murtaza Cassoobhoy, MD on February 13, 2023
4 min read

Most people who are prone to migraines get a painful attack once or twice a month. But if you have the condition known as chronic migraine, you get headaches much more often -- 15 or more days a month for at least 3 months. These frequent and severe attacks can make living a normal life a challenge.

If you have migraines, you don’t need to be told how painful they are. They aren’t just a “bad” headache. Symptoms can include:

  • Severe throbbing pain on one or both sides of your head
  • Nausea
  • Vomiting
  • Feeling dizzy
  • Tingling in your face, hands, or feet
  • Auras (seeing flashing lights, colors, lines, or shadows)

During a migraine, you might also find bright lights, sounds, touch, and smells painful.

Chronic migraine shares these symptoms. The difference is in the timing. To be diagnosed with this condition, you’ll have headaches at least 15 days a month.

Doctors are learning more about what brings on these headaches, which often run in families. Some are the result of changes in your brain chemicals. Abnormal brain activity is also involved.

Every person who has migraines has different triggers, but common ones include a lack of sleep, caffeine, and being under stress.

Most people who get chronic migraines are women. This may be because hormone changes are another well-known cause. These shifts happen around your monthly period, as well as during pregnancy and through menopause. Birth control can also play a role.

Both migraine and chronic migraine can be treated with the same drugs. These include medications that treat the pain and symptoms (like vomiting or nausea) as well as drugs that treat the underlying cause of migraine. In some cases, there are medical devices you can use to interrupt the headache. Still, no treatment is perfect.

Because of that, chronic migraines can take a toll on your personal life. If you get painful headaches for half of each month, you lose days of work or school and precious time with friends and family. It’s common for people with chronic migraines to also have depression.

Taking care of yourself every day may prevent your migraines from turning into a long-term problem. For instance:

Catch some ZZZs. Not getting enough sleep can trigger a migraine. Aim for 7 to 8 hours of rest each night.

Watch your diet. While caffeine can soothe your pain, stopping it suddenly is a common cause of migraine. Other common food triggers include MSG (monosodium glutamate), nitrates in cured meats like hot dogs, artificial sweeteners, and alcohol.

Manage your stress. Tension and worry are common triggers. Try to carve out a few minutes each day to do something you love, or learn to breathe deeply when you’re in the midst of a crisis. You might join a support group or talk to a counselor.

Have a meal plan. Fasting and skipping meals can trigger headaches. Try to eat around the same times each day.

Get moving. Exercise is a good way to ease your anxiety and stress. It can also help you get to, and stay at, a healthy weight. Since obesity raises your risk of chronic migraines, getting in shape is crucial.

Know your triggers. Not all migraines result from triggers. But if yours do, that set of triggers is unique to you. To learn what yours are, keep a headache diary. Each time you have an attack, write down details about what you were doing, how long the headache lasted, and how you felt before it started. This will help you begin to notice patterns -- and avoid your triggers.

Be careful with your medicine. If you have chronic migraine, you’ll probably take preventive medications. If you get a headache anyway, you might be tempted to use what your doctor will call acute medicine. It’s designed to treat sudden attacks. But too much can lead to a problem called medication-overuse headache (MOH). The drug that’s supposed to stop headaches starts to cause them. You could wind up with a dull, constant pain every day.

To prevent this, try not to take any pain-relief drug more than two to three times a week or 10 times in the same month. If you think you’re having MOHs, talk to your doctor.

Don’t wait to seek help. If you can’t stop throwing up or have a change in vision, get emergency medical care. You should also get checked out if a headache lasts more than 72 hours, is severe, or if you have any new symptoms that are frightening to you.