According to researchers at the Norwegian University of Science and Technology (NTNU), more than half of the world's population suffers from headaches. According to the results of the study, women are more affected by headaches and migraines than men.

Definition of headache

Headache, characterized by recurrent headaches, is one of the most common nervous system disorders. Headache is the painful and incapacitating manifestation of a small number of primary headache disorders, namely migraine, tension headache and facial vascular disease. They can also be caused by or occur secondary to a long list of medical conditions, the most common being medication overuse headache.

Frequency of headaches

Worldwide, the prevalence of common headache in adults (symptomatic headache at least once in the past year) is estimated to be about 50%. Between half and three quarters of adults aged 18 to 65 years worldwide have had a headache in the past year, and of these, more than 30% have reported a migraine. Between 1.7 and 4% of the world's adult population is affected by headache for at least 15 days per month. Despite regional variations, headache is a global problem affecting all populations, regardless of age, race, income level, or geographic location.

Headache disease burden

In addition to being painful, headache is also disabling. In the Global Burden of Disease Study, updated in 2013, migraine alone is the 6th leading cause of disability-adjusted life years lost. Headache as a whole is the 3rd leading cause.

Headaches place a real burden on sufferers, sometimes with significant personal suffering, altered quality of life and financial cost. Repeated attacks, often accompanied by the constant fear of the next painful episode, undermine family, social and professional life. Long-term efforts to live with chronic headaches can also predispose the subject to other diseases. Anxiety and depression, for example, are far more common in people with migraines than in healthy individuals.

Types of headaches

Migraine, tension headache and medication overuse headache are important public health issues and are responsible for high levels of disability and ill health in the population.

Migraine

This is a primary headache.
Migraine most often appears during puberty and affects people between the ages of 35 and 45.
It is twice as frequent in women as in men due to hormonal influences;
It is triggered by the activation of a mechanism in the depths of the brain that causes the release of inflammatory substances, generating pain, around the nerves and blood vessels of the head.
It is recurrent, often lifelong and characterized by attacks.

The attacks have the following characteristics:

headache that can be:

moderate to severe in intensity;
with unilateral and/or pulsating pain;
aggravated by usual physical activities;
can last from a few hours to 2 or 3 days;

frequency is between once a year and once a week;
in children, attacks tend to be shorter and abdominal symptoms are more pronounced

Tension headache

This is the most common primary headache.
In some populations, more than 70% of people report episodic tension headaches;
The chronic form of headache, occurring more than 15 days per month, affects 1 to 3% of adults;
Tension headaches often appear in adolescence and affect 3 women for every 2 men.
The mechanism of onset may be stress related or associated with cervical musculoskeletal problems.
Episodic tension headache attacks usually last a few hours but may persist for several days.
Chronic tension headache can be permanent and is much more disabling than the episodic form.
This headache is often described as a band-like pressure around the head that radiates from the neck to the head or spreads from the head to the neck.

Vascular Algebra of the face

This is a primary headache.
It is relatively rare, affecting less than one adult in 1000 and it affects 6 men for every woman.
It develops mostly from the age of 20 years.
It is characterized by frequent (up to several times a day), brief but extremely severe recurrent headaches, localized in or around a reddening and watering eye, a runny or stuffy nose on the affected side and sometimes a drooping eyelid.
There are episodic and chronic forms.

Medication Overuse Headache

It is caused by the chronic and excessive use of headache medications.
It is the most common secondary headache.
It is present most of the time, oppressive, persistent, with frequent paroxysm on waking.
It could affect up to 7% of individuals in certain populations, women more often than men.

Treatment

Appropriate treatment of headache involves training of health professionals, accurate diagnosis, recognition of the condition, treatment with cost-effective medications, simple lifestyle modifications and patient education. The main therapeutic classes to manage them are analgesics, antiemetics, antimigraine drugs and prophylactic medications.

Barriers to Effective Care

The main clinical barrier is the lack of knowledge among health care providers. Worldwide, medical schools devote an average of only 4 hours to headache during graduate training. A large number of headache sufferers are not diagnosed or treated. Only 40% of migraine and tension headache sufferers and only 10% of medication-induced headache sufferers are diagnosed.

This lack of awareness extends to the general public, who do not perceive the seriousness of headaches because they are usually episodic and are neither fatal nor contagious. Judging by the small number of consultations in developed countries, many people seem to be unaware that effective treatments exist. It is estimated that 50% of headache sufferers self-medicate.

Many governments, seeking to contain health care costs, do not recognize that headache disorders are a major burden on society. They sometimes fail to recognize that the direct costs of treatment are small compared to the considerable indirect savings that could be achieved (e.g., by reducing the number of lost workdays) if resources were devoted to the proper treatment of headache disorders.

WHO action

This obvious burden calls for action. Recognizing this, WHO is a partner with the non-governmental organization Lifting The Burden in the global headache campaign. This initiative, which began in 2004, aims not only to raise awareness of the problem but also to improve access to and quality of care worldwide. In 2011, the WHO published the Atlas of headache disorders, which describes the burden of disease attributable to headache disorders and the resources available to reduce them.

One in six people in the world suffer from headaches every day

Do you suffer from headaches? You are not alone! Researchers from the Norwegian University of Science and Technology (NTNU) have just demonstrated that 52% of the world's population suffers from headaches at least once a year. To reach this conclusion, the researchers compiled over 357 studies on the subject between 1961 and 2020.

Published in the Journal of Headache and Pain on April 12, the results of the study reveal that 26% of them describe a tension headache (which is characterized by pressure or tightness in the head), 14% suffer from migraine and 4.6% have recurrent headaches at least 15 days a month. Every day, more than 15% of the world's population suffers from headaches, or one in six people.

Women suffer more headaches than men

The Norwegian study also reveals that headaches (especially migraines) are more frequent in women than in men. Indeed, 57.8% of women report suffering from migraine at least once a year against 44.4% for men. Every month and for a period of 15 days, 6% of women have a headache against 2.9% of men. According to Lars Jacob Stovner, professor of neurology at NTNU, "this probably has to do with female sex hormones, and in particular estrogen fluctuations".

Headaches, more frequent than before?

While the researchers report that headaches are widespread around the world, they also wondered if they have gained ground since 1961. While estimates tend to show that more and more people are suffering from headaches worldwide, the researchers are reluctant to jump to conclusions given the wide variation in numbers. However, they encourage scientists from all over the world to harmonize their research in order to determine, for example, the influence of genetics, stress, light or pollution on our migraines.