Headache Disorders Affect Nearly One in Every Three People
Headache disorders affected almost 3 billion people worldwide in 2023 – nearly one in every three people, a figure unchanged since 1990 – and ranked sixth among causes of health loss, according to new research published in The Lancet Neurology. The analysis is part of the Global Burden of Disease (GBD) 2023 study and estimated health loss from migraine, tension-type headache, and medication-overuse headache from 1990 through 2023.
The study, led by researchers at IHME and the Norwegian University of Science and Technology (NTNU), examined the health loss resulting from headache disorders, and how long people have headache across different ages and sexes. Health loss was measured in years lived with disability (YLDs), which captures the total time people spend living with health conditions that limit daily activities and overall well-being. Drawing on population-based studies worldwide, the analysis provides the most comprehensive picture to date of how headache disorders affect daily life and overall health.
Headache disorders rank among the world’s most disabling conditions, disproportionately affecting women
In 2023, headache disorders accounted for an age-standardised rate of 541.9 YLDs per 100 000 people, ranking sixth among all causes of disability globally. The burden of headache disorders was more than twice as high among women as men, with rates of 739.9 and 346.1 YLDs per 100 000, respectively. Across every age group, women consistently spent more time experiencing headache symptoms than men.
“Our analysis shows that headache disorders have remained unchanged in three decades,” said Yvonne Xu, co-author and research scientist at IHME. “And women experience significantly higher levels of headache-related disability because they have headaches more frequently and for longer durations than men. Recognizing this is essential for improving how we prevent and manage headache disorders worldwide.”
Migraine and medication overuse drive most of the global burden from headache disorders
Although tension-type headache is nearly twice as prevalent as migraine, migraine accounts for about 90% of headache-attributed YLDs. In 2023, migraine alone caused an estimated 40.9 million YLDs globally, with an age-standardised rate of 487.5 YLDs per 100 000. Tension-type headache accounted for 54.4 YLDs per 100 000, showing that migraine, though less common, is far more disabling and drives most of the overall burden of headache disorders. While the highest rates of disability from migraine were seen in North Africa and the Middle East, closely followed by high-income regions such as Europe and North America, the burden remains high worldwide.
Medication-overuse headache, defined as the worsening of an existing headache due to excessive use of medication (e.g., pain medication) mainly used to treat migraine or tension-type headache, further amplifies this burden. While this condition affects relatively few, its impact on population-level disability is substantial because of the high individual burden. For migraine, medication overuse accounted for 22.6% of YLDs in men and 14.1% in women, while for tension-type headache, it contributed 58.9% and 56.1%, respectively. Overall, medication overuse was responsible for more than one-fifth of all headache-related disability globally.
“Our findings show that a large part of the global headache burden is preventable,” said Andreas Kattem Husøy, lead author and post-doctoral fellow in the Department of Neuromedicine and Movement Science at NTNU and Norwegian Centre for Headache Research (NorHead). “Integrating headache services into primary care, especially in low- and middle-income countries where effective treatments remain scarce, could reduce lost productivity and improve quality of life for hundreds of millions.”
Improved care and education are key to reducing the global burden of headache disorders.
Headache disorders remain one of the most common and disabling health conditions worldwide. The burden is unevenly distributed by sex and further intensified by overuse of pain medication, a preventable cause of long-term pain and disability. Although effective and affordable treatments are available, access to appropriate care and education on safe medication use remain limited in many settings.
The findings highlight an urgent need to strengthen prevention, management, and access to care for headache disorders worldwide. With greater awareness and coordinated action, much of the global burden of headache disorders can be prevented.
