Table of ContentsView AllTable of ContentsWhen It Won’t Go AwayEmergency SymptomsCausesTreatment at HomePrescriptionsNeurologist Referral
Table of ContentsView All
View All
Table of Contents
When It Won’t Go Away
Emergency Symptoms
Causes
Treatment at Home
Prescriptions
Neurologist Referral
Although unpleasant and sometimes debilitating, mostheadachesare not dangerous and can be managed safely at home with over-the-counter (OTC) or prescription medication. However, if you are experiencing a headache that won’t go away despite treatment at home, it’s important to seek medical help right away.
Serious head pain may requireintravenous(through a vein) medication in an emergency room to relieve. Also, a persistent or continuous headache could be a sign that your headaches are transforming into a chronic type or that a serious underlying condition occurring, such as astroke, nervous system infection, or brain blood vessel problem.
This article explores the potential causes and treatments of a persistent headache. It also reviews headache features that should alert you to seek medical help.
ozgurcankaya / Getty Images
When a Headache Won’t Go Away
Headaches are classified as primary orsecondarydisorders.
Primary vs. Secondary HeadachesPrimary headaches exist on their own with no underlying cause. In contrast, a secondary headache is a symptom of a health-related factor (e.g., sinus infection or medication-induced).
Primary vs. Secondary Headaches
Primary headaches exist on their own with no underlying cause. In contrast, a secondary headache is a symptom of a health-related factor (e.g., sinus infection or medication-induced).
The most common primary headache disorders aremigraineandtension-type. Migraine and tension-type headaches are generally acute or episodic, meaning they last a finite time (e.g., hours to days) and occur less than 15 days per month.
Persistent or continuous headaches, on the other hand, can signal one of the following:
Status Migrainosus
Withstatus migrainosusheadaches (or intractable headaches), can last for 72 hours or longer and are often resistant to typical migraine medications. This condition manifests in less than 1% of people affected with migraine headaches.
Chronic Daily Headaches
In a small percentage of people, episodic migraine and tension-type headaches transform into chronic headaches, which occur 15 or more days per month for at least three months, as follows:
Other chronic daily headaches include:
Secondary Headaches
A headache that won’t go away may also indicate a severe underlying condition.
While not a complete list, examples include:
Keep in MindSecondary headaches are less common than primary headaches. They are only diagnosed in 2% to 7% of people who visit the emergency room with headaches.
Keep in Mind
Secondary headaches are less common than primary headaches. They are only diagnosed in 2% to 7% of people who visit the emergency room with headaches.
Emergency Symptoms and Pain Severity
As stated above, while most headaches are not a cause for alarm, certain features warrant medical help.
Seek Emergency Medical Attention
Go to the nearest emergency room or call 911 if your headache:
A persistent migraine headache—one lasting more than 72 hours—is also a reason to go to the emergency room for further evaluation and relief.
Lastly, speak with a healthcare provider promptly or obtain medical attention in these scenarios:
When Should You Worry About a Headache?
Causes of Continuous Headaches
Several factors can make a person vulnerable to developing chronic or continuous headaches, although sometimes they manifest for unknown reasons.
For example, factors linked to the transformation from episodic tochronic migraineinclude:
Chronic tension-type headachesmay also manifest from similar factors mentioned above, namely, stress, lack of sleep, and headache medication overuse.
How Often Should Pain Medications Be Taken?
COVID-19 and Continuous HeadacheCOVID-19is a type of coronavirus that first appeared in late 2019. One Latin American study found that a subset of people who experienced a severe COVID-19 course developed a chronic headache, consistent with a diagnosis of a new daily persistent headache. Common traits of the headache were intense, “burning,” and located at the back of the head.
COVID-19 and Continuous Headache
COVID-19is a type of coronavirus that first appeared in late 2019. One Latin American study found that a subset of people who experienced a severe COVID-19 course developed a chronic headache, consistent with a diagnosis of a new daily persistent headache. Common traits of the headache were intense, “burning,” and located at the back of the head.
At Home, What Helps a Headache That Won’t Go Away?
Headache treatment depends on factors like severity and type but often entails a combination of medication and home remedies.
Migraine and Tension-Type Headaches
Medications to help treatmigraine headachesinclude:
Medications for Treating Migraine Headaches
Home remedies to treat a migraine headache include:
OTC Tylenol or an NSAID is usually sufficient to treat tension-type headaches.An ice pack over the neck and forehead can also be soothing.
Precaution for OTC MedicationsDue to possible harm, not everyone can take Tylenol or NSAIDs. Only take these drugs after speaking with a healthcare provider to ensure they are safe and appropriate for you.
Precaution for OTC Medications
Due to possible harm, not everyone can take Tylenol or NSAIDs. Only take these drugs after speaking with a healthcare provider to ensure they are safe and appropriate for you.
If a headache persists (despite the above therapies taken under the care of a provider), seek emergency medical attention.
Once in the emergency room, you can expect to undergo a medical assessment to rule out serious causes. The evaluation may involve one or more of the following:
Status Migrainous
If deemed you are experiencing a severe migraine headache orstatus migrainous, you will likely be given intravenous medications and fluids to ease symptoms.
While protocols vary among hospitals, a typical “migraine cocktail” consists of one or more of the following:
How Are Migraines Treated the ER?
Pharmacological treatment ofchronic daily headachesinvolves the following:
Lifestyle behaviors and non-pharmacological therapies can also help manage continuous or chronic headaches. These include:
15 Alternative and Home Migraine Treatments
If you are diagnosed with asecondary headache, treatment is focused on the underlying issue.
For example, secondary headaches arising from meningitis, a ruptured aneurysm, or an ischemic stroke (as described above) require intensive hospital care, including close monitoring, intravenous (IV) medications, and/or surgery.
Prescriptions for Intense, Lasting Headaches
If your headaches are chronic, lasting longer than usual, and/or interfering with your daily functioning and quality of life, you may be a candidate for preventive headache medication.
Common preventive medications for migraine include:
Botulinum toxin injections(Botox) are intended to temporarily decrease muscle contractions. They may be administered as a preventive treatment for chronic migraine.
CGRP Inhibitors for Migraine Treatment
Common preventive medications for tension-type headaches include:
Neurologist Referral for Individualized Diagnosis
Aneurologistis a physician who specializes in diagnosing and treating nervous system disorders, including migraines and other types of headaches.
See a neurologist if you are experiencing severe or frequent headaches, especially if they are not responding well to current treatments.
You and your neurologist can devise an individually tailored treatment plan, one that will likely include a delicate combination of medication, lifestyle habits, and complementary therapies.
Keep in mind that the proper treatment regimen may require some trial and error. As you navigate this process, don’t hesitate to contact loved ones for emotional support.
What Is a Headache Specialist and Do You Need One?
Summary
Most headaches are no cause for alarm and can be treated with OTC or prescribed medication and home remedies. However, a headache that persists despite typical therapies can indicate that something more serious is happening in the nervous system. It can also be a sign of a chronic headache disorder.
Seek medical attention immediately if you have a persistent headache or if your headaches are associated with other problematic features, such as sudden and severe onset, prolonged vomiting, vision changes, or fever.
23 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Singh TD, Cutrer FM, Smith JH.Episodic status migrainosus: a novel migraine subtype.Cephalalgia. 2018;38(2):304-311. doi:10.1177/0333102416686341Yancey JR, Sheridan R, Koren KG.Chronic daily headache: diagnosis and management.Am Fam Physician. 2014;89(8):642-648.Ghadiri-Sani M, Silver N.Headache (chronic tension-type).BMJ Clin Evid. 2016;2016:1205.Garza I, Schwedt TJ.Hemicrania continua. In:UpToDate, Swanson JW (Ed), UpToDate, Waltham, MA. April 10, 2024.Yamani N, Olesen J.New daily persistent headache: a systematic review on an enigmatic disorder.J Headache Pain. 2019;20(1). doi:10.1186/s10194-019-1022-zVandenbussche N, Laterza D, Lisicki M, et al.Medication-overuse headache: a widely recognized entity amidst ongoing debate.J Headache Pain. 2018;19(1):50. doi:10.1186/s10194-018-0875-xWijeratne T, Wijeratne C, Korajkic N, Bird S, Sales C, Riederer F.Secondary headaches - red and green flags and their significance for diagnostics.eNeurological Sci. 2023;32:100473. doi:10.1016/j.ensci.2023.100473Phu Do T, Remmers A, Schytz HW et al.Red and orange flags for secondary headaches in clinical practice: SNNOOP10 list.Neurology.2019;92(3):134-144. doi:10.1212/WNL.0000000000006697American Migraine Foundation.What is status migrainosus?March 31, 2022.Torres-Ferrús M, Ursitti F, Alpuente A, et al.From transformation to chronification of migraine: pathophysiological and clinical aspects.J Headache Pain. 2020;21(1):42. doi:10.1186/s10194-020-01111-8Chowdhury D.Tension type headache.Ann Indian Acad Neurol.2012 Aug;15(Suppl 1):S83-8. doi:10.4103/0972-2327.100023Cheema S, Stubberud A, Rantell K, Nachev P, Tronvik E, Matharu M.Phenotype of new daily persistent headache: subtypes and comparison to transformed chronic daily headache.J Headache Pain. 2023;24(1):109. doi:10.1186/s10194-023-01639-5Carrión-Nessi FS, Ascanio LC, Pineda-Arapé AG, et al.New daily persistent headache after SARS-CoV-2 infection in Latin America: a cross-sectional study.BMC Infect Dis. 2023;23(1):877. doi:10.1186/s12879-023-08898-2Ashina M, Buse DC, Ashina H et al.Migraine: integrated approaches to clinical management and emerging treatments.Lancet2021;397(10283):1505-1518. doi:10.1016/S0140-6736(20)32342-4Rizzoli P, Mullally W.Headache.Am J Med. 2018;131(1):17-24. doi:10.1016/j.amjmed.2017.09.005Weatheral MW.The diagnosis and treatment of chronic migraine.Ther Adv Chronic Dis.2015;6(3):115–123. doi:10.1177/2040622315579627American Migraine Foundation.Migraine cocktails: what they are and why they are misunderstood. February 10, 2022.American Migraine Foundation.Magnesium and migraine. October 20, 2021.Garza I, Schwedt TJ.Chronic daily headache: associated syndrome, evaluation, and management. In:UpToDate, Swanson JW (Ed), UpToDate, Waltham, MA. May 20, 2024.Kroner JW, Peugh J, Kashikar-Zuck SM, et al, Powers SW.Trajectory of improvement in children and adolescents with chronic migraine: results from the cognitive-behavioral therapy and amitriptyline trial.J Pain. 2017;18(6):637-644. doi:10.1016/j.jpain.2017.01.002Repiso-Guardeño A, Moreno-Morales N, Armenta-Pendón MA, et al.Physical therapy in tension-type headache: a systematic review of randomized controlled trials.Int J Environ Res Public Health. 2023;20(5):4466. doi:10.3390/ijerph20054466Herd CP, Tomlinson CL, Rick C, et al.Botulinum toxins for the prevention of migraine in adults.Cochrane Database Syst Rev.2018;6:CD011616. doi:10.1002/14651858.CD011616.pub2Ashina S, Mitsikostas DD, Lee MJ, et al.Tension-type headache.Nat Rev Dis Primers. 2021;7(1):24. doi:10.1038/s41572-021-00257-2
23 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Singh TD, Cutrer FM, Smith JH.Episodic status migrainosus: a novel migraine subtype.Cephalalgia. 2018;38(2):304-311. doi:10.1177/0333102416686341Yancey JR, Sheridan R, Koren KG.Chronic daily headache: diagnosis and management.Am Fam Physician. 2014;89(8):642-648.Ghadiri-Sani M, Silver N.Headache (chronic tension-type).BMJ Clin Evid. 2016;2016:1205.Garza I, Schwedt TJ.Hemicrania continua. In:UpToDate, Swanson JW (Ed), UpToDate, Waltham, MA. April 10, 2024.Yamani N, Olesen J.New daily persistent headache: a systematic review on an enigmatic disorder.J Headache Pain. 2019;20(1). doi:10.1186/s10194-019-1022-zVandenbussche N, Laterza D, Lisicki M, et al.Medication-overuse headache: a widely recognized entity amidst ongoing debate.J Headache Pain. 2018;19(1):50. doi:10.1186/s10194-018-0875-xWijeratne T, Wijeratne C, Korajkic N, Bird S, Sales C, Riederer F.Secondary headaches - red and green flags and their significance for diagnostics.eNeurological Sci. 2023;32:100473. doi:10.1016/j.ensci.2023.100473Phu Do T, Remmers A, Schytz HW et al.Red and orange flags for secondary headaches in clinical practice: SNNOOP10 list.Neurology.2019;92(3):134-144. doi:10.1212/WNL.0000000000006697American Migraine Foundation.What is status migrainosus?March 31, 2022.Torres-Ferrús M, Ursitti F, Alpuente A, et al.From transformation to chronification of migraine: pathophysiological and clinical aspects.J Headache Pain. 2020;21(1):42. doi:10.1186/s10194-020-01111-8Chowdhury D.Tension type headache.Ann Indian Acad Neurol.2012 Aug;15(Suppl 1):S83-8. doi:10.4103/0972-2327.100023Cheema S, Stubberud A, Rantell K, Nachev P, Tronvik E, Matharu M.Phenotype of new daily persistent headache: subtypes and comparison to transformed chronic daily headache.J Headache Pain. 2023;24(1):109. doi:10.1186/s10194-023-01639-5Carrión-Nessi FS, Ascanio LC, Pineda-Arapé AG, et al.New daily persistent headache after SARS-CoV-2 infection in Latin America: a cross-sectional study.BMC Infect Dis. 2023;23(1):877. doi:10.1186/s12879-023-08898-2Ashina M, Buse DC, Ashina H et al.Migraine: integrated approaches to clinical management and emerging treatments.Lancet2021;397(10283):1505-1518. doi:10.1016/S0140-6736(20)32342-4Rizzoli P, Mullally W.Headache.Am J Med. 2018;131(1):17-24. doi:10.1016/j.amjmed.2017.09.005Weatheral MW.The diagnosis and treatment of chronic migraine.Ther Adv Chronic Dis.2015;6(3):115–123. doi:10.1177/2040622315579627American Migraine Foundation.Migraine cocktails: what they are and why they are misunderstood. February 10, 2022.American Migraine Foundation.Magnesium and migraine. October 20, 2021.Garza I, Schwedt TJ.Chronic daily headache: associated syndrome, evaluation, and management. In:UpToDate, Swanson JW (Ed), UpToDate, Waltham, MA. May 20, 2024.Kroner JW, Peugh J, Kashikar-Zuck SM, et al, Powers SW.Trajectory of improvement in children and adolescents with chronic migraine: results from the cognitive-behavioral therapy and amitriptyline trial.J Pain. 2017;18(6):637-644. doi:10.1016/j.jpain.2017.01.002Repiso-Guardeño A, Moreno-Morales N, Armenta-Pendón MA, et al.Physical therapy in tension-type headache: a systematic review of randomized controlled trials.Int J Environ Res Public Health. 2023;20(5):4466. doi:10.3390/ijerph20054466Herd CP, Tomlinson CL, Rick C, et al.Botulinum toxins for the prevention of migraine in adults.Cochrane Database Syst Rev.2018;6:CD011616. doi:10.1002/14651858.CD011616.pub2Ashina S, Mitsikostas DD, Lee MJ, et al.Tension-type headache.Nat Rev Dis Primers. 2021;7(1):24. doi:10.1038/s41572-021-00257-2
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Singh TD, Cutrer FM, Smith JH.Episodic status migrainosus: a novel migraine subtype.Cephalalgia. 2018;38(2):304-311. doi:10.1177/0333102416686341Yancey JR, Sheridan R, Koren KG.Chronic daily headache: diagnosis and management.Am Fam Physician. 2014;89(8):642-648.Ghadiri-Sani M, Silver N.Headache (chronic tension-type).BMJ Clin Evid. 2016;2016:1205.Garza I, Schwedt TJ.Hemicrania continua. In:UpToDate, Swanson JW (Ed), UpToDate, Waltham, MA. April 10, 2024.Yamani N, Olesen J.New daily persistent headache: a systematic review on an enigmatic disorder.J Headache Pain. 2019;20(1). doi:10.1186/s10194-019-1022-zVandenbussche N, Laterza D, Lisicki M, et al.Medication-overuse headache: a widely recognized entity amidst ongoing debate.J Headache Pain. 2018;19(1):50. doi:10.1186/s10194-018-0875-xWijeratne T, Wijeratne C, Korajkic N, Bird S, Sales C, Riederer F.Secondary headaches - red and green flags and their significance for diagnostics.eNeurological Sci. 2023;32:100473. doi:10.1016/j.ensci.2023.100473Phu Do T, Remmers A, Schytz HW et al.Red and orange flags for secondary headaches in clinical practice: SNNOOP10 list.Neurology.2019;92(3):134-144. doi:10.1212/WNL.0000000000006697American Migraine Foundation.What is status migrainosus?March 31, 2022.Torres-Ferrús M, Ursitti F, Alpuente A, et al.From transformation to chronification of migraine: pathophysiological and clinical aspects.J Headache Pain. 2020;21(1):42. doi:10.1186/s10194-020-01111-8Chowdhury D.Tension type headache.Ann Indian Acad Neurol.2012 Aug;15(Suppl 1):S83-8. doi:10.4103/0972-2327.100023Cheema S, Stubberud A, Rantell K, Nachev P, Tronvik E, Matharu M.Phenotype of new daily persistent headache: subtypes and comparison to transformed chronic daily headache.J Headache Pain. 2023;24(1):109. doi:10.1186/s10194-023-01639-5Carrión-Nessi FS, Ascanio LC, Pineda-Arapé AG, et al.New daily persistent headache after SARS-CoV-2 infection in Latin America: a cross-sectional study.BMC Infect Dis. 2023;23(1):877. doi:10.1186/s12879-023-08898-2Ashina M, Buse DC, Ashina H et al.Migraine: integrated approaches to clinical management and emerging treatments.Lancet2021;397(10283):1505-1518. doi:10.1016/S0140-6736(20)32342-4Rizzoli P, Mullally W.Headache.Am J Med. 2018;131(1):17-24. doi:10.1016/j.amjmed.2017.09.005Weatheral MW.The diagnosis and treatment of chronic migraine.Ther Adv Chronic Dis.2015;6(3):115–123. doi:10.1177/2040622315579627American Migraine Foundation.Migraine cocktails: what they are and why they are misunderstood. February 10, 2022.American Migraine Foundation.Magnesium and migraine. October 20, 2021.Garza I, Schwedt TJ.Chronic daily headache: associated syndrome, evaluation, and management. In:UpToDate, Swanson JW (Ed), UpToDate, Waltham, MA. May 20, 2024.Kroner JW, Peugh J, Kashikar-Zuck SM, et al, Powers SW.Trajectory of improvement in children and adolescents with chronic migraine: results from the cognitive-behavioral therapy and amitriptyline trial.J Pain. 2017;18(6):637-644. doi:10.1016/j.jpain.2017.01.002Repiso-Guardeño A, Moreno-Morales N, Armenta-Pendón MA, et al.Physical therapy in tension-type headache: a systematic review of randomized controlled trials.Int J Environ Res Public Health. 2023;20(5):4466. doi:10.3390/ijerph20054466Herd CP, Tomlinson CL, Rick C, et al.Botulinum toxins for the prevention of migraine in adults.Cochrane Database Syst Rev.2018;6:CD011616. doi:10.1002/14651858.CD011616.pub2Ashina S, Mitsikostas DD, Lee MJ, et al.Tension-type headache.Nat Rev Dis Primers. 2021;7(1):24. doi:10.1038/s41572-021-00257-2
Singh TD, Cutrer FM, Smith JH.Episodic status migrainosus: a novel migraine subtype.Cephalalgia. 2018;38(2):304-311. doi:10.1177/0333102416686341
Yancey JR, Sheridan R, Koren KG.Chronic daily headache: diagnosis and management.Am Fam Physician. 2014;89(8):642-648.
Ghadiri-Sani M, Silver N.Headache (chronic tension-type).BMJ Clin Evid. 2016;2016:1205.
Garza I, Schwedt TJ.Hemicrania continua. In:UpToDate, Swanson JW (Ed), UpToDate, Waltham, MA. April 10, 2024.
Yamani N, Olesen J.New daily persistent headache: a systematic review on an enigmatic disorder.J Headache Pain. 2019;20(1). doi:10.1186/s10194-019-1022-z
Vandenbussche N, Laterza D, Lisicki M, et al.Medication-overuse headache: a widely recognized entity amidst ongoing debate.J Headache Pain. 2018;19(1):50. doi:10.1186/s10194-018-0875-x
Wijeratne T, Wijeratne C, Korajkic N, Bird S, Sales C, Riederer F.Secondary headaches - red and green flags and their significance for diagnostics.eNeurological Sci. 2023;32:100473. doi:10.1016/j.ensci.2023.100473
Phu Do T, Remmers A, Schytz HW et al.Red and orange flags for secondary headaches in clinical practice: SNNOOP10 list.Neurology.2019;92(3):134-144. doi:10.1212/WNL.0000000000006697
American Migraine Foundation.What is status migrainosus?March 31, 2022.
Torres-Ferrús M, Ursitti F, Alpuente A, et al.From transformation to chronification of migraine: pathophysiological and clinical aspects.J Headache Pain. 2020;21(1):42. doi:10.1186/s10194-020-01111-8
Chowdhury D.Tension type headache.Ann Indian Acad Neurol.2012 Aug;15(Suppl 1):S83-8. doi:10.4103/0972-2327.100023
Cheema S, Stubberud A, Rantell K, Nachev P, Tronvik E, Matharu M.Phenotype of new daily persistent headache: subtypes and comparison to transformed chronic daily headache.J Headache Pain. 2023;24(1):109. doi:10.1186/s10194-023-01639-5
Carrión-Nessi FS, Ascanio LC, Pineda-Arapé AG, et al.New daily persistent headache after SARS-CoV-2 infection in Latin America: a cross-sectional study.BMC Infect Dis. 2023;23(1):877. doi:10.1186/s12879-023-08898-2
Ashina M, Buse DC, Ashina H et al.Migraine: integrated approaches to clinical management and emerging treatments.Lancet2021;397(10283):1505-1518. doi:10.1016/S0140-6736(20)32342-4
Rizzoli P, Mullally W.Headache.Am J Med. 2018;131(1):17-24. doi:10.1016/j.amjmed.2017.09.005
Weatheral MW.The diagnosis and treatment of chronic migraine.Ther Adv Chronic Dis.2015;6(3):115–123. doi:10.1177/2040622315579627
American Migraine Foundation.Migraine cocktails: what they are and why they are misunderstood. February 10, 2022.
American Migraine Foundation.Magnesium and migraine. October 20, 2021.
Garza I, Schwedt TJ.Chronic daily headache: associated syndrome, evaluation, and management. In:UpToDate, Swanson JW (Ed), UpToDate, Waltham, MA. May 20, 2024.
Kroner JW, Peugh J, Kashikar-Zuck SM, et al, Powers SW.Trajectory of improvement in children and adolescents with chronic migraine: results from the cognitive-behavioral therapy and amitriptyline trial.J Pain. 2017;18(6):637-644. doi:10.1016/j.jpain.2017.01.002
Repiso-Guardeño A, Moreno-Morales N, Armenta-Pendón MA, et al.Physical therapy in tension-type headache: a systematic review of randomized controlled trials.Int J Environ Res Public Health. 2023;20(5):4466. doi:10.3390/ijerph20054466
Herd CP, Tomlinson CL, Rick C, et al.Botulinum toxins for the prevention of migraine in adults.Cochrane Database Syst Rev.2018;6:CD011616. doi:10.1002/14651858.CD011616.pub2
Ashina S, Mitsikostas DD, Lee MJ, et al.Tension-type headache.Nat Rev Dis Primers. 2021;7(1):24. doi:10.1038/s41572-021-00257-2
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