Lifting the Burden

Almost 50 per cent of the world's population are affected by headache, making it one of the ten most disabling global health complaints, concludes a new study in Cephalalgia (March 2007 issue).

An international research group, chaired by Professor Lars Jacob Stovner of the Norwegian University of Science and Technology, collated all studies on headache prevalence and its consequences published up to 2006. The review shows that headache is a truly global complaint, with a major impact on both quality of life and the economy.

According to the review, one in nine (11 per cent) of the world's adult population have migraine. Ordinary headache, correctly called tension-type headache, afflicts almost half (42 per cent) of all adults. While migraine tends to be more burdensome for the individual, the review authors claim that, because of the numbers of people affected, tension-type headache has an even greater impact on society as a whole.

This finding is confirmed by studies from developed countries that show more work days are lost each year from tension-type headache than from migraine.

The review also reveals some interesting differences in headache prevalence across the world. For example, both migraine and tension-type headache seem to be less prevalent in Africa, although the authors call for more studies in this region as the evidence there is limited.

For most individual people, headache is a minor ailment that is coped with quite easily, but the authors warn this leads to complacency. Professor Stovner explains: "We often hear that headache is a trivial disorder. For the many with a serious headache problem this attitude can be very disheartening.

"A most disquieting finding of the study is that 3% of the world's adult population suffer from chronic daily headache - that is, headache on more than every other day for at least several months. This group of more than 100 million people worldwide probably carry the greatest headache burden, and possibly also a stigma since their disorder is not generally acknowledged as a proper disease."

Dr. Timothy Steiner at Imperial College, London, UK, co-author of the article and chairman of Lifting The Burden: The Global Campaign to Reduce the Burden of Headache Worldwide, adds: "This study is important in helping us to understand the scale of the headache burden everywhere in the world. It shows, starkly, why we need a Global Campaign, and it strongly supports the messages the Campaign takes to governments and others responsible for health-service policy and delivery. There are still parts of the world, such as China, India and Africa, where the Campaign needs to undertake more research to improve our knowledge of how headache affects both people and society, but elsewhere the evidence is crystal clear.

"In many cases, headache disorders such as migraine and tension-type headache can be simply and effectively treated, but first they must be recognised as needing treatment and doctors and other health-care providers trained in their diagnosis and management. The public need to know that treatments are available and governments must understand the benefits - in public health and in better productivity - of making these treatments available. The Global Campaign, with the committed support of the World Health Organization, has precisely these objectives."

^{Stovner LJ, Hagen K, Jensen R, Katsarava Z, Lipton R, Scher AI et al. The global burden of headache: a documentation of headache prevalence and disability worldwide. Cephalalgia 2007;27:193-210.}