How To Treat Long-Term COVID Chronic Headache Symptoms?
Chronic headache of Long COVID is more prevalent in middle-aged women, accompanied by long-term COVID symptoms such as fatigue, cognitive dysfunction, and dizziness, as well as hyposmia and insomnia or other sleep disturbances. Cross-sectional studies have shown that the topography of headache is predominantly bilateral, predominantly frontal or periocular, and compressive.
The chronic headache phenotype is highly variable, occurring mostly in the temporal and occipital lobes, and often changes according to the pulse rhythm occur in approximately one-third of patients. Headache of Long COVID often mimic the primary headache phenotype. The two most common phenotypes described are tension-type headache and migraine-like headache.
Migraine-like headache may be associated with nausea, vomiting, photophobia, and phonophobia and exacerbated by daily physical activity, whereas tension-type headache is not exacerbated by daily physical activity and rarely associated with other symptoms.
Patients with a history of headache commonly report worsening headache. Tension-type and migraine-like headache features can also be seen in patients who have no personal history of headache or who have not experienced headache in the acute infection phase.
We should follow this figure to reason when diagnosing chronic headache of Long COVID:
For people with more severe symptoms of chronic headaches, the ideas of designing treatment options are roughly:
(1) According to the results of the patient’s comprehensive physical examination and four special examinations as well as the communication with the patient, find out the most likely pathogenesis of the patient’s long-term COVID chronic headaches, namely exploring the reason.
(2) Prescriptions are prescribed for treatment according to the pathogenesis and the patient’s physical condition.
(3) For the main direction of medication, if COVID-19 remains in the body, antiviral drugs such as Paxlovid are used first. If there is no virus in the body, medication is decided by specific manifestations of symptoms. For example, if people suffer from a mild occasional chronic headache, they can try to take over-the-counter aspirin and Tylenol. Over-the-counter pain medications such as ibuprofen (Advil) and acetaminophen (Tylenol) may also be taken. For chronic tension-type headache, which is the feeling of excessive pressure or tightness in the head, non-steroidal anti-inflammatory drugs (NSAIDs) are the first choice for acute treatment, followed by combination agents including caffeine. Try taking low doses of over-the-counter medications to relieve seizures, soothe blood pressure, and relieve depression. If there is an inflammatory reaction, patients can take some anti-inflammatory drugs such as indomethacin.
(4) For the symptoms that affect the working life of patients, some drugs for the improvement of symptom experience, such as brain strengthening, refreshing, stimulating nerves, and other effects, can also be used according to specific symptoms. Low doses of amitriptyline have been shown to be more effective in patients with post-COVID-19 symptoms of chronic headaches.
(5) Hot or cold compresses can be beneficial if people present with tension headaches. Apply this method on your neck for about 15 to 20 minutes. Oxygen therapy and physical brain massage can also be tried, and studies have shown that these two methods are also beneficial in reducing headache.
(6) If patients suffer from psychiatric symptoms such as insomnia, anxiety, and depression, they should seek help from psychologists and herbalists to eliminate these psychological symptoms. This is also helpful in removing long-term COVID-19 symptoms of chronic headaches.
