A PAINFUL PROBLEM

Taking the odd paracetamol or ibuprofen is normally fine (as long as you don’t fall into certain categories – see panel, far right), but prolonged use can be problematic. ‘We get worried when someone is selfmedicating with painkillers for a long-term condition, such as arthritis,’ says Dr Foster. Not only can it cause heart problems and internal bleeding, but addiction may be an issue, too.

Painkillers containing opiates, such as codeine, can be addictive. ‘Those with a history of substance misuse (including alcohol and cigarettes), OCD sufferers and patients with chronic illness are more susceptible,’ warns Dr Foster. And the more you take, the more ineffective the drug becomes – so the more you need. ‘Although the amount of codeine in over-thecounter medication is limited, it’s the paracetamol combined with the codeine (often sold as co-codamol) that can really do damage,’ he explains.

Overdosing on paracetamol can cause fatigue, abdominal pain, nausea, and can lead to kidney and liver damage, and even death. What’s more, headache medication can actually cause pain. According to The National Institute for Health and Care Excellence (NICE), continuous use of painkillers, such as aspirin, NSAIDs and paracetamol is believed to cause ‘medication overuse headaches’ (also known as ‘rebound’ headaches) in 1-2% of the global population. These headaches are more prevalent in women. ‘Ironically, the best way to treat them is to come off the painkiller,’ explains Dr Foster.

With these facts in mind, when is the right time for painkillers? Dr Foster says that, when taken occasionally, over-the-counter remedies are usually harmless. ‘But, if the pain is constant and impacting your life, avoid selfmedication and visit your GP,’ he adds.