Ask the Expert: Treating Chronic Daily Headache, Fibromyalgia and More

A: Chronic daily headaches are commonly associated with fibromyalgia, TMJ, IBS and other chronic pain disorders. The treatment for all those disorders is even similar. However, there is always a risk that overuse of pain medications will cause rebound headache, tolerance (a need for higher and more frequent dosing) and/or dependency. Opioid-type analgesics, caffeinated products, barbiturates, triptans and ergots are known to be the main cause of rebound headaches. There is a debate as to whether nonsteroidal anti-inflammatory medications (such as Advil and Aleve®) may also be responsible. I think that you should seek help from a headache clinic, where these issues can be addressed. George Urban, MD, Diamond Headache Clinic, Chicago, IL

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