A leading neuroscience expert has issued a stark warning about a surprising side effect from common painkillers, including paracetamol, ibuprofen, and co-codamol, which is increasingly observed by GPs across the UK.
Dr Dan Baumgardt, a senior lecturer at the University of Bristol's school of neuroscience, explains that while these medications are effective for short-term relief, using them for longer than three months can ironically trigger persistent, ongoing headaches.
The Hidden Headache Cycle
This condition, known as medication-overuse headache (MOH), often presents a confusing pattern for patients. Doctors frequently see patients whose repeated headaches started or significantly worsened after they began taking painkillers regularly for three months or more.
This frustrating cycle can affect individuals managing migraines, tension headaches, or other chronic pains like back or joint issues. Some patients end up taking several types of medication, more and more frequently, only to find their headaches intensify.
Dr Baumgardt states that MOH is thought to affect approximately 1–2% of the population and is three to four times more common in women.
Which Medications Are The Culprits?
It's not just powerful prescription drugs that pose a risk. The expert clarified that a range of common pain relief options can contribute to the problem:
- Opiates like codeine, used for moderate pain, come with a list of side-effects including constipation, drowsiness, and notably, headaches.
- Common over-the-counter painkillers like paracetamol and NSAIDs (non-steroidal anti-inflammatories) such as ibuprofen can also play a role.
- Some combination medications, like co-codamol which mixes paracetamol with an opiate, are also implicated.
- Other drugs, such as triptans used for migraines, can cause similar issues if used too often.
While paracetamol is generally safe within recommended limits, regular use alone has been shown in studies to trigger chronic headaches in some people. Exceeding the dose can lead to severe complications like liver failure.
When Does 'Use' Become 'Overuse'?
The term "overuse" can be misleading. For paracetamol or NSAIDs like ibuprofen, medication-overuse headaches may develop if they are taken on 15 or more days per month – patients may not be exceeding the daily dose limit.
With opiates, the risk appears even higher, with headaches potentially occurring after use on just ten days a month.
Dr Baumgardt's key advice is clear: "It's important to talk to a doctor if you need to use any painkiller, even over-the-counter ones, for a long time." Individual susceptibility varies, meaning not everyone will develop these headaches.
Breaking the Cycle and Seeking Help
Treatment for suspected medication-overuse headache involves gradually reducing the medication under medical guidance, with the aim of stopping it entirely.
If you experience headaches on more than 15 days a month, it is crucial to consult your GP. A doctor can help identify underlying causes and explain these often-debilitating symptom patterns.
Keeping a headache diary – noting symptoms, frequency, and daily details – can be an invaluable tool to support diagnosis.
"Why some medicines, especially painkillers, can make headaches worse isn't fully understood," Dan added. "However, it's important to be aware of this now well-established link." For some patients, only after stopping the medication do they discover the uncomfortable truth: their pain was being fuelled by the very drugs they depended on for relief.
