When people mention using pain medication with headaches people always post about it causing issues with rebound headaches as a result of taking the pain medication more than 3-4 days per week.

However if someone is taking pain medication for another reason (e.g. back pain) then could rebound headaches happen as a result?

Mike,

Certainly. Codeine will cause rebound headaches regardless of why you are taking it.

It is also habit forming and coming off it is very unpleasant and difficult. So caution is advised.

Peter.

Hi, Peter is right. before i knew that what i was suffering from is Cluster headaches, i was taking a pain killer that contains codeine, i beleive it made my headaches worse.
Also i know people who got hooked on codeine, one of them is still taking it everyday as they find it too hard to come off it. The other person required treatment to stop taking it.
I would stay away from codeine if possible.
All the best

Mike NZ wrote on May 10^th, 2016 at 2:24am:

... if someone is taking pain medication for another reason (e.g. back pain) then could rebound headaches happen as a result?

I stopped using all CH medication many years ago (best decision I ever made) and the main reason was what we know here as rebound headaches - another headache coming on just to spite you for taking an abortive.

My belief is entirely different and it's not another headache at all.

It's same one. You haven't turned it off at all, and simply hit the pause button. Worst for me was the original coming back just in time to greet the next one so I got to enjoy them both together.

I reckon this is why so many abortives fail so many CHeads, along with the opioids' happy little habit of inventing extra pain so you'll take more of them.

I have no science to back up my personal opinion and beliefs, but it's worked for me for a bloody long time.

As to Mike's original question, I've certainly had to use strong painkillers for other matters I choose not to discuss, and not once has it brought on a headache.

I truly hope it's the same for us all.

Thank you for the replies.

I know that even the small amount of codeine in the paracetamol / codeine pain killers you can get over the counter is enough to send my migraines into overdrive, so there is no way I'll touch it.

Before my CHs were diagnosed I was given codeine to try to deal with the pain, which of course it didn't really touch. Instead by following the dosing instructions to the letter they just made the problem worse and coming off them was not at all fun.

Brian's comment:

Quote:

I've certainly had to use strong painkillers for other matters I choose not to discuss, and not once has it brought on a headache.

I hope I follow in your footsteps on this.

What is pretty surprising is that there are not a lot of different pain killers around, especially when you look at how many other types of medication there are.

All we have is essentially:

• Paracetamol
  
• Aspirin and NSAIDs (non-steroidal anti-inflammatory drugs)
  
• Opioids
  

Realize that a drug overuse rebound headache is different than a cluster headache.  It feels different, acts different, is different.

I have approached drugs the same way AussieBrian has.  I eliminated all the drugs years ago.  The only thing they did for me was keep me on a cloud. I could never tell what was happening around me. I just thought maybe they were causing more harm than good. Since I left the drugs, I have had some severe episodes, but I have fought through them with ice and O2.  I do have sumatriptan tablets if I need but try not to use.

I have been PF since starting the D3 regimen for almost 4 weeks now. No need for the sumatriptan or O2 in that time.

My girlfriend takes a lot of pain killers for knee pain and she suffers very strong headaches and I tend to think that they are from the opioids. I have tried to tell her to get off of them but she seems to think that they are working when I think they are not.

I did not have any rebound headaches when I was taking the drugs, but then again I was so "doped up", how would I have known.

I enjoy being in control now.

Please folks...I fear a confusion for newcomers re "meds". Can we be a little more clear that OPIATES are what we are talking about.....mainly....and are ineffective/inappropriate CH aborts/prevents...but that does NOT necessarily mean ALL CH meds are such?

Like Brian...and MANY others...I refrained from ALL meds a (save O2) for 7 years. Because, in my case, I tired of the constant battle with ineffectiveness, side effects, and Physician frustration with MY failure to respond (sheesh...that coulda been funny...but THEY were clueless).

Anyway...eventually I could not handle it anymore...and finally found an advocate Doc who knew her shit! For many years I prospered in that relationship....with a variety of CH meds ( O2 always present) but the others GAVE ME MY LIFE BACK...like verapamil and Zomig NS e.g.

To go med free is a VERY personal decision...to be made with CAREFUL analysis.....PLEASE don't scare folks off from the limited options we DO have available.....

To be clear.....D3 and O2 properly used are most definitely the best first options...and age, I guess...
seems to be working (mostly) for me  ;)

Best

Jon

Jon,

I am with you completely.  The decision to "go off" the variety of meds is a very personal decision. I was just tired of the way that I felt while taking them.

The D3 and O2 work extremely well for me. I do have a supply of sumatriptan that I can use if necessary.

After having lived with the beast for 34 years, I just made a decision that not everyone has the luxury of doing. Not everyone can be rid of meds. My neuro told me years ago that his feeling was that I would grow out of the attacks. I'm still waiting, at 64, to grow out of this.

Over the counter pain killers and opioids will not abort a CH. So, best stay away from them in the first place, but I understand Suma can cause RH in some folk if overused, (but not for me), but as for prevents i.e. Verapamil, I'm not sure the same applies.

As for other issues when taking pain killers, and you land up with a headache. Well, that's another story altogether.

Cheers, Hoppy.

I'm aware of the many abortives when it comes to CH, and what works for me, and doesn't work.

Opiates/ opioids don't kill CH, and shouldn't be taken to get rid of one, although I've seen it happen in a hospital, the nurses kept giving more and more of an opioid until the hit stopped by itself, and the CH'er was incapacitated.

Some opiates have a side effect of causing a headache that has nothing to do with CH. Even the triptans will cause rebound headaches if you use them daily. Even using imitrex once daily will cause CH rebound headaches.

I've taken aspirin and a muscle relaxer and a heat pack and ice pack to try to control my neck pain which happens when I'm getting hit. But pain meds, opiates, won't help a cluster headache, and won't cause a rebound cluster headache. Stay away from opiates to treat CH. It doesn't work and will only mess you up eventually.

Rebound headaches. "Rebound Headaches--A Review", Au. John S. Warner, M.D., in HEADACHE QUARTERLY, 10:3(1999). (There is some confusion on the board about the meaning of "rebound". There appears to be an emerging consensus in the medical literature to define "rebound" as a headache which is caused by the overuse of any medication used to abort a headache or relieve pain. "Recurrence" [of a headache] is being used to refer to the redevelopment of an attack when its "normal" duration is longer than the useful life of the medication which has been taken. That is, the medication effectiveness is reducing before the headache has come to an end; the pain redevelops.)
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Sumatriptan has a hard initial punch and relatively short effective life--a combination which works well for most Cluster attacks. However, some people, whose Clusters have a longer life, find that the med is wearing down even as the pain continues. One can understand how this sequence comes into one's thinking: Attack, Imitrex injection, pain continues, it's a rebound cluster which has developed from the Imitrex. In fact, this is a recurrence of the attack, not a rebound.

This is one of the reasons that several other triptans were developed having less initial punch but longer effective life. While aimed at the migraine crowd, at first, a number of cluster users have found this characteristic of value to them.

Before making any judgment about the value of your present triptan discuss, with your doc, the value of trying a longer lived triptan.
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Consider trying a quite different med which, for me, replaced any of the standard abortives.

Headache 2001 Sep;41(8):813-6 

Olanzapine as an Abortive Agent for Cluster Headache.


Rozen TD.
Department of Neurology, Jefferson Headache Center/Thomas Jefferson University Hospital, Philadelphia, Pa.

OBJECTIVE: To evaluate olanzapine as a cluster headache abortive agent in an open-label trial. BACKGROUND: Cluster headache is the most painful headache syndrome known. There are very few recognized abortive therapies for cluster headache and fewer for patients who have contraindications to vasoconstrictive drugs. METHODS: Olanzapine was given as an abortive agent to five patients with cluster headache in an open-label trial. THE INITIAL OLANZAPINE DOSE WAS 5 MG, AND THE DOSE WAS INCREASED TO 10 MG IF THERE WAS NO PAIN RELIEF. THE DOSAGE WAS DECREASED TO 2.5 MG IF THE 5-MG DOSE WAS EFFECTIVE BUT CAUSED ADVERSE EFFECTS. To be included in the study, each patient had to treat at least two attacks with either an effective dose or the highest tolerated dose. RESULTS: Five patients completed the investigation (four men, one woman; four with chronic cluster, one with episodic cluster). Olanzapine reduced cluster pain by at least 80% in four of five patients, and TWO PATIENTS BECAME HEADACHE-FREE AFTER TAKING THE DRUG. Olanzapine typically alleviated pain within 20 minutes after oral dosing and treatment response was consistent across multiple treated attacks. The only adverse event was sleepiness. CONCLUSIONS: Olanzapine appears to be a good abortive agent for cluster headache. IT ALLEVIATES PAIN QUICKLY AND HAS A CONSISTENT RESPONSE ACROSS MULTIPLE TREATED ATTACKS. IT APPEARS TO WORK IN BOTH EPISODIC AND CHRONIC CLUSTER HEADACHE.

PMID 11576207 PubMed

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Olanzapine has a brand name of "Zyprexa" and is a antipsychotic. Don't be put off by this primary usage. Several of the drugs used to treat CH are cross over applications, that is, drugs approved by the FDA for one purpose which are found to be effective with unrelated conditions--BJ.
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Unfortunately I have had a couple of tragic injuries that have required pain meds. Pain meds have never helped me with CH's.

However they have triggered a cycle (on more than one occasion) when withdrawing dosage from daily pain med use.

Bottom line, I strongly advise staying away from pain meds for CH relief!

-Gregg in Las Vegas