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Widespread: Pain is central to many conditions - from headaches to hangovers and backache

HEADACHE

Tension headaches, the most common type, can be stopped in their tracks by a simple painkiller (aspirin, paracetamol or ibuprofen) - you don’t need the stronger combination painkillers on the market, says Dr Andrew Dowson, director of the headache service at King’s College Hospital, London.

The secret is using a dissolvable tablet. ‘A soluble pain killer can save you five to ten minutes in achieving pain relief, as the tablets do not have to dissolve in your stomach before starting to be absorbed. One dose will often be enough, as most headaches are highly amenable to some sort of treatment,’ he says.

‘Everyone is different, and paracetamol may work better for some headaches and ibuprofen for others, but the key is not to take more than the recommended amount.

‘And if you still need them after five days, talk to your GP rather than opting for something stronger.’

He, like many headache specialists, is concerned that treating headaches with painkillers, particularly those combining paracetamol or ibuprofen with codeine or caffeine, more than twice a week, on a regular basis, puts you in danger of dependence.

‘If you get headaches often and take painkillers regularly, you can get more headaches,’ he says.

‘The body becomes acclimatised to a frequently used pain reliever, then develops a withdrawal effect, a headache, when medication stops.’

Thousands of people find themselves taking ever-increasing doses of painkillers in a desperate attempt to keep on top of recurring headaches without realising that the painkillers themselves are causing the so-called ‘rebound headaches’.

Your GP can prescribe drugs to help swiftly break the cycle.

DRUG-FREE ALTERNATIVES: Tension headaches can be relieved, and sometimes stopped, by simple relaxation techniques such as head or neck massage or a hot bath, says Dr Dowson. 

 

For those who suffer really badly, ordinary painkillers - no matter how strong - won’t work, and Dr Dowson recommends sumatriptan. This has recently become available without prescription (as Migraleve Ultra £7.89 for two tablets or Imigran Recovery, £7.99 for two tablets).

Migraines are caused by abnormal brain activity and the brain’s blood vessels enlarging; sumatriptan is thought to help the blood vessels return to their normal size and stop the action of the pain-triggering nerves.

However, Dr Dowson says many migraine sufferers may not need this expensive drug if they use ordinary painkillers more efficiently.

The key is acting very quickly, and taking a larger-than recommended initial dose - three painkilling tablets rather than the recommended two for the first dose - and specifically in a fast-acting form (ask the pharmacist for fast-acting painkillers such as Nurofen migraine pain caplets, £5.28 for 12, which contain an amino acid called lysine that speeds absorption).

‘The earlier you hit a migraine, the better,’ says Dr Dowson. ‘Any treatment in the first half hour will be more effective than something taken later.’

He explains the need to take a larger initial dose. ‘Migraines can slow down the transit time of the gastrointestinal tract, resulting in sluggish absorption, of both food and painkillers.

‘If you take an ordinary dose of painkiller, your body is likely to absorb less of it, but if you take three ibuprofen or paracetamol at the start, you should end up with the right amount of the active ingredient in your blood.’

He also suggests having an anti-sickness drug (ask the pharmacist for something with domperidome) handy to reduce symptoms of nausea caused by the effect of the migraine on the digestive system. This should improve the gastric process and aid absorption of painkillers during an attack.

DRUG-FREE ALTERNATIVES: Dr Dowson says 4head Stick hot and cold packs (£4.99), and pressing on your temples can help with symptom-control during a migraine, but will not usually stop an attack. However, he says studies have shown that long-term daily use of magnesium (believed to have a relaxing effect on muscles), vitamin B2, coenzyme Q10, or the herb butterbur can reduce the frequency of migraines by as much as 50 per cent.

‘Most migraines have triggers,’ he says. ‘And if you can identify yours, you may be able to avoid the attacks. Dehydration is a common one. When I feel the early signs of a migraine, I drink two litres of water. It usually works for me.’

HANGOVER

‘A hangover is actually a mild, shortterm form of depression caused by excessive alcohol consumption, triggering a disturbing imbalance of chemical messengers in your brain,’ says Sultan Sid Dajani, a pharmacist and spokesman for the Royal Pharmaceutical Society.

‘It can also traumatise the stomach. That’s why the old hangover “cure” - ibuprofen or aspirin - on top of alcohol, can induce vomiting and even stomach ulcers in some people, and was never really your best option.’

Dr Dajani’s suggests taking a fastacting effervescent or soluble paracetamol when you wake up - this does not cause stomach problems and comes in a form which is very easily absorbed. Also drink lots of water.

An extremely bad hangover, he says, might benefit from the stronger action of soluble/effervescent cocodamol (available from pharmacists for around £3.99 for 32 tablets).

This combines a small dose of codeine, which works on the pain receptors in your brain, plus a dose of paracetamol which goes to the site of the pain.

DRUG-FREE ALTERNATIVES: Drink a pint of water before you go to bed and eat something simple (such as an apple) to fuel the start of the body’s repair processes while you sleep.

A delicate stomach may be settled by an indigestion remedy such as Zantac (£3.49 for 12), allowing you to start eating again and so replace some of the lost nutrients.

But you can boost nutritional intake with a dose of Metatone tonic (£6.99 for 500ml) or Dioralyte (£3.55 for six) which contain readily absorbed vitamins and minerals.

• The advice given is current at time printing. Many common painkillers interact with other medicines, so always check with a pharmacist if you are on any other medication, and see your GP if your pain does not subside in a few dayS