When the occasional headache strikes, most of us head for the medicine cabinet or local pharmacy and take an over-the-counter pain medication, such as acetaminophen (Tylenol), ibuprofen (Motrin), aspirin, or pain-relieving medications containing caffeine.
While over-the-counter pain-relievers are helpful in improving headache pain, they must be taken with caution because they could actually make your headaches worse if they aren't taken correctly. The overuse or misuse of pain relievers -- exceeding labeling instructions (such as taking the medications 3 or more days per week) or not following your doctor's advice -- can cause you to "rebound" into another headache.
When the pain medication wears off, you may experience a withdrawal reaction, prompting you to take more medication, which only leads to another headache and the desire to take more medication. And so the cycle continues until you start to suffer from chronic daily headaches with more severe headache pain and more frequent headaches.
Pain-reliever overuse appears to interfere with the brain centers that regulate the flow of pain messages to the nerves, worsening headache pain.
This rebound syndrome is especially dangerous if your medication contains caffeine, which is often included in many pain-relievers to speed up the action of the other ingredients. While it can be beneficial, caffeine in medications, combined with consuming caffeine (coffee, tea, soft drinks or chocolate) from other sources, makes you more vulnerable to a rebound headache.
In addition to the rebound headache, over-use of pain-relievers can lead to addiction, more intense pain when the medication wears off, and possible serious side-effects.
Who Gets Rebound Headaches?
Any person with a history of tension headaches, migraines, or transformed migraines can be affected by rebound headaches if he or she overuses certain medications.
What Pain-Relievers Are Responsible for Causing Rebound Headaches?
Many commonly used immediate relief medications, when taken in large enough amounts, can cause rebound headaches. Medications once thought of as "safe" are turning up as the likeliest culprits. These include:
While small amounts of these medications per week may be safe (and effective) -- at some point, the continued medication use can lead to the development of low grade headaches that just will not go away.
Taking larger or more frequent doses of the offending immediate relief medication is not recommended. This not only exposes the person to a higher level of the medication's harmful ingredients, but it can make the headache worse and continue indefinitely.
Are There Treatments for Rebound Headaches?
Usually, discontinuing the medication or gradually tapering the medication dose will lead to more easily controlled headaches. You will probably be asked to record your headache symptoms, noting the frequency and duration of headaches.
Some people may need to be "detoxified" under more carefully monitored medical conditions. People taking large doses of sedative hypnotics, sedative-containing combination headache pills or narcotics such as codeine or oxycodone may need to be admitted to the hospital so they can be detoxified and recover under supervision.
Unfortunately, for many chronic daily headache sufferers, detoxification for the first several weeks leads to increasing headaches. Supervision and treatment by a headache specialist are therefore very important.
Eventually, the headaches disappear and resume their previous intermittent nature.
Can Rebound Headaches Be Prevented?
Yes. You can prevent rebound headaches by using pain-relieving medications on a limited basis, only when necessary. Do not use them more than once or twice a week, unless instructed otherwise by your doctor.
Also, avoid caffeine-containing products while taking a pain-relieving medication, especially medication that already contains caffeine.
