Pain relievers cause relapses of headaches, scientists find

By Brittany Abeijon

Pain medications taken to prevent or treat headaches have now been found to cause them.

Scientists have found that half of chronic migraines and as many as 25 percent of all headaches are actually “rebound” episodes triggered by the overuse of common pain medications, according to an Aug. 30 article in the New York Times.

Dr. David Lawrance, medical director of McKinley Health Center, said some people find themselves in a bind with something called chronic daily headaches.

“People with consistent headaches tend to take a medication almost every day to reduce their headaches and find that their headaches just become more common,” Lawrance said. “These are actually rebound headaches.”

Virtually any headache medications, prescription or over-the-counter, can actually cause headaches if taken on a daily basis.

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“Over-the-counter medications such as acetaminophen and ibuprofen are the most common offenders, but they are probably no worse than others,” Lawrance said. “They just happen to be readily available.”

Acetaminophen is marketed in the United States under the name Tylenol, and ibuprofen is known under the brand name of Advil, according to the U.S. National Library of Medicine.

Research shows that most people will not experience rebound headaches if their headaches and pain medication use are occasional.

“People with several headaches a week are particularly at risk, and they should not take a particular headache medication more than one or two days in a row,” Lawrance said. “If they are getting several headaches a month that interfere with their activities, they should talk to their health care professional about headache prevention.”

Although rebound headaches have earned a different title than regular tension or migraine headaches, Lawrance said they can feel the same and essentially are the same headache that returns when the medication levels fall.

“It is as if something in the brain has reset to be in pain when there is less than a certain amount of the medication present,” he said.

Pain medications such as Advil and Tylenol have been known to relieve headaches but, marketed as a ‘pain medication,’ the drugs are meant for any type of bodily pain, yet head pain seems to be the sole reason for rebound headaches.

“Rebound headaches don’t happen to the person who is not headache-prone,” Lawrance said. “People with arthritis often take the same medications to treat their joint pain that are used to treat headaches. They don’t appear to be headache prone. It is not so much the medications themselves that cause the headaches but how the brain adapts to their presence.”

Lawrance said many things change in the presence of pain such as the body becoming tolerant of pain medication by adapting to it. Rebound headaches are another kind of adaptation because the brain requires the presence of the medication to be headache-free.

Headaches, pain medications and rebound headaches have grown into a vicious cycle that can be difficult and painful for one to break.

“For people with frequent headaches, we can find a preventive medication that helps, but they don’t help the person with rebound headaches,” Lawrance said. “The way to stop rebound headaches is to stop taking headache medications. It sounds cruel and unusual, but that’s the trick.”