Such patients frequently start out with migraine, only to end up, years later with chronic daily headache. The presenting headache may be due to over use of medication. With daily or almost daily headaches and the use of medication, these individuals often report depression and sleep disturbances. There may be significant underlying, stressful family dynamics. The first step in dealing with analgesic rebound headaches is to stop the daily use of these drugs.
Many facilities resort to hospitalization.
Patients must understand that drugs used regularly contribute to headaches. With their discontinuance, the patient often experiences significantly less headaches. In the practice of Dr. Lichten, he often incorporates a series of occipital nerve blocks in the treatment of muscle-contraction, analgesic rebound, and cervicogenic headaches. At the same time treatment is directed toward the underlying factors. The management of headache disorders is complicated by many intertwining factors.