Headache Disorders Continue to Affect 3 Billion People Worldwide With No Improvement in Three Decades

Headache disorders remain one of the world’s most persistent and disabling health problems, and new global estimates show that little has changed over the last 30 years. According to a major analysis from the Global Burden of Disease (GBD) 2023 study, nearly 3 billion people lived with headache disorders in 2023—about one in every three people on Earth. Despite medical advances, better diagnostics, and increased awareness, the global rate of headache-related disability has remained unchanged since 1990, making headaches a chronic, long-term burden for billions.

This new research was conducted by the Institute for Health Metrics and Evaluation (IHME) and the Norwegian University of Science and Technology (NTNU). It provides a deep dive into how much time people spend living with headaches, how this varies across different countries and age groups, and why these disorders continue to rank among the top causes of health loss globally. The study specifically examined migraine, tension-type headache, and medication-overuse headache, giving a full picture of disability levels from 1990 through 2023.

Global Disability From Headaches Remains Extremely High

In 2023, headache disorders accounted for an age-standardized rate of 541.9 years lived with disability (YLDs) per 100,000 people. This metric reflects how much time people spend living with symptoms that disrupt normal activity and well-being. When all major causes of disability are ranked globally, headache disorders come in sixth place, highlighting how common and debilitating they truly are.

One striking detail in the study is the gender gap. Women experienced much higher levels of disability—739.9 YLDs per 100,000 compared to 346.1 YLDs per 100,000 in men. This means women consistently spend more time living with headache symptoms, across every age group examined. The researchers note that women tend to have headaches more often and for longer durations, which contributes significantly to the unequal burden.

Migraine Drives Nearly All Global Disability From Headaches

While tension-type headache is the most common headache disorder worldwide—nearly twice as common as migraine—it is migraine that causes most of the disability.

Some key figures from 2023:

Migraine caused 40.9 million YLDs globally
Age-standardized migraine disability rate: 487.5 YLDs per 100,000
Tension-type headache disability rate: 54.4 YLDs per 100,000

Migraine alone accounts for about 90% of all disability from headache disorders. This means that although more people experience tension-type headaches, migraine attacks are far more disruptive, painful, and longer lasting, creating a disproportionately heavy burden.

Geographically, the highest disability rates from migraine were found in North Africa, the Middle East, and high-income regions such as Europe and North America. Still, migraine remains a significant health issue everywhere, including low-income countries where diagnosis and treatment options are often limited.

Medication-Overuse Headache Adds to the Global Burden

Another major contributor to headache-related disability is medication-overuse headache (MOH). This condition occurs when individuals frequently rely on pain medications—particularly for migraine and tension-type headaches—leading to worsening symptoms over time.

Although fewer people develop MOH compared to migraine or tension-type headache, the condition is extremely disabling. The study found that medication overuse accounts for:

22.6% of migraine YLDs in men
14.1% of migraine YLDs in women
58.9% of tension-type headache YLDs in men
56.1% of tension-type headache YLDs in women

Overall, medication overuse is responsible for more than one-fifth of total headache-related disability worldwide. This is especially concerning because MOH is largely preventable through better education, safer prescribing, and improved access to care.

Why the Global Burden Has Not Improved

Despite massive advances in medicine and neuroscience, the global burden of headache disorders has barely shifted in over 30 years. There are several reasons:

Widespread lack of access to effective treatments
Many low- and middle-income countries still lack basic headache care, including trained specialists, preventive medications, and affordable acute treatments.
Poor awareness and underdiagnosis
Headaches—especially migraines—are often dismissed as minor or normal, resulting in delayed diagnosis or no diagnosis at all.
High rates of self-treatment
People frequently rely on over-the-counter painkillers without medical guidance, which increases the risk of medication-overuse headache.
Persistent stigma
Headache disorders are sometimes misunderstood or minimized, discouraging people from seeking proper care.

Why Women Bear a Bigger Burden

The study repeatedly emphasizes the gender disparity in headache-related disability. There are several known factors:

Hormonal fluctuations affect migraine frequency and severity
Women report longer-lasting headache episodes
Women are more likely to develop chronic migraine
Social expectations can delay care seeking or lead to self-treatment

Understanding this imbalance is important for designing more effective prevention and treatment strategies that target the groups most affected.

What Can Be Done to Reduce the Burden

The researchers stress that a large portion of the global headache burden is preventable. They recommend several key steps:

Integrate headache care into primary healthcare, especially in low- and middle-income countries
Improve access to both acute and preventive medications
Educate patients on safe medication use to reduce MOH
Strengthen national health policies that recognize migraine and chronic headache as major public-health issues
Expand training for healthcare providers to diagnose and treat headache disorders effectively

If these steps are implemented, hundreds of millions of people could see improved quality of life and reduced disability.

Additional Context: Understanding the Three Main Headache Disorders

To give readers a clearer understanding, here’s a brief overview of the conditions examined in the study.

Migraine

Migraine is a neurological disorder involving severe, pulsating headaches often accompanied by nausea, light sensitivity, sound sensitivity, and in some cases, aura (visual or sensory disturbances). Attacks can last from hours to days. Migraine affects more women than men and is strongly influenced by hormonal, genetic, and environmental factors.

Tension-Type Headache (TTH)

This is the most common type of headache, characterized by a dull, pressing, or tightening sensation around the head. Although less disabling than migraine, tension-type headaches can still affect concentration and productivity, especially when frequent.

Medication-Overuse Headache

As discussed earlier, this condition is triggered by frequent use of headache medications and leads to worsening headaches over time. It is fully reversible with proper medical guidance, but many people are unaware they even have it.

Why This Research Matters

Headache disorders are not life-threatening, but they impact daily life in profound ways. They affect school performance, productivity, mental health, family life, and even economic output. With 3 billion people affected and migraine alone causing 40.9 million years of disability, the numbers are too large to ignore.

The findings from the GBD 2023 study highlight the urgent need for better headache care worldwide. With the right investments in prevention, treatment, and education, much of this burden could be reduced.

Research Reference:
https://www.sciencedirect.com/science/article/pii/S1474442225003886