Burden of headache.

Although headache is the most prevalent pain disorder, the substantial societal and individual burden associated with it has been previously overlooked. The primary headaches including migraine, tension-type and cluster are the most prevalent forms but also a very high number of headaches secondary to analgesic overuse and various brain diseases are ignored without any specific acknowledgement or treatment. Migraine is listed as number 20 of all diseases with regard to years lived with disability, and headache accounts for approximately 20% of lost work days. Chronic headaches (occurring for more than half of all days per month) affects 4-5% of the general population and differs not only from the episodic forms in frequency, but also in respect to lack of effect of most treatment strategies, more medication overuse and more loss of quality of life than the episodic forms. The burden of headache disorders remains substantial and is estimated to cost a minimum of US$100 million per million inhabitants per year. As most headache disorders remain prevalent, disabling, underdiagnosed and undertreated, public health initiatives to improve prevention and treatment are urgently required. Considerable benefits for society can be gained by specific strategies leading to reductions in the amount of sickness absence and impaired working abilities. The burden on affected individuals and their families quality of life may be improved by a general acceptance of the impact of headache disorders and the development of specific treatment strategies.