33 For months I’ ve been having headaches everyday and over the counter pain killers aren’ t working. What can I do?

‘HAVING headaches every day isn’t normal and you need to see your GP to find out the cause,’ says Dr Shazia Afridi, a consultant neurologist for Guy’s and St Thomas’ Hospital, London.

‘One possibility is that the pains could be caused by medication overuse, the trigger for which can be taking too many painkillers too frequently — for more than 10 days in a month.’ As each dose wears off, the pain comes back, so you take more painkillers. Then overuse causes the painkiller to stop easing the headache and it actually starts

causing them. ‘Pills containing codeine are particularly bad for this, but you can get overuse headaches with paracetamol,’ says Dr Afridi. ‘They typically cause a dull, constant headache.’ The cure is to stop taking the pills — either immediately, or gradually tapering off to prevent withdrawal symptoms.

Most people manage to do this as outpatients but in some cases, peop need to be hospitalised.

‘Another possibility is that you’re suff from migraines — these headaches pulsating or throbbing and accompani light and/or noise sensitivity, somet with nausea and vomiting,’ says Dr Afri

‘In around one third of cases patients experience aura, such as flashing light

‘Triggers for migraines can inc hormone changes in the menstrual c alcohol, not sleeping well, sleeping much or missing meals.’

GPs can prescribe preventative medic including betablockers, the antidepreessant

amitriptyline and epilepsy drugs such as sodium valproate (these aren’t suitable for women of child-bearing age because of links with birth defects).

Treatments for migraine include drugs called triptans, which can be combined with the anti-nausea drug domperidone, both available on prescription (sumatriptan is also available over the counter).

Other treatments on the NHS include devices such as transcranial magnetic stimulators, which deliver magnetic pulses to relieve pain (these are prescribed by specialist headache centres in NHS neurology departments and there are half a dozen nationally).

Botox injections may also be given where other treatments have failed and the patient has more than 15 headache days a month.