Medication Dependent Headache

What is medication dependent headache?

Medication dependent headache is headache that is caused by taking too many painkillers over a prolonged period. People often use such painkillers for existing headaches.


Medication dependent headache is caused by the daily use of painkillers (such as paracetamol, aspirin, diclofenac, naproxen or ibuprofen) to relieve headaches. The disorder does not occur in patients who use these painkillers for other reasons. In many cases, patients were already using these painkillers before the headaches started, possibly just out of habit. There is a danger that patients start to take more and more painkillers. This leads to pain that, as it were, comes on top of the existing headache. The patients then need even more painkillers to relieve the new pain, as they were already used to taking a lot of painkillers.

Medication dependent headache may also be related to the use of caffeine, which is present not only in coffee, but also in tea, ice-tea and chocolate.

Signs and symptoms

This type of headache is present nearly every day, and usually lasts throughout the day. The pain resembles that of tension headache, since both cause bilateral pain that feels as if a band is wound tightly around the head.

How is medication dependent headache diagnosed?

There is no specific test to diagnose this disorder. The pattern of complaints is often so typical that this is enough for a diagnosis. Sometimes keeping a headache diary may help clarify the pattern. If you visit the clinic with medication headache, you will always be given a neurological examination, to exclude other causes. In addition, the doctor will test the mobility of your neck and shoulder, to see whether certain movements are restricted or painful. The doctor will also feel your neck to see whether pressing on any of the vertebrae causes pain.

Do I need additional examinations?

  • Diagnostic examination for other non-physical factors important for your pain, have already been done by yourself trough filling out your pain questionnaires.
  • If necessary, an X-ray of your neck will be made to exclude other possible causes.

What are my treatment possibilities?

Multidisciplinary Treatment

Depending on the cause of your pain, your pain specialist will decide whether or not to embark on physical treatment. Based on the results of the completed pain questionnaire, additional examinations can be carried out and, apart from physical treatment, other methods of treatment will be suggested.

Non-physical Treatments

If the results of your pain questionnaire are abnormal, your pain specialist will offer you one of the non-physical treatments listed below:

Physical Treatments


  • Stop pain medication for at least 3 months
  • Amitriptyline (as support medication)
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