The headache of headache

Headache is extremely common, affecting all age groups and being potentially very disabling, with more people suffering it in Australia than diabetes and heart disease. Support and research are provided by Headache Australia (see headacheaustralia.org,au) a branch of the Brain Foundation, with a headache awareness week occurring in September.

One of the lesser known but fascinating causes of headache is, paradoxically, a headache due to frequent use of acute pain relief called 'medication overuse headache' otherwise known as an analgesic or rebound headache, as described in the International Classification of Headache Disorders. It can begin as occasional headache but over time become more frequent, and in some people is experienced as even a daily headache.

This can occur particularly in those with migraine or tension headaches. It can be associated with other symptoms such as nausea, and usually begins with frequent use of medication used to relieve acute headache, such as paracetamol, triptans, and opiates such as codeine and morphine. These medications are not the same as regular use of preventer medication used typically for migraine.

This can lead to a cycle of taking more analgesia in order to treat the headache, when the best approach may in some circumstances be to lessen the amount of medication or potentially cease it for a period of time, following consultation with your doctor. The withdrawal time frame can vary depending on the medication, Your doctor might also consider adding in a preventer in order to minimise acute analgesic use. Relapse can occur unless an adequate plan is in place and in some patients a “detoxification” program may be necessary, aiming to avoid relapse into this cycle of headache. The best approach as always is prevention, so if you are at all concerned about how to proceed with taking pain relief, why not speak with your GP or specialist.