Painkillers Causing You Pain?

Up to a million people in the UK have "completely preventable" severe headaches caused by taking too many painkillers, doctors have said.

Hundreds of thousands of people are suffering from ‘disabling’ headaches caused by overuse of painkillers, experts warn.

As many as one in 50 of the population regularly has headaches triggered by the very drugs meant to be numbing their pain.

The risk is highest for those who take aspirin, ibuprofen or paracetamol at least every other day to treat either a headache or another condition such as joint pain.

The health watchdog NICE says that taking too many of these pills can actually make the brain more sensitive to pain, leaving the sufferer prone to further headaches.

Bad odds: One in 50 people regularly get headaches from the drugs meant to be ridding them of the pain (posed by model)

Often they get into a ‘vicious cycle’ whereby their headaches get worse, they take more drugs and the pain becomes even more debilitating. As many as 10million Britons suffer from severe headaches but NICE is concerned that many doctors are not properly diagnosing the type of pain or offering the best treatment.

Many could be better off taking alternative drugs called triptans, inhaling oxygen or even having acupuncture, the watchdog says.

Professor Martin Underwood, a GP and Warwick Medical School researcher who helped draw up the guidelines, said: ‘We have effective treatments for common headache types.

'However, taking these medicines for more than ten or 15 days a month can cause medication overuse headache, which is a disabling and preventable disorder.

‘Patients with frequent tension-type headaches or migraines can get themselves into a vicious cycle, where their headaches are getting increasingly worse, so they take more medication which makes their pain even worse as they take more medication.’

Official figures show that the NHS spends over £470million a year on painkiller prescriptions, although not all will be for headaches. Some 62.5million prescriptions were handed out by GPs last year, a 4 per cent rise in just 12 months.

But Dr Gillian Leng, deputy chief executive of NICE, said that too many people were not being given a ‘correct or timely diagnosis’ by their doctors, adding: ‘The key features of medication overuse and the symptoms that distinguish the types of primary headache can be overlooked, and concerns from patients about possible underlying causes can lead to unnecessary hospital investigations.

‘These can mean people experience delays in receiving adequate pain relief from what can be an extremely disabling condition.’

Doctors advising the watchdog said some patients were so worried about their headaches they were begging their GPs to refer them for expensive brain scans to rule out tumours.

Dr Manjit Matharu, a consultant at the National Hospital for Neurology in London, said: ‘Most people’s headaches will not be caused by brain tumours or other serious health problems, and so these should not be offered to patients solely for reassurance.’

A condition known as medication overuse headache (MOH) is thought to affect one million Britons, about six per cent of headache patients seen by GPs each year.

‘In some specialised UK headache clinics, up to 90 per cent of patients may have chronic migraine complicated by MOH,’ says Dr Nicholas Silver, consultant neurologist at The Walton Centre for Neurology and Neurosurgery, Liverpool.

‘Diagnosis of MOH is easily overlooked,’ says Dr Silver. ‘But alarm bells should ring when patients find their original painkillers stop working and they request something stronger because there is an escalation in the intensity and frequency of their headaches. Seemingly unrelated symptoms can develop too, including fatigue, dizziness, vertigo, neck and back pain, poor sleep, restless legs, mood change or poor short-term memory.’

People with MOH must be weaned off the drugs as soon as possible. If you take pills for an extended period of time, you could become a victim

A patient with MOH must be weaned off the drugs as soon as possible – and rotating different classes of painkillers will not prevent the condition developing. If you take any form of painkiller in any combination over an extended period, you will be much more prone to developing the condition.

‘Coming off painkillers will typically trigger worsening of the pain for a week, sometimes longer where opiates are being consumed, and it may take up to six weeks to see real improvements,’ explains Dr Silver. ‘Although, all that may be required in about 40 per cent of patients is to cease all painkilling medications, ensure you drink plenty of fluids and avoid caffeine as it can trigger headaches, eat regular meals and get a decent amount of sleep.’

Where a patient suffers with chronic pain due to an underlying condition, Dr Silver advises entirely rethinking your method of treatment if you start to develop MOH. ‘The problem is that many people self-prescribe painkillers,’ he says. ‘But a proper diagnosis of what is causing the original pain is essential. Once that has been ascertained, appropriate long-term treatment should be given. If someone suffers with a painful autoimmune disease such as rheumatoid arthritis, they should be taking a disease-modifying drug and not masking the symptoms of pain and swelling with anti-inflammatory painkillers.

‘In other cases such as osteoarthritis, where there is bone and cartilage degeneration, the patient should try alternative solutions such as glucosamine and chondroitin supplements which have been proven to reduce pain in about 50 per cent of sufferers. Of course if the pain is unbearable, a patient should consider surgery to alleviate symptoms.’


The guidelines also include a recommendation for acupuncture in patients susceptible to migraine and tension headaches.

"We would expect that to lead to more people getting acupuncture, but given there is good evidence to show this is effective for the prevention of both tension-type and migraine-type headaches then that is a good thing because people are getting access to an effective treatment," Prof Martin Underwood said.

Doctors have also been asked not to refer patients for brain scans "solely for reassurance" that they do not have a brain tumour. The NICE panel said a tumour would come with other symptoms such as a change in behaviour or epilepsy.

The chief executive of the Migraine Trust, Wendy Thomas, said: "The guideline will assist with accurate diagnosis, appropriate referral and evidence-based information for those with troublesome and disabling headaches.

"It will also raise awareness of medication overuse, which can be an issue for those with severe headaches.

"People with disabling migraine will experience improved quality of life as a result of this guideline."

Dr Fayyaz Ahmed, the chair of British Association for the Study of Headache, welcomed the guidelines.

He said: "Headache is the most prevalent condition and one in seven of the UK population has migraine.

"The condition puts an enormous burden on the healthcare resources and the economy in general."


Naveed Bashir said…
very inforamtive post dear thank you for this i like it very much Pain killers

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