Chronic migraine
When migraine stops being episodic and settles in almost daily, there are sensitization mechanisms at work that can be understood and modulated.
What chronic migraine is
Migraine is described as chronic when headache occurs on 15 or more days a month over several months, with migraine features on a good proportion of those days. It is what happens when a migraine pattern settles in.
Beyond the pain itself, it usually comes with sensitivity to light and sound, nausea, and a significant effect on work, mood and daily life.
Why the tests come back “normal”
Chronic migraine involves sensitization of the trigeminovascular system and of central pain processing. The brain becomes more reactive to stimuli it used to tolerate.
Sustained stress, irregular sleep, overuse of painkillers and the sheer frequency of attacks all feed the cycle that makes it chronic. This is why treatment cannot stop at relieving the pain of the moment.
Common symptoms
- Headache on 15 or more days a month over several months
- Throbbing pain, often on one side, that worsens with activity
- Sensitivity to light and sound
- Nausea or digestive discomfort during attacks
- Fatigue, irritability and difficulty concentrating
How the IDENTA Model approaches it
We begin with an integrated assessment that places the migraine in your wider context, including sleep, stress, medication use and any emotional comorbidity, and builds a hypothesis about how it became chronic.
We work on autonomic and sleep regulation, on evidence-based psychotherapy for the stress and avoidance component, and on psychoeducation about triggers and painkiller use. Neurostimulation with rTMS or tDCS is considered only where it is indicated, as a complement.
This is always done under ongoing medical supervision and, where appropriate, in coordination with your neurologist or the doctor treating you.
What you can expect
- An account of why your migraine became chronic, not just of the symptom on the day.
- Strategies to reduce frequency and impact, with measurable follow-up.
- Coordination with your medical care rather than a replacement for it.
This information is provided for general education. It does not replace an individual medical assessment and is not a diagnosis. If you live with these symptoms, an initial assessment allows your case to be evaluated as a whole.
Frequently asked questions
Can chronic migraine go back to being episodic?
In many cases it is possible to reduce the frequency and return to an episodic pattern by working on the factors driving chronification, such as sleep, stress and painkiller use, within a structured plan. Results vary from person to person.
Does this replace my neurological treatment?
No. It complements that treatment and is coordinated with it. We bring together the medical side, nervous system regulation and the psychological component of pain.
Can painkillers make migraine worse?
Overusing painkillers can contribute to chronification, in what is known as medication overuse headache. Part of the work is bringing that use into order safely and always under medical supervision.
Start with an initial assessment
Every process at IDENTA begins with listening. Request an assessment and get a structured opinion on your case.