Morguefile
Painkillers may not be the solution, but the hidden cause of your annoying headaches.
António Variações would be wrong (): it seems contradictory, but the pills we take for headaches may, in fact, be perpetuating them.
Medication overuse headache is a well-documented medical phenomenon, but the good news is that, once identified, it is usually reversible.
Most headaches are harmless and do not indicate a serious problem. Although many people worry that they have a brain tumor, less than 1% of people with headaches actually have one.
How there are many possible causes for headaches, GPs need to investigate further. A detailed medical history and physical examination are essential, sometimes followed by a referral to a specialist.
The challenge lies in determining whether a headache signals a serious underlying cause or whether it is benign. Even benign headaches, however, can significantly affect a person’s daily life and still require appropriate care.
Treatment depends on the type of headache. For example, migraines can be treated with antiemetic medications or beta-blockers, while headaches related to anxiety or depression can improve with psychological support. Lifestyle changes, such as dietary changes and exercise, can also help control many types of chronic headaches.
A clear pattern
Doctors also frequently see another type of persistent headache that has a clear pattern. Patients report recurrent headaches that began or worsened after regular use of painkillers for three months or more.
This can happen in people with migraines, tension headaches or other painful conditions such as back or joint pain. Some may take several types of medication, often more frequently, and end up getting stuck in a frustrating cycle which, at first glance, doesn’t seem to make sense.
The likely diagnosis is medication overuse headache. This condition is thought to It affects around 1 to 2% of people and is three to four times more common in women.
The culprits are usually the painkillers themselves. Opioids such as codeine, used to treat moderate pain caused by injuries or after surgery, have a long list of side effects, including constipation, drowsiness, nausea, hallucinations and headaches.
It’s not just strong opioid medications that can cause headaches. Common painkillers such as paracetamol and NSAIDs (non-steroidal anti-inflammatory drugs such as ibuprofen) can also contribute to the problem and even . Some medications even combine paracetamol with an opioid, such as co-codamol.
Paracetamol has a simpler side effect profile compared to medicines such as codeine. When taken within recommended daily limits – which depend on age and weight – it is generally a safe and effective pain reliever. This has contributed to its widespread use and easy availability.
However, taking a higher dose than recommended or using it too frequently can be very dangerous. This can lead to serious – sometimes fatal – complications such as liver failure.
Although side effects are less common, studies have shown that regular use of acetaminophen alone can also trigger chronic headaches in some people.
Medications other than pain relievers can also cause problems. Excessive use of triptans – medicines to stop migraine attacks – can also lead to medication overuse headaches.
The term “overuse” may imply that patients are taking more than the recommended daily dose, which can happen and carries its own serious risks. However, In many cases of medication overuse headaches, patients are not exceeding dose limits or taking the medication every day.
In the case of paracetamol or non-steroidal anti-inflammatory drugs (NSAIDs), medication overuse headaches may develop if they are taken during 15 days or more per month. With opioids, headaches can occur with even less frequent use – sometimes after just ten days a month.
Therefore, it is important to speak to a doctor if you need to use any painkillers, even over-the-counter ones, for a long period. Not everyone develops medication overuse headaches, and the risk appears to vary from person to person, meaning that individual susceptibility plays an important role.
Treatment
Treating these headaches can be a challenge. Patients often have difficulty recognizing for themselves that their medications are causing the problem. The usual approach is to gradual reduction medication under medical supervision, until it is completely discontinued.
This may seem incomprehensible to patients, especially as they expect painkillers such as paracetamol to relieve their headaches. Some fear that the pain will worsen as the medication is reduced. Therefore, it is essential to work closely with a doctor – to confirm the diagnosis, monitor progress and plan the next steps in treatment.
If you have headaches for more than 15 days a month, it is important to consult your doctor. Talking about it can help identify underlying causes and explain these often debilitating symptom patterns. Keeping a headache diary – noting symptoms and daily details – can also help with diagnosis.
