There is no objective way to measure headache severity (as one would hypertension, anemia, or a broken bone). People suffering from headache disorders are often unable to describe the extent of their illness, and cannot easily explain how pain limits their productivity, family life, or social commitments.
WHO published the Atlas of Headache Disorders in 2011. One of its important findings was that among countries that contributed data to the study, only 12% included headache disorders in their annual health reports. Here's a screenshot of a map on page 28 of the Atlas showing the very few countries (colored red) that systematically collected national data on headache.
Fortunately, awareness of headache as a significant public health problem has increased dramatically since then. The Global Burden of Disease studies have been particularly influential in shining light on the extent of disability headache disorders cause. Headache disorders are highly prevalent and certain forms result in significant disability. Headaches account for more disability adjusted life years (DALYs) than all other neurological disorders combined (including dementias). Three headache forms -- migraine, tension-type headache, and medication-overuse headache -- collectively make up the third highest cause of disability worldwide.
Moving forward
For researchers
- Check your country's health reports for information on headache disorders. Not all countries routinely gather data on headache disorders, probably because these are not recognized as non-communicable diseases of public health importance.
- There are large knowledge gaps in headache epidemiology. Consider undertaking epidemiological studies if you work in an area with no (or very little updated data) on headache prevalence. The Global Campaign against Headache has developed and tested methodologies for population-based research which could be adapted for use in your locality.
For clinicians
- Do not dismiss headache as a trivial complaint.
- Ask patients to describe extent of headache disability, not just severity on a pain scale.
For people with headache
- Download a headache diary and record headache days for at least four weeks. Note how much medication you take; when you had to miss work or school; and when you were not well enough to do household tasks. This makes it easier for a doctor or nurse to see the extent of your illness when you come to the clinic.
