Rebound Headache Symptoms

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 antimigraine 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 new and different headache that’s known as a rebound headache.

The medical term for rebound headache is medicine overuse headache, or MOH. Other terms for it are drug-induced headache, analgesic rebound headache, or medicine misuse headache.

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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 get a clinical diagnosis of MOH or rebound headache, you must meet all of the following criteria, according to StatPearls:

  • You have a pre-existing headache disorder.
  • 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.
  • Your headaches get worse when you take more of the analgesic medicine.
  • Your headaches stop when you quit taking the analgesic medicine.

Rebound headache symptoms

Medicine overuse can cause more than just pain in your head. Other MOH symptoms include:

  • Nausea or vomiting.
  • Sensitivity to light or sound.
  • Irritability or restlessness.
  • Difficulty concentrating or memory problems.
  • Insomnia.
  • Constipation.
  • Depression.

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.

Rebound headaches usually happen when you first wake up in the morning. It can feel better when you take headache medicine. But it 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:

  • Simple analgesics or pain killers. These include aspirin, acetaminophen, and NSAIDS (ibuprofen and naproxen). Rebound headaches can happen when you take more than the recommended daily dosages. These medicines also can cause MOH when used 15 or more days per month.
  • Combination pain relievers. These include OTC pain relievers that contain two or more of the following: caffeine, aspirin, acetaminophen, or butalbital. Taking these drugs has a high risk of MOH if you take them for 10 or more days per month.
  • Triptans and ergotamines. If you use these drugs for 10 or more days per month to treat migraine, you’re at moderate risk for rebound headaches.
  • Opioids. Butorphanol, codeine, hydrocodone, morphine, oxycodone, tramadol, and other opioids can cause MOH when used 10 or more days per month.
  • Caffeine: Caffeine intake of more than 200 mg per day — an 8-oz. cup of coffee contains 95 mg of caffeine — increases your risk of rebound headaches.

An important note: The cause of most cases of MOH is OTC or prescription pain relievers used to treat headaches and other pain. If you’re on migraine 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 of it slowly.

When you stop taking the overused medicine, your rebound and primary 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:

  • Medicines. Your doctor may prescribe a medicine that is more effective at preventing or treating the condition — or doesn’t cause rebound headaches.
  • 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.
  • 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.
  • Targeted physical therapy. A physical therapist can help you correct posture and other issues that can contribute to your underlying headache.
  • 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.

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.

Sources

Stopping The Vicious Cycle of Rebound Headaches. Harvard Health. Link.

Medication Overuse Headache. American Migraine Foundation. Link.

Medication Overuse Headache. StatPearls. Link.

Headache. Association for Behavioral and Cognitive Therapy. Link.

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