Rebound headaches occur in patients whose persistent headache pain causes them to overuse headache medication.
This may cause symptoms to worsen instead of improve.
It is important to understand that rebound headache is a syndrome (condition) and is not one particular type of headache that a patient suffers.
SYMPTOMS OF REBOUND HEADACHE
- Daily or nearly daily headache
- Pain on both sides of the head
- Pressing/tightening quality
- Mild degree of sensitivity to light or sound
- Tight and tender neck and shoulder muscles
- Regularly taking symptomatic pain medication
DIAGNOSING REBOUND HEADACHE
Rebound headache develops most often in a migraine patient. The following situation is common in rebound headache patients:
- The migraine worsens for some reason
- The patient takes more symptomatic migraine headache medication
- The patient’s medication eventually becomes less effective
- A daily or near daily tension-type headache develops often accompanied by periodic, severe migraine headache
CAUSES OF REBOUND HEADACHE
Many headache specialists believe that any symptomatic headache medication can cause rebound headache.
Over-the-counter medications are the most common causes.
TREATING REBOUND HEADACHE
Rebound headache patients are often difficult to treat and require a pain care center’s multidisciplinary approach to treatment, including strict medication management, stress management training, and physical therapy.
If patients with rebound headache stop taking the medication that causes the syndrome, in four to eight weeks 80% see dramatic improvement without doing anything else. But, for many patients, the initial few weeks may result in a worsening of their headache.
If the medication is not stopped, additional treatments will have very limited benefit. For instance, some patients may benefit from addition of a prophylactic (preventive) medication, such as an antidepressant. But, studies have shown that a prophylactic headache medication often will not have a beneficial effect when given to a patient that is rebounding.
An important element in treating rebound headache is helping you to rid yourself of the automatic reaction to take a medication at the first sign of head pain. Techniques such as relaxation, imagery, and biofeedback can be helpful.
Aerobic conditioning, neck and shoulder muscle stretches, and massage may also help.