Rebound headaches are caused by an excessive use of medication in treating a headache. These headaches can be more debilitating than the initial headache and can lead to long term health conditions.
Rebound headaches can be difficult to treat with a high degree of success because most people who receive treatment go on to relapse and develop more rebound headaches. The best way to move forward is to avoid them from ever happening.
What are Rebound Headaches ?
Rebound headaches are a result of overuse of pain medication for the treatment of someone’s headaches. Typically these people are taking medication for the pain three or more times a week and with certain medications will set themselves up for a relapse event which causes the very thing they are trying to avoid to occur all over again.
The best advice is to try and take preventative measures instead of relying on overmedicating oneself.
Rebound headaches generally occur after long-term or regular use of pain medications for headaches. A person can wake up and actually feel worse than before once their normal medication wears off.
It is also common that a person can experience a rebound headache as a withdrawal from another substance, like caffeine.
The type of headache medication one uses factors into what defines “overuse”. One should always take their medication as directed by their doctor to ensure one doesn’t get side effects, like rebound headaches. Taking headache medication 10-15 times or more a month can lead to a rebound event.
The International Headache Society (IHS) has a criteria for rebound headaches that people fall under:
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experiencing a headache 15 or more days per month in those with preexisting headaches
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the overuse of headache medication for longer than three months
According to the National Institute of Neurological Disorders and Stroke (NINDS), the period of pain relief becomes progressively shorter, a pattern is formed that leads to the development of chronic headaches. The pattern of more frequent usage of pain medication to treat the initial headache continues and cycles into more rebound headaches that can last for weeks.
Symptoms for rebound headaches can include:
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anxiety
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pain that become worse
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depression and psychological distress
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irritability
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insomnia and poor quality sleep patterns
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memory issues
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nausea
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impaired function abilities
Who’s at Risk?
Rebound headaches are more common in females than males 3-1 to 4-1 in frequency. They are also more prevalent in people 30-50 years of age.
Rebound headaches can affect those who suffer from other underlying headache disorders like, migraines and tension headaches.
There is evidence to suggest that rebound headaches can occur more often in people who have a family history of substance abuse or have had a diagnosis for a personality disorder.
The NINDS, states that people who take headache relief medication more often than 3 times a week are at a higher risk for developing rebound headaches.
The World Health Organization (WHO) suggests that overuse headache medication can negatively impact up to 5% of a population and represents the most common secondary headache disorder.
Drugs That Cause Rebound Headaches
There are a variety of medications from over the counter (OTC) pain relievers, prescription meds to opioids that can result in a rebound headache. Some bring about a rebound event quicker than others.
The most common medications responsible for rebound headaches when taken from 10-15 days a month are:
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opioids, ergotamine and triptan when used 10 or more days per month.
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acetylsalicylic acid, acetaminophen / paracetamol, non-steroidal anti-inflammatory drugs when used 15 or more days per month.
Prevention
The best method for the treatment of rebound headaches is to focus on the underlying persistent headaches with preventative medication. This approach implements a plan to avoid a headache before it begins by taking a more preventative method, reducing the need for taking a pain medication for every headache.
A general rule is to limit the use of the pain medication to 10 times or less per month and to always follow the instruction on the bottle. Listen to your doctor if the headaches persist or become more frequent. In these cases your doctor may suggest a prophylaxis medication.
The less frequent one uses pain meds the less likely one will have a rebound headache.
Overuse of medications can lead to kidney issues, gastrointestinal problems and ulcers.
Aspirin, ibuprofen and acetaminophen can result in complications when taken long term.
Treatment
The best way of dealing with most rebound headaches is to withdrawal from using too much medications per month. After one reduces the amount of medication one is taking the rebound effect should normalize after two months.
Depending on the type of medication one is taking will depend on how fast a medical professional will supervise the withdrawal process.
Drugs like, analgesics, ergotamine or triptan will usually have a recommendation by a medical professional to stop taking them abruptly.
Other drugs like opioids, benzodiazepines, and barbiturates it will be advised to slowly titrate usage.
Nonpharmacological Approach
The use of neurofeedback has been used successfully for years to help in the reduction and severity of all headache types. This approach aims at normalizing brainwave patterns and the need for pain medication, thus reducing a rebound affect from the meds. The use of this preventative strategy when combined with a proper diet has helped many people who suffer from headaches become pain free.
Rebound headaches are a result of a misuse of pain medications and represent the vicious cycle of negative side effects they cause. The self treatment for an initial headache with the use of a common medication over time loses it’s affect and causes one to use even more. The cycle spins out of control resulting in an episodic state of pain becoming a chronic one. The answer for many is to simply follow your doctors advise, reduce the amount of medication your taking, and to start a preventative plan which includes neurofeedback, dietary changes and stress reduction training practices.
-A Balanced Brain is a Pain-Free Brain-