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The Beyond Pain Foundation

Migraine types we support

Migraine guide

Chronic migraine

Chronic migraine means having headache on more days than not. It is one of the most disabling forms of migraine, and it often makes holding down a job very hard. The good news is that it can improve, and specialist treatments can make a big difference.

Headache days a month
15 or more
For at least
3 months
UK adults affected
Over 1 million
Also have medication overuse headache
About 2 in 3

This guide is general information, not medical advice. Medicines and treatments must be prescribed or recommended for you by a doctor or pharmacist. We do not give doses here.

Related guides: Medication overuse headache, Migraine without aura, Status migrainosus.

What it is

Migraine is called chronic when you have headache on 15 or more days a month for at least 3 months, and at least 8 of those days have migraine features. Migraine on fewer days than this is called episodic migraine.

Chronic migraine usually builds up gradually as attacks become more frequent. Each year a small number of people with episodic migraine move into the chronic pattern, but many also move back, especially with the right treatment.

Symptoms

  • Headache on most days, with some days of full migraine
  • Sensitivity to light, sound and smells
  • Feeling sick or being sick
  • Sometimes aura, dizziness or vertigo
  • Tiredness, poor sleep and difficulty concentrating

Depression, anxiety, poor sleep and other long-term pain are more common alongside chronic migraine, and are worth raising with your doctor because treating them can help.

The link with medication overuse

About two in three people with chronic migraine also have medication overuse headache, caused by taking painkillers or triptans too often. Cutting back, with your GP's support, is often the first step to improvement and helps other treatments work.

Read our guide to medication overuse headache

Treatment

Acute medicines are best kept to 2 days a week or fewer, and codeine and other opioids are not recommended. Preventive treatment is the main focus.

  1. Preventive tablets

    From your GP. Allow at least 3 months for each

    Beta-blockers, amitriptyline, topiramate or candesartan, started low and built up. Topiramate and sodium valproate can harm an unborn baby: they must not be used in pregnancy, and anyone who could become pregnant needs highly effective contraception while taking them.

  2. CGRP medicines

    Specialist, usually after 3 preventives haven't worked

    Injections every month or 3 months, a hospital drip every 3 months, or daily or every-other-day gepant tablets. They are reviewed after 12 weeks. In chronic migraine they are continued if headache days fall by at least 30%.

  3. Botox

    31 to 39 small injections every 12 weeks

    Licensed only for chronic migraine. Offered by a specialist after at least 3 preventives, once medication overuse has been dealt with. It is judged after 2 rounds.

  4. Other options

    Varies

    Nerve blocks at the back of the head, acupuncture, relaxation and CBT, riboflavin and magnesium, and nerve stimulation devices, which aren't available on the NHS for migraine.

Waiting for specialist care

5 months or more

In a 2026 Migraine Trust survey, most people waiting to see a neurologist about their migraine had waited longer than 5 months, and almost 3 in 10 about a year. Over a third had turned to private care.

When to get urgent help

Call 999 if you have

  • a sudden, extremely bad headache that peaks within minutes
  • weakness, numbness or a drooping face on one side, or slurred speech
  • sudden loss of sight
  • confusion, drowsiness or a seizure (fit)
  • a high temperature with a stiff neck or a rash
  • a headache after a head injury

Call NHS 111 if

  • an attack lasts more than 3 days
  • your headaches suddenly change or get much worse

See your GP if

  • you need painkillers on more than 2 days a week
  • you've tried 2 or 3 preventives without success and want a referral
  • low mood or anxiety are building up

Work and your workspace

Migraine can count as a disability under the Equality Act 2010 (the Disability Discrimination Act in Northern Ireland) if it has a substantial, long-term effect on your everyday life. Conditions that come and go still count, and the law looks at how you would be without treatment. If it applies, your employer must make reasonable adjustments.

People with chronic migraine lose many more working days than those with episodic migraine. Talking to your employer early, with a plan for bad days, can protect your job.

Adjustments that often help

  • Working from home, with a set-up that suits you
  • Flexible start times and hours
  • Regular breaks and lower-glare screens
  • A quiet, dark place to rest
  • Adjusted absence trigger points
  • Time off for appointments and treatment

A migraine-friendly workspace

  • A chair with good lumbar and neck support
  • A desk big enough to put your screen at arm's length
  • Screen raised so the top is at eye level
  • A flicker-free monitor with an anti-glare or blue-light filter
  • Lighting without flicker or glare, and blinds to control daylight

Access to Work can pay towards equipment and support. Acas and Citizens Advice give free advice on your rights.

How The Beyond Pain Foundation can help

If NHS waits are too long, or the help you need is not available to you on the NHS, we may be able to fund:

  • A private headache specialist consultation and follow-up
  • Botox or nerve blocks from a specialist, if recommended and the NHS wait is too long
  • A trial of a nerve stimulation device, so you can see whether it works for you
  • Home-working equipment that removes triggers: a supportive chair, a large enough desk, a good monitor, screen filters and better lighting
  • Support to stay in work

Every award depends on your situation and the funds we have that month. A letter from your doctor, a headache diary and a written quote all help your application.

Apply for funding Check the requirements

Support and sources

The Migraine Trust

Information and support service

Information on every type of migraine, a free information and support service, and advice on treatment and work.

migrainetrust.org

National Migraine Centre

Charity headache clinic

Specialist appointments in person and online, including routine appointments for a voluntary donation, plus free factsheets.

nationalmigrainecentre.org.uk
Sources for this guide

Written in our own words from the sources above. Last reviewed: October 2026. Figures can differ between sources; where they do, we give the range.