Have you ever heard of rebound headaches? Maybe they were called medication overuse headaches (MOH) or analgesic rebound headaches. Whatever they are called, they are more intense than migraines and very debilitating. If you ever have experienced headaches or migraines, you should make sure you know all you can about these headaches and how to avoid them. Later in the article, we will address what to do for headaches and migraines so as not to have to take medication to care for them. First, let’s take an in-depth look at medication overuse headaches.
Knowing about medication overuse headaches in advance can help you avoid a great deal of pain in the future. Sadly, doctors fail to educate their patients before the onset of MOH and end up trying to help them cope after they already begin. It is important for you to be proactive in this situation, and if you are seeking care from a medical doctor for headaches or migraines, ask him or her about your risk of developing medication overuse headaches.
Exactly What Are Medication Overuse Headaches?
According to the International Classification of Headache Disorders from the International Headache Society, medication overuse headaches are a type of interaction between the overuse of medication that is supposed to relieve headaches and a patient that has a susceptibility to migraines and headaches already. They go on to say they are the most common cause of migraine-like headaches that occur on more than 15 days out of the month, making them chronic in nature. They are a mix of migraines and tension-type headaches. A key feature of these headaches, they go on to explain, is that patients rarely respond to medication while suffering from medication overuse headaches.
The criteria for a MOH are:
- They are present for more than 15 days during a month’s time.
- You have headaches that become much worse when medication is being overused.
- You have been using medication for over three months to care for headaches and using more than recommended.
- After two months of discontinuing the medication, your headaches return to their normal pattern.
What Medications Cause Medication Overuse Headaches?
This is probably one of the most debated and biggest questions surrounding the subject of MOH. The most recent information from Goadsby, et al. confirms that all drugs used for caring for headaches can cause MOH in patients who have primary headache disorders (this includes headaches and migraines). So, what medications does this include?
- Ergotamine: Taken 10 or more days a month for more than 3 months — DHE-45, Migranal Nasal Spray
- Triptan: Taken 10 or more days a month for more than 3 months — Imitrex, Maxalt, Zomig, Amerge, Relpax, Axert, Frova, and Treximet
- Analgesic: Taken for 15 days or more a month for more than 3 months — acetaminophen
- Opioid: Taken 10 days a month for more than 3 months (Patients taking opioids have the highest relapse rate after withdrawal)
- Combination of medications: Combining ergotamine, triptans, analgesics, and opioids and taking them for more than 10 days for more than 3 months.
- Other: Any medication that has been taken for more than 3 months to care for headaches or migraines can be to blame.
NSAIDs are anti-inflammatory drugs such as Aleve. In studies, they seemed to be acceptable to use moderately (10 – 14 days a month). But when used for more than 15 days a month, they were connected to MOH. Therefore, restrict their use to no more than 3 days a week and do not use them for migraine prevention.
Caffeine is not listed although it can be a drug for some people and it can cause medication overuse headaches. In fact, some headache and migraine medications contain caffeine and can contribute to MOH.
Avoiding Medication Overuse Headaches
Basically, the answer to this is simple: Do not overuse medications to relieve your headaches and migraines. Sounds easy, right? Not for the chronic sufferer. This means there will be days you will really feel like you need to take medication but you cannot. Doctors may recommend taking lower doses of certain medications, which may help some. The long-term answer is trying to find an effective preventative regimen to reduce the need for medications overall. Again, this sounds like an easy solution. But many wonder where to begin.
Upper Cervical Chiropractors Address the Root of Headaches
The best solution to avoiding medication overuse headaches is to find out what is causing you to have headaches and to try to fix that problem. Upper cervical chiropractors are specially trained in just that. A strong connection has been seen between headaches and migraines and a misalignment in the bones of the upper cervical spine, predominantly the C1 and C2 — the top bones of the neck. When these bones are out of alignment, rather than protecting the brainstem as they were designed to do, they put it under stress and cause an issue with brain and body communication. They can also act as a block or a hindrance to the proper flow of blood and cerebrospinal fluid. Either of these scenarios can be the underlying cause of headaches.
Here at Precision Spinal Care in Laguna Hills, California, we use a method that is very gentle and does not require us to pop or crack the neck to get positive results. This technique allows the bones to move back into place naturally and leads to a long-lasting solution. The healing properties of the body then take over and help to repair any damage done by the misalignment. Many patients report seeing a huge improvement in the frequency and severity of headaches after only a couple of visits. Some see their headaches go away and not return.