When Medicine Makes Headaches Worse
Curing Rebound Headaches
The only way to stop rebound headaches is simple, at least in
theory: Stop taking the medication that's causing them. However, it isn't easy
"During withdrawal, you can get nausea and extreme
fatigue," says Diamond, "as well as severe headaches."
These symptoms usually abate within days or weeks, but full
recovery is a gradual process and can take months, Gallagher says.
Gallagher also observes that the effects of the overused drug
are not only physiological. "There's a psychological dependence that can
develop as well," he says. "A person gets used to taking the medication
in response to any headache pain or even a sensation that they think
might develop into headache pain. That makes going off the drug
To help ease both the physical and psychological symptoms of
withdrawal, other medications might be necessary.
"Most patients need a bridge, a regimen of transitional
medications to help them through," says Smith. Depending on the type of
medication a person was abusing, a doctor may prescribe an anti-inflammatory
drug and a muscle relaxant to help with sleep. Sometimes an injection of
steroids might be useful, Smith says, as well as beta-blockers and
"Instead of going cold turkey, some doctors prefer to taper
off the abused medication gradually," says Smith. "That's often a
reasonable idea, especially if patients are taking barbiturates, since they may
have seizures during withdrawal."
While Smith says that most of the people he sees are able to
kick the drug without being hospitalized, Diamond says that many of his
patients need the extra help. Hospitals allow for transitional medications to
be administered intravenously around the clock, and in some cases, it may be
important for a person to be under observation for the first few days of
In addition to medications, behavioral techniques offer relief
as well. "We use biofeedback to help people learn how to relax their body
and muscles and control their blood vessels," says Diamond. "And we
also use other relaxation techniques."
Kicking your reliance on a painkiller is not easy, and it may
require work and cause significant discomfort. "It may take three months or
more for a person to get completely free of the cycle," says Smith. But
given the risks of chronically overusing painkillers, he considers those few
months "time well spent."
Getting the Right Help
The price of headaches, both to the individual and society, are
enormous. "The economic estimates for the cost of headaches range from 5 to
13 billion per year," says Gallagher. "That's in time off from work,
the inability to work at full capacity, and the costs of medical care."
Rebound headaches only account for a portion of that total, but
they carry the special risks that come with overusing medication in addition to
the chronic pain. Even so, many people, including doctors, don't really
understand how serious a condition rebound headaches can be, Smith says.
"We see patients at our clinic every day," Smith tells
WebMD, "and I can tell you that there are still a lot of doctors out there
who are not giving the right advice to their patients about how to use
painkillers. We've got to prevent people from developing this problem in the
Diamond gives a straightforward suggestion. "If you're
taking any kind of painkiller on a near-daily basis," he says, "whether
it's over-the-counter or prescription, get help now."