Difference between a rebound headache and a migraine

Thank you for reaching out with your question - it's a good one. Medication overuse headache (MOH) or rebound is very frustrating. We take these medications to stop pain, not create more of it. The thing is when we use acute migraine medications and/or pain relievers, whether the are over-the-counter or prescription more than 10 days a month we may increase our risk of MOH, and no one wants to have both migraine and MOH.
Migraine and MOH have distinct features and there are diagnostic criteria for both. The criteria for migraine is as follows from the International Headache Society's Classification of Headache Disorders;
"At least five attacks1 fulfilling criteria B-D
Headache attacks lasting 4-72 hr (untreated or unsuccessfully treated)2;3
Headache has at least two of the following four characteristics:
unilateral location
pulsating quality
moderate or severe pain intensity
aggravation by or causing avoidance of routine physical activity (eg, walking or climbing stairs)
During headache at least one of the following:
nausea and/or vomiting
photophobia and phonophobia
Not better accounted for by another ICHD-3 diagnosis." You can read more here; https://ichd-3.org/1-migraine/1-1-migraine-without-aura/

Here is the criteria for medication overuse headache as well;
"Headache occurring on ≥15 days/month in a patient with a pre-existing headache disorder
Regular overuse for >3 months of one or more drugs that can be taken for acute and/or symptomatic treatment of headache1;2;3
Not better accounted for by another ICHD-3 diagnosis." More information can be found here; https://ichd-3.org/8-headache-attributed-to-a-substance-or-its-withdrawal/8-2-medication-overuse-headache-moh/

I actually fell into a rebound cycle a number of years ago from too much caffeine which is a stimulant. For a small subset of people with migraine disease too much caffeine (and it doesn't take that much) can create this problem. As long as I stick with one cup a day, may two every couple of weeks, I am able to avoid MOH.

While we wait for others to share their experiences let me share some of our resources on MOH; https://migraine.com/search?s=medication%20overuse%20headache

I hope this helps, will you let me know? I'm hoping you have a low pain weekend, Nancy Harris Bonk, Patient Leader/Moderator (team member)

Thanks so much for your help. I had a shoulder reversal surgery in mid April and was on Norco 10/325 for several weeks. I'm seeing my Neurologist on Monday.

Since the surgery the migraines have not been the best. In fact within the last several weeks they have been quite bad. We have had over 4 inches of rain this month alone. Thanks for asking.

I take Emgality and Qulipta