Scientifically proven: the global burden of headache disorders

For several decades, the World Health Organisation (WHO) has published the Global Burden of Disease Study at regular intervals. Despite many challenges, this report aims to show how common different diseases are across the world. The report also aims to show how much these conditions affect people’s health and well-being. Alongside conditions such as heart disease and cancer – both of which are considered to be widespread diseases – headache disorders are among the diseases with the greatest impact.

Striking facts and figures

Collecting and analysing global data on headaches to give a reliable and accurate picture is a major challenge requiring the intensive input of scientists from every continent.

The findings show that almost three billion people (more precisely: 2.9 billion) suffer from headache disorders. This is more than one in three people on earth. The most recent analysis looked at the period from 1990 to 2023. It focused on the three most common types of headache: migraine, tension-type headache, and medication-overuse headache. The goal was to measure how much these conditions reduce people’s health.

How do you measure suffering?

Living with headaches severely affects your life. The WHO identifies migraine as one of the most disabling conditions worldwide. But how is it possible to actually measure the burden of a disease?

Scientists have spent time developing special terms and concepts to measure a disease’s impact. One measure they came up with is called “years lived with disability” (YLDs). YLDs indicate the total time people spend living with health issues that limit their daily activities. They also help to show how much “healthy life time” is lost owing to pain and suffering. The number is always calculated in relation to the size of the population. To make comparisons easier, YLDs are calculated per 100,000 people (about the size of a medium city).

Women are more affected

The latest WHO data from 2023 gives a good insight into the global headache burden. The figures show that headache disorders cause more than 540 years lived with disability (YLDs) per 100,000 people. This places headaches sixth among all causes of disability worldwide.

The figures also highlight a long-established difference between the sexes. With about 740 YLDs estimated for women and about 364 YLDs for men, women are affected for more than twice as “long” as men. This difference persists across age groups. Throughout their lives, women lose far more healthy life time to headaches than men who are the same age.

Migraine causes the greatest burden

Tension-type headache (or just “tension headache”) is the most common form of headache. It occurs almost twice as often as migraine. However, about 90% of all disability caused by headaches is due to migraine. In 2023 alone, migraine caused around 41 million YLDs worldwide. This equates to more than 480 years per 100,000 people.

To compare: tension-type headache caused about 54 YLDs per 100,000 people – much less time spent suffering. The research team’s conclusion is clear: migraine affects far fewer people than tension-type headache, but it is much more disabling and accounts for the largest share of the overall burden caused by headache disorders.

Medication overuse is a big part of the problem

The third type of headache investigated in the study is medication-overuse headache. It develops when headache medication is used incorrectly while treating an existing (i.e., “primary”) headache disorder, tension-type headache and migraine being the most widespread (read more about it in this article).

A study published in The Lancet estimates that 1–2% of the global population is affected by medication-overuse headache. This equates to 50 to 100 million adults worldwide. Again, women are affected more than men – about two to three times more often, in fact.

Medication-overuse headache contributes significantly to disability. In migraine, it accounts for about 22% of YLDs in women and about 14% in men. In tension-type headache, MOH rates are even higher: about 59% in women and about 56% in men.

Much of this suffering is actually preventable

Researchers from the Global Burden of Disease Study conclude that a large part of headache-associated suffering could be avoided. One of the lead authors, Andreas Kattem Husøy (based in Trondheim, Norway), emphasises the importance of better prevention, better treatment, and improved access to care in all countries. With greater awareness and coordinated action, much of the global burden of headache disorders could be reduced, the scientists say.

Good medical support and personal prevention strategies are essential

So realistically, what can be done? If you are a person living with headaches, it’s important to seek medical help early on and to consult experienced headache specialists. In addition, tailored individual headache prevention strategies are essential. The first step is to identify the exact type of headache you are suffering from. Your next move is to find out your personal headache triggers – and then to adjust your habits to reduce attacks. When prevention improves, the need for pain medication usually decreases.

One simple rule may help

A helpful guideline for safe medication use is the 10–20 rule: take acute headache medication on no more than 10 days per month. Keep at least 20 days medication-free. The amount of medication taken on each day does not matter. What matters is the number of days on which it is taken.

Following this 10-20 rule helps prevent MOH. Keeping a record of medication use is a good idea. It helps you to keep track of how much you are taking. Digital tools like the Prevent Headache app can make this much easier. A medication counter issues an automatic warning if your medication use is becoming excessive. The app also makes it easy to include headache prevention in your daily life. It helps you to recognise and track your personal triggers – and also supports you in adjusting your lifestyle to manage your triggers and reduce your headaches.

To reduce the global impact of headache disorders, two things are essential: good, widely available medical care, and effective, patient-centred prevention. If both are implemented consistently, the burden of headache disorders could be significantly reduced for people all over the world.