Daily headaches are a pattern, not something to keep treating one day at a time. Two numbers usually change the conversation.
A headache on most days is a pattern worth investigating. One commonly
missed possibility is that frequent use of headache medication can itself help
maintain the cycle. Start by counting two numbers for the past month:
headache days and medication days. Those two numbers can change what
should happen next.
You don’t really think of yourself as someone with headaches.
You just have one most days.
There’s the bottle in your desk. The one in the car. The one in your bag. You take something in the morning before it gets going, because you learned that if you wait, the day is lost.
Some days it’s a band around your head. Some days it sits behind one eye. Some days it starts at the base of your skull by three in the afternoon and climbs.
You’ve stopped counting.
In fact, if I asked how many days in the last month you had a headache, you would probably
say “a lot.” If I asked how many days you took something for it, you would have to think even harder.
Both of those numbers matter enormously.
Start With Two Numbers
Frequent headaches and frequent headache medication travel together, and the relationship runs in both directions.
When pain relievers are taken often enough, over long enough, the headache pattern can change. Episodic headaches become more frequent, then daily. They start arriving in the early morning. The medication that used to work now works for a few hours before the pain returns, so you take more, which maintains the cycle.
This is a recognized condition. Headache specialists call it medication-overuse headache, or rebound headache, and the approximate thresholds are worth knowing.
• simple pain relievers such as acetaminophen, ibuprofen, naproxen or aspirin, on about 15 or more days per month
• combination pain relievers, migraine-specific medications such as triptans, ergotamines, or any opioid, on about 10 or more days per month
• sustained over roughly three months
Read those numbers, then count your own.
Most people in this pattern have no idea they are in it, because every individual decision made sense. You had a headache. You took something.
Two things follow. This is treatable, and it is managed medically. And coming off the pattern usually involves a period of worse headaches before better ones — which is why opioid and sedative-containing medications in particular must never be stopped abruptly on your own.
So the instruction is not stop your medication. It is count the days, write the number down, and bring it.
The Pattern Matters
Not every daily headache is the same headache. Frequent headaches may reflect migraine, tension-type headache, medication-overuse or rebound headache, a cervicogenic headache arising from the neck, or another cause.
Migraine often brings throbbing pain, nausea, or sensitivity to light and sound, and is made worse by ordinary activity. Many people with migraine have been told for years that they have sinus headaches, because facial pressure and congestion are common features.
A headache with a cervical component may begin in the neck or at the base of the skull, stay on the same side, follow a consistent path forward toward the eye or temple, and change with neck position or sustained posture.
Chronic daily headache is a descriptive term for headache occurring on 15 or more days a month, not a single diagnosis.
The point isn’t to diagnose yourself. It’s to notice the pattern.
The Ordinary Contributors
Sleep, caffeine, skipped meals, hydration, alcohol, jaw clenching, vision, medications, blood pressure, stress and hours spent in one sustained position can all matter. Often more than one is involved.
If your headache is reliably worst on a Saturday morning, that is a clue about caffeine. If it arrives with a new pair of glasses, that is a clue too.
And “it’s stress” is where headache investigations go to die. Stress belongs on the list. It doesn’t belong as the answer.
When a Headache Needs Urgent Attention
A sudden worst-headache-of-your-life, headache with new weakness, numbness, confusion, or speech or vision changes, fever with a stiff neck, or a severe or worsening headache following head injury needs urgent medical evaluation.
A new or steadily changing headache pattern — particularly later in life, or with scalp
tenderness or jaw pain while chewing in an older adult — also deserves prompt medical attention.
What We Can Actually Examine
At Ptak Family Chiropractic in Santa Monica, we start by determining what kind of
headache pattern you have and whether there is a mechanical or neurological component we can identify.
Pain that begins in the neck or base of the skull and travels forward. We examine cervical movement and the upper cervical structures to see whether we can reproduce your familiar headache — not simply find something tender.
Headache brought on by sustained neck position. We examine movement, strength and endurance, and look at the positions and loads that precede the headache.
Measurably restricted neck movement. We determine where movement is restricted and whether changing that movement changes the headache pattern.
A history of whiplash, a fall or neck injury. That changes what we examine and which findings matter.
Numbness, tingling, weakness, balance changes or other neurological symptoms. A neurological examination helps determine what should happen next.
And we count the days with you. Headache days and medication days, both.
What We Find Determines What We Do
There shouldn’t be one treatment for everyone with headaches.
If cervical joint or mechanical dysfunction is relevant, chiropractic and manual care may be useful.
If weakness or poor neck endurance is contributing, strengthening becomes part of the program.
If mobility is restricted, we address mobility.
If sustained position or workload is part of the pattern, we work on changing the load and on improving your capacity to tolerate it.
If neurological findings are present, those findings determine what happens next.
And if our examination tells us your headache belongs with your physician or another
specialist, we’ll tell you and help point you in the right direction.
One honest note about goals. Fewer headache days usually means fewer doses, and fewer doses is often what breaks the cycle. That is a realistic aim. Curing migraine is not.
Bring Four Answers
How many days last month did I have a headache?
How many days did I take something for it?
Where does my headache usually begin?
What reliably brings it on, or makes it worse?
You Are Not Supposed to Have a Headache Most Days
Somewhere along the way this became normal for you. It shouldn’t be.
If you have quietly reorganized your life around it — the bottle in every bag, the appointments you schedule for mornings because afternoons are unreliable, the plans you cancel, the dread when you notice it starting at two o’clock — that is not a personality trait.
It is an unmanaged condition.
Come and talk it through with us. We never charge you to sit down and talk about your needs. Bring the four answers above and your medication list. We will tell you what we think is driving it and what isn’t, and if this belongs with your physician or a neurologist, you will hear that from us that day along with exactly what to bring them.
One conversation, one careful examination, and two honest numbers.
For many people, that is where a daily headache finally starts to make sense.
About the author. Dr. Jeffrey Ptak, DC, DSS, MSS, MA. Bachelor of Science in Psychology, The American University, 1977. Neuroscience research at the Laboratory of Neuropsychology, National Institutes of Health, 1977 to 1980, with peer-reviewed publications in Physiology & Behavior in 1977 and in Catecholamines: Basic and Clinical Frontiers in 1979. Doctoral study in behavioral neuroscience at the City University of New York. Doctor of Chiropractic, Los Angeles College of Chiropractic, 1985 — the professional degree under which he practices. Founder of Ptak Family Chiropractic, Santa Monica, since 1986. Postgraduate study in Chiropractic Functional Neurology through the Carrick Institute, and advanced training through the International Association of Functional Neurology and Rehabilitation. Graduate coursework in Traditional Chinese Medicine at Emperor’s College. Master of Arts in Spiritual Psychology, University of Santa Monica, 2012, and Master of Arts in Spiritual Psychology with an emphasis in Consciousness, Health and Healing, 2016. Master of Spiritual Science, 2021, and Doctor of Spiritual Science, 2025, Peace Theological Seminary & College of Philosophy.
Educational purposes only. This article does not diagnose any condition and is not a substitute for medical care. Do not start, stop or change any prescribed medication without consulting the prescribing physician; some medications must not be discontinued abruptly. Seek emergency care for a sudden severe headache, the worst headache of your life, or headache with fever and stiff neck, confusion, weakness, numbness, slurred speech, vision loss, or headache following head injury. Individual results vary and no particular outcome is promised.
Ptak Family Chiropractic
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Chiropractic for Adults and Children
3122 Santa Monica Blvd., Suite 102 · Santa Monica, CA 90404
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