How Acute Migraines Become Chronic Migraines

Uncontrollable and Controllable Factors

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Migraines are debilitating and can put a huge damper on a person's daily functioning and quality of life. This is magnified when migraines become chronic. The good news is that "chronification of migraines" can be prevented by adopting certain healthy lifestyle habits.

Let's explore the factors, both controllable and uncontrollable, that may trigger the transformation from an acute migraine to a chronic migraine.

What Is a Chronic Migraine?

A chronic migraine is a migraine with or without aura that occurs on 15 or more days per month. According to criteria from the International Headache Society, this must go one for at least 3 months.

Uncontrollable Factors

There are some factors in life that you cannot change — they are simply out of your control but may contribute to your migraines becoming chronic. These factors include:

  • female gender
  • your DNA — some people have certain genes that make them more likely to develop chronic migraines
  • a lower socio-economic status and lower level of education
  • a history of a closed head injury

Controllable Factors

The good news is that most of the factors that contribute to the chronification of migraines are within a person's control. One big modifiable factor is the over-utilization of acute migraine therapies like nonsteroidal anti-inflammatories, combination analgesics (Fiorinal or Fioricet), and triptans, for treating migraines.

Depending on the medication, using an abortive migraine therapy for 10 to 15 or more days per months can not only predispose a person to developing chronic migraines but also developing a medication overuse headache. Over-utilizing other pain-alleviating therapies, like caffeine, has also been found to contribute to the development of chronic migraines.

More factors include:

  • obesity
  • mood problems, like depression and anxiety
  • stress
  • poor sleep hygiene, especially snoring

The quality of your acute migraines also affects the likelihood of them becoming chronic. For example, how well your migraine therapies work is important — if they are not working well, you are more likely to develop chronic migraines.

What This Means for You

Remain proactive in your migraine health. A lot of it is in your control — manage your weight by exercising, monitoring your calories, and eating a diet rich in fruits, vegetables, and whole grains. Adopt stress management techniques that work for you whether that's writing in a journal, exercising, doing yoga, meditating, or engaging in a hobby that is pleasurable.

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Article Sources
  • American Headache Society. Can Headaches Worsen and Why?
  • Bigal ME & Liptn RB. Concepts and mechanisms of migraine chronification. Headache. 2008 Jan;48(1):7-15.
  • Headache Classification Committee of the International Headache Society. "The International Classification of Headache Disorders: 3rd Edition (beta version)". Cephalalgia 2013;33(9):629-808.
  • Houle T & Nash TM. Stress and headache chronification. Headache. 2008 Jan;48(1):40-4.