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Marshall James Nev, PLC | Rebound Headaches in Richmond

Lexington-Richmond Headache Clinic
Marshall James Ney, DMD, FAAOP
Fellow American Academy of Oral Facial Pain

527 W. Main St.
Richmond, 40475
(859) 623-3761

Rebound Headaches


Rebound headache is caused by taking over the counter or prescription medication too often.
The result is the patient has a daily headache.

Learn More

over_the_counter_meds.jpgRebound headache is caused by short-acting, mostly over the counter (OTC) pain relief medication and some prescription medication such as Vicoden (Hydrocodone). Also, drugs like Oxycontin, when taken over a long period of time, can through other mechanisms cause you to feel pain from something that should not cause pain, such as slightly pinching your arm. The fancy name for this is Allodynia. The long term use of any narcotic runs the risk of this irreversible pain mechanism to occur.

Short acting pain medication (aspirin, Ibuprofen, Tylenol) all have a half-life of about 2 hours. So when you come off the medication’s short half-life, the pain returns and a few hours later you need the medication again. Now this type of short half life medication works well on knees, hands or back, but not on headache.

If your headache has the characteristics below, keep reading:

  • Daily or nearly daily headache
  • Pain on both sides of the head
  • Pressing/tightening quality ("like a tight belt around my head") perhaps a mild degree of photophobia (sensitivity to light) or phonophobia (sensitivity to sound)
  • Tight and tender neck and shoulder muscles
  • the patient is regularly taking symptomatic/abortive pain medication

Rebound headache most often develops in the daily headache patient. Typically these headaches may start out with migraine or muscle tension and the headache gradually becomes more and more frequent over several months with a gradual change in the type of headache: The migraine headache happens less often and is replaced by a tension-type headache, which becomes a daily occurrence. (migraine is fast throbbing and muscle pain is steady/slowly throbbing pain.

A common scenario in rebound headache patients is the following:

  • For some reason (sometimes increased stress), the migraine/muscle tension type headache worsens;
  • The patient ingests more and more of their symptomatic/abortive migraine headache medication or over the counter (OTC) medications;
  • Eventually, the patient's medication becomes less and less effective;
  • Gradually, a daily or near daily tension-type headache develops often accompanied by periodic, severe migraine headaches and the use of OTC medication increases.

I believe that I personally had as part of my daily headache problem the ingestion of too many short acting OTC medications. I would not leave the house without my right pocket full of Ibuprofen and the left pocket with Excedrin. However, I did not completely manage my pain until I used my own protocol to manage my own headaches. This involved going through a very difficult period when I discontinued the OTC medications.

Please note that I am not going to let you go “cold turkey.” We will first get your bite corrected with a splint (no dental work) and help you manage your sleep and muscle inflammation before getting off of OTC medication.

I care too much for you to treat you the way I treated myself. Since I went through the hell of withdrawal of OTC, I know first hand what I may be asking my patient to do! Consequently, I will make it a lot easier for you then it was for me.

However, we must do this together. You have got to listen to what I say and I will have to listen to you as sincerely as you have listened to me.

Bottom Line: Together we can help!


Richmond Dentist | Rebound Headaches. Marshall James Ney is a Richmond Dentist.