It’s common to reach for pain relievers to treat the occasional headache. But using them too often or for too long can trigger what’s known as a rebound headache.
Here’s what you need to know about why you’re having a rebound headache and what you can do to stop it.
What Is a Rebound Headache?
A rebound headache is caused by the overuse of pain relievers or other drugs to treat headaches or migraines. When taken as directed, over-the-counter (OTC) and prescription headache medicine can help with pain. But problems can happen if you take too much or take it too often.
If you overuse headache medicine, it may temporarily relieve the initial headache. But when the medicine wears off, you may experience a headache known as a rebound headache. This headache can even be different from the initial headache.
The medical term for rebound headache is medicine overuse headache (MOH). Other terms for it include drug-induced headache or analgesic rebound headache.
What Are the Symptoms of a Rebound Headache?
Now that you know what causes rebound headaches, how can you tell them apart from other headaches?
Diagnosis of rebound headache
To be diagnosed with a rebound headache, you have to meet all of these criteria:
- You have a preexisting headache disorder, such as tension-type headaches or migraines.
- You have headaches 15 or more days per month.
- You have taken analgesic medicines — drugs used to treat headache or migraine pain — more than two or three days per week for more than three months.
Rebound headache symptoms
Medicine overuse can cause more than just pain in your head. Other MOH symptoms include:
- Constipation.
- Depression.
- Difficulty concentrating or memory problems.
- Insomnia.
- Irritability or restlessness.
- Nausea or vomiting.
- Sensitivity to light or sound.
How long does a rebound headache last?
For many people, rebound headaches are chronic. They happen daily or nearly every day, according to the American Migraine Foundation (AMF).
How long you have symptoms from a rebound headache can vary by person. It can feel better when you take headache medicine. But the headache returns or rebounds once the medicine wears off. If you have headaches upon waking, you could have a rebound headache. When in doubt, talk to your doctor.
Rebound Headache Home Treatment
To prevent rebound headaches, it’s important to avoid overusing medicine. Always read the label directions, and don’t use more than what’s recommended.
Avoid medicine overuse triggers
Medicine overuse is also specific to certain types of medicines. According to the AMF, common medicines that contribute to MOH when used for three months or longer are:
- Butalbital-containing medicines — These are prescription medicines sometimes prescribed for migraines. Using these drugs more than 10 days per month can lead to MOH.
- Combination pain relievers — These include OTC pain relievers that contain two or more of the following: caffeine, aspirin, or acetaminophen. Taking these drugs has a high risk of MOH if you take them for 10 or more days per month.
- Opioids — Butorphanol, codeine, hydrocodone, morphine, oxycodone, tramadol, and other opioids can cause MOH when used 10 or more days per month.
- Simple analgesics or painkillers — These include aspirin, acetaminophen, and nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen. Rebound headaches can happen when you take these 15 or more days per month.
- Triptans and ergotamines — These are prescription medicines for migraines. If you use these drugs for 10 or more days per month to treat migraine, you’re at risk for rebound headaches.
- Caffeine — Caffeine intake of more than 200 milligrams per day increases your risk of rebound headaches. An 8-ounce cup of coffee contains 95 milligrams of caffeine.
An important note: There are two types of medicines to treat headaches: preventive medicines and as-needed medicines. As-needed medicines are taken when you get a headache to try to relieve the pain. Overusing as-needed medicines can cause MOH. If you’re on headache prevention medicines, you need to take these daily.
Stop taking the triggering medicines
The main way to treat MOH or rebound headaches is to stop taking the overused medicine. But talk to your doctor before stopping your medicine. They can decide whether you can stop it abruptly or whether you need to taper off it slowly.
When you stop taking the overused medicine, your headaches may get worse for a while. You can also experience some of the other rebound headache symptoms listed above.
Get additional treatment help
With time, your rebound headaches will get better. But it can take two to six months to break the rebound headache cycle.
You may need additional support to manage the symptoms of your pre-existing headache disorder. These include:
- Biofeedback — A therapist uses sensors to help you identify where you have muscle tension in your head and neck and provide strategies to relax those muscles.
- Cognitive behavioral therapy — A therapist helps you change behavior and habits that cause or worsen your underlying headache disorder. You’ll learn relaxation and stress-coping skills to help manage your symptoms.
- Medicines — Your doctor may prescribe a medicine that is more effective at preventing or treating the condition or doesn’t cause rebound headaches.
- Support groups — Dealing with rebound or other headaches can take an emotional toll and interfere with daily life. Joining a headache support group can help you learn other coping strategies and provide a place to share your experiences.
- Targeted physical therapy — A physical therapist can help you correct posture and other issues that can contribute to your underlying headache.
Preventing Rebound Headaches
After you work with your doctor to choose a new pain reliever to treat symptoms of your primary headache, you still need to use caution. To prevent new rebound headaches, don’t take any new medicines for more than two days per week unless your doctor says to.
Editor's Note: This article was originally published on , and was last reviewed on .