New Daily Persistent Headache: Symptoms, Causes & Treatments

If you have had daily head pain for a few months, you might have a distinct type of primary headache: new daily persistent headache.

Sometimes confused with chronic headache disorders, new daily persistent headache (NDPH) is unique in one way:  NDPH sufferers have no prior history of a chronic headache syndrome before developing this long lasting headache.

Chronic headaches (including NDPH)  affect 45 million Americans  every year. NDPH itself is relatively rare, but that is all the more reason to educate yourself on this  headache disorder .

These clinical features are the work of the international medical community. The International Classification of Headache Disorders (ICHD) describes NDPH in great detail, published by the International Headache Society.

NDPH must not be confused with other primary and secondary causes of headaches. The key difference is this:

Before the first onset of headache symptoms, the NDPH sufferer had absolutely no history of chronic headaches. The telltale sign is when patients remember the exact date of their first headache.

How long does NDPH last?  Three months is the minimum cutoff. You can try preventive treatments before then and headache pain  can  last much longer than that. But three months is when your healthcare provider will officially be able to diagnose NDPH.

These diagnostic criteria should help you and your doctor figure out whether you should receive a diagnosis of NDPH. But a doctor may still need to administer brain magnetic resonance imaging (MRI) or CAT scan.

When should you be concerned about a headache?  Three months is the minimum cutoff for NDPH. Once head pain has persisted for three straight months, you may have this primary headache disorder, and you should see your healthcare provider right away.

Why new daily persistent headache occurs is unclear, but it  seems to be  related to inflammation and/or cervical spine  joint hypermobility.

There are, however, a few known root causes and risk factors for NDPH. Determining which applies to you is important as it allows you and your provider(s) to target the root cause of your pain.

Causes and risk factors of NDPH:

According to a 2016 clinic-based study by Dr. Todd Rozen published in  Headache,  more than  50% of patients cannot identify  an NDPH trigger.

How common is NDPH?  Actually, NDPH is rare.  A landmark study  published in  Cephalalgia  shows that only 0.03% of Norway’s general population experienced NDPH, and that the average age is 35 years old.

Does new persistent daily headache ever go away?  In some patients, NDPH can be easily treated and never recur. In others, NDPH may recur later in life.

Nevertheless, you need to treat your NDPH. Fortunately, there are some great NDPH treatment options.

Low levels of  cerebrospinal fluid  (CSF) can cause cervicogenic headaches, but  also can cause  new daily persistent headaches. Chiropractic care is the number one treatment option for correcting the spinal alignment and normalizing CSF.

Pain from the upper cervical joints  can be felt  in the head, leading to chronic headaches. Chiropractic care is one of the most common non-medicine  treatments for chronic headaches.

Cervical spine joint hypermobility may influence the onset of NDPH.  One study found  that 11 out of 12 NDPH sufferers were found to have cervical spine joint mobility.

Physical therapy and chiropractic care are your best bet at solving cervical spine joint hypermobility. And chiropractic care should be your first choice to handle abnormal CSF levels and pain in your upper cervical joints.

Live in the Denver, CO area? Denver Upper Cervical Center is at your disposal. We work with patients to determine the root cause of your headaches, so you can get back to living life uninterrupted.  Click here  to visit our New Patient Center page.

Intravenous methylprednisolone (IVM, Solu-Medrol) is used to treat arthritis, blood disorders, eye conditions, and even immune system disorders.

In patients who identified an infection at the onset of their NDPH, IVM therapy seems to be very effective after two weeks.

In  a 2010 study , nine patients received IVM followed by oral steroids. After two weeks, seven recovered. After six weeks, all nine recovered.

Peripheral nerve blocks are a type of regional anesthesia. This anesthetic can be injected near an offending bundle of nerves to stop pain signals from a specific part of your body.

Especially in the geriatric community, peripheral nerve blocks seem to be  safe and effective methods  of treating NDPH.

Drug therapy seems to be effective  in only a quarter  of patients. Prescriptions may work for you, but there are more effective treatment options, and with less side effects.

Antiseizure drugs  (AKA anticonvulsants or antiepileptics) like valproate, topiramate, or gabapentin are commonly prescribed for NDPH. Antiseizure drugs have been moderately effective in studies, but  valproate seems to show  the most promise.

Muscle relaxants  like baclofen or tizanidine are occasionally used to fight NDPH. Muscle relaxants should  only be used short term.

Selective serotonin reuptake inhibitors  (SSRIs) are a type of antidepressant  shown to prevent migraines  better than placebo. Unfortunately, only about 50% of people who start SSRI therapy are able to quit due to antidepressant withdrawal. They also come with many major potential side effects, including increased risk of suicide.

Tricyclic antidepressants , such as amitriptyline, are somewhat effective migraine preventers. However, the  side effects  can scare some off:

Nonsteroidal anti-inflammatory drugs  (NSAIDs) are painkillers like aspirin and ibuprofen. But these work well  to relieve  periodic  headaches , not NDPH.

New persistent daily headache is a debilitating disorder.

If you now or if you ever experience daily headaches that started from nowhere and persist for months, talk to your healthcare provider about NDPH treatments, such as intravenous methylprednisolone, antidepressants, antiepileptics, or upper cervical chiropractic care.

If you live in the greater Denver area,  click here to request an appointment  at Denver Upper Cervical Chiropractic. We work  with  our patients to treat the root causes of headaches. We reserve Fridays for out-of-town patients.

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