Treating headaches. A conceptual framework.

BACKGROUND

Similar medications are effective in migraine and muscle contraction headache therefore the term recurrent headache is used to cover the spectrum of classic migraine and muscle contraction headache.

OBJECTIVE

The concept of a threshold to headache triggers is proposed. Treatment for chronic headaches is directed at raising the threshold or removing triggers.

DISCUSSION

The most important factors that lower the threshold to headaches are hormones, mood and sleep disturbance. Therapeutic strategies for raising the threshold and treatment of the acute headache are discussed.