Regular use of painkillers such as aspirin, paracetamol and triptans could aggravate problems for some of the UK’s millions of headache sufferers, according to guidance published today.
The National Institute for Health and Clinical Excellence advises GPs and other healthcare professionals of a potential risk for people with migraines.
As many as ten million people suffer from headaches and they account for four per cent of GP consultations, according to NICE.
The guidance states that "medication overuse" can occur in patients with headache who have been taking a medicine for up to half of the days in a month, over three months. This can backfire and cause more headaches in about one in 50 patients.
It also says that different headaches need different treatments, so it is vital to diagnose each patient correctly.
"We have effective treatments for common headache types," said guideline author GP Professor Martin Underwood, of Warwick Medical School.
"However, taking these medicines for more than ten or fifteen days a month can cause medication overuse headache, which is a disabling and preventable disorder."
He added: "Patients with frequent tension-type headaches or migraines can get themselves into a vicious cycle, where their headaches are getting increasingly worse, so they take more medication which makes their pain even worse as they take more medication.
"I hope this guideline will improve awareness of medication overuse headache both in primary care and among the general public because prevention is simple and treatment is difficult."
Chief executive of the charity Migraine Trust, Wendy Thomas, commented: "The guideline will prove to be a tremendous step forward in addressing many difficult areas in the management of headaches, including migraine, that are among the most common neurological problems presented to GPs and neurologists.
"People with disabling migraine will experience improved quality of life as a result of this guideline."
Neurologist Dr Manjit Matharu, of the National Hospital for Neurology and Neurosurgery, warned of unnecessary brain scans.
He said: “By clearly outlining the common features associated with primary headaches, the guideline will improve recognition and empower healthcare professionals to manage headaches more effectively, with better targeting of treatments.
"Also, it will enable healthcare professionals to undertake investigations confidently while avoiding the need for unnecessary brain scans."
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