Abstract
Primary chronic headaches cause more disability and necessitate high utilisation of health care. Our knowledge is based on selected populations, while information from the general population is largely lacking. An age and gender-stratified cross-sectional epidemiological survey included 30,000 persons aged 30–44 years. Respondents with self-reported chronic headache were interviewed by physicians. The International Classification of Headache Disorders was used. Of all primary chronic headache sufferers, 80% had consulted their general practitioner (GP), of these 19% had also consulted a neurologist and 4% had been hospitalised. Co-occurrence of migraine increased the probability of contact with a physician. A high Severity of Dependence Scale score increased the probability for contact with a physician. Complementary and alternative medicine (CAM) was used by 62%, most often physiotherapy, acupuncture and chiropractic. Contact with a physician increased the probability of use of CAM. Acute headache medications were taken by 87%, while only 3% used prophylactic medication. GPs manage the majority of those with primary chronic headache, 1/5 never consults a physician for their headache, while approximately 1/5 is referred to a neurologist or hospitalised. Acute headache medication was frequently overused, while prophylactic medication was rarely used. Thus, avoidance of acute headache medication overuse and increased use of prophylactic medication may improve the management of primary chronic headaches in the future.
Highlights
Headache is a common complaint in the general population
Headache accounts for 4% of the general practitioners (GPs) consultations, and 2–4% of these are referred to specialists or hospitals [5, 6]
Participants with self-reported chronic headache were invited to a clinical interview, a physical and neurological examination conducted by neurological residents
Summary
Headache is a common complaint in the general population. The most common primary headaches are migraine and tension-type headaches, while other primary headaches are rare [3]. The primary headaches are usually paroxysmal, but 3% of the general population has primary chronic headache, i.e. more than 15 headache days per months [4]. Headache accounts for 4% of the general practitioners (GPs) consultations, and 2–4% of these are referred to specialists or hospitals [5, 6]. Headache is probably the most common reason for referral to neurologists [5,6,7]. 20–30% of all new referrals to out-patients neurological departments are due to headache [5, 6, 8, 9]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
