Causes and risk factors
Exact cause of Rebound headache is not known. Pain depends upon the frequency of the headache, type of headache, type and dose of medication used for relieving headache such as simple pain relievers, combination pain relievers, opiates, migraine medications. Daily dose of caffeine i.e. from coffee can also contribute to rebound headache. Risk factors for rebound headache include family or past history of chronic headaches.
Clinical presentation
Patient with rebound headache presents with headache commencing every morning on waking, continuous pain throughout the day, relief from pain relievers but recurring once the dose wears off, pain aggravated by mental or physical exertion. Associated symptoms such as pain in neck, nausea, vomiting, anxiety, restlessness, difficulty in concentration, weakness of memory, irritability, depression, nasal obstruction, congestion, coryza and sleeplessness may be present.
Investigation
Medical history by the patient of chronic headaches thus frequent use of medications and Clinical examination by the doctor helps in diagnosis of rebound headaches.
Treatment
Treatment involves breaking the cycle of rebound headaches. Avoiding taking analgesics for headache will help break the cycle. It may cause withdrawal symptoms such as nausea, vomiting, irritability. Hospital admission may be required in severe cases. Anti convulsants or anti depression medicines after breaking cycle contribute further to the treatment. Cognitive behavioural therapy [CBT] will also help in managing rebound headaches.
Other Modes of treatment
The other modes of treatment can also be effective in treating rebound headache. Homoeopathy is a science which deals with individualization considers a person in a holistic way. This science can be helpful in combating the symptoms. Similarly the ayurvedic system of medicine which uses herbal medicines and synthetic derivates are also found to be effective in treating rebound headaches.