Rebound Headache - Making a Plan to End the Cycle Do you have a headache every day or almost daily? Have we ruled out tumors or other uncommon reasons for your headaches? If so, its time we consider another reason for your headaches that is one of the most common reasons for every day headache. Could these be medication withdrawal headaches? These are headaches that are caused by the withdrawal effects of the very same medications we use to treat the headache. So, if you take a pain medication more than two or three times per week, it’s possible that your headaches could be secondary to the pain medications. Just like the caffeine user can find they need a cup of coffee everyday, the person taking headache medications more frequently may find themselves needing it more often. Definitions Acute--a medical term that refers to something occurring right now. Acute Pain medications are any medications that you take when you have pain. Examples include, but are not limited to: Ibuprofen (Motrin), Acetaminophen (Tylenol), Sumatriptan (Imitrex), Fioricet (Acetaminophen, Caffeine, Butalbital), Acetaminophen/Oxycodone (Percocet), Morphine, Hydrocodone Preventative Headache Medications: These medications are taken everyday whether you have a headache or not. They may reduce either the intensity of the headaches or the frequency of headaches, if you take them for one to three months. Here Is a Sample Plan for Getting over Rebound Headache For any of this to work, you must have the correct expectations. It will be uncomfortable. It may last longer than you think. Don’t give up after just a few weeks. Work on your lifestyle triggers. If you have insomnia read about Sleep Hygiene. If diet possibly plays a role, read about Diet and Migraines Consider Meditation or Yoga to help reduce the intensity of the headaches. Cut your caffeine intake to no more than one caffeinated beverage per week. Walk 30-60 minutes per day or do an equivalent exercise. 2. Stop all pain medication other than preventative headache medications. You can either stop “cold turkey” or slowly reduce your use over several weeks. If you are taking narcotics or barbiturates, discuss how to slowly reduce your use with Dr. Beck. 3. Limit yourself to one day per week when you can take a rescue medication to treat a severe headache. A rescue medication is a simple headache medication like Ibuprofen or a Triptan like Imitrex. 4. Avoid all medications with caffeine, narcotics or barbiturates. 5. Be aware that any acute pain medication can be a problem. I once had a patient who stopped all his headache medications but continued taking Percocet (Acetaminophen/Oxycodone) for his back pain. This is often a complicating problem in regard to overcoming rebound headache. If we cannot find a way to get you off all your pain medications, then it’s unlikely we’ll be successful. 6. Stay on your preventative headache medication after you stop the acute headache pain medications. Consider starting a preventative headache medication if you are not already on one. This may help to reduce the intensity of your headaches a little bit during the withdrawal process. These medications are unlikely to be able to stop your headaches fully if you remain in the rebound headache cycle and continue to overuse acute pain medications. 7. Other options to consider are Acupuncture and message. Some people also report benefit from Chiropractor visits. Try a Velcro Headband or ice packs. Read more about treatment options in my section Headaches

Rebound Headache - Making a Plan to End the Cycle

Do you have a headache every day or almost daily? Have we ruled out tumors or other uncommon reasons for your headaches? If so, its time we consider another reason for your headaches that is one of the most common reasons for every day headache. Could these be medication withdrawal headaches? These are headaches that are caused by the withdrawal effects of the very same medications we use to treat the headache. So, if you take a pain medication more than two or three times per week, it’s possible that your headaches could be secondary to the pain medications. Just like the caffeine user can find they need a cup of coffee everyday, the person taking headache medications more frequently may find themselves needing it more often.

Definitions

Acute--a medical term that refers to something occurring right now.

Acute Pain medications are any medications that you take when you have pain. Examples include, but are not limited to: Ibuprofen (Motrin), Acetaminophen (Tylenol), Sumatriptan (Imitrex), Fioricet (Acetaminophen, Caffeine, Butalbital), Acetaminophen/Oxycodone (Percocet), Morphine, Hydrocodone

Preventative Headache Medications: These medications are taken everyday whether you have a headache or not. They may reduce either the intensity of the headaches or the frequency of headaches, if you take them for one to three months.

Here Is a Sample Plan for Getting over Rebound Headache

For any of this to work, you must have the correct expectations. It will be uncomfortable. It may last longer than you think. Don’t give up after just a few weeks.

1.Work on your lifestyle triggers.

If you have insomnia read about Sleep Hygiene.

If diet possibly plays a role, read about Diet and Migraines

Consider Meditation or Yoga to help reduce the intensity of the headaches.

Cut your caffeine intake to no more than one caffeinated beverage per week.

Walk 30-60 minutes per day or do an equivalent exercise.

2. Stop all pain medication other than preventative headache medications. You can either stop “cold turkey” or slowly reduce your use over several weeks. If you are taking narcotics or barbiturates, discuss how to slowly reduce your use with Dr. Beck.

3. Limit yourself to one day per week when you can take a rescue medication to treat a severe headache. A rescue medication is a simple headache medication like Ibuprofen or a Triptan like Imitrex.

4. Avoid all medications with caffeine, narcotics or barbiturates.

5. Be aware that any acute pain medication can be a problem. I once had a patient who stopped all his headache medications but continued taking Percocet (Acetaminophen/Oxycodone) for his back pain. This is often a complicating problem in regard to overcoming rebound headache. If we cannot find a way to get you off all your pain medications, then it’s unlikely we’ll be successful.

6. Stay on your preventative headache medication after you stop the acute headache pain medications. Consider starting a preventative headache medication if you are not already on one. This may help to reduce the intensity of your headaches a little bit during the withdrawal process. These medications are unlikely to be able to stop your headaches fully if you remain in the rebound headache cycle and continue to overuse acute pain medications.

7. Other options to consider are Acupuncture and message. Some people also report benefit from Chiropractor visits. Try a Velcro Headband or ice packs.

Read more about treatment options in my section Headaches