The Chiltern Health Centre, where I have been most recently for a chiropractic consultation, and at the beginning of last year for hypnotherapy, drew my attention to a recent report from NICE, regarding medication overuse headaches. This blog, written by one of the practitioners at the clinic, talks about the report's findings and looks at it from a Chiropractic and Osteopathic perspective (the author is herself an Osteopath).
Medication Overuse headache is caused, put simply, by taking too many painkillers. This amounts to taking over the counter medicines such as aspirin, paracetamol and ibuprofen (which is an NSAID - non-steroidal anti-inflammatory drug) on more than 15 days a month, or opioids, ergots, triptans for more than 10 days a month. These latter three are anti-migraine medicines. I have in fact been prescribed with Triptans, to help fight any migraine attacks. I got a prescription of 6 tablets about 3 or 4 years ago, and am now down to my last tablet.
Taking painkillers for a headache can result in a withdrawal headache if you rely too much on the drugs to eliminate the pain. The "vicious cycle" as it so often described is accurate. My head hurts, and I want it to stop. So I take a pill. But taking the pill makes my head hurt, and because my head still hurts, I take another pill. My head still hurts. And so the cycle continues.
NICE's recommendation, according to the blog & the report, is cease taking the medication immediately, and stay off them for a month. Unfortunately, as is pointed out by the blog and many other sources, "Headache symptoms are likely to get worse in the short term before they
improve and there may be associated withdrawal symptoms"
So. My head hurts. I take a pill. The pill makes my head hurt. I take another pill. Cycle.
My head hurts. I stop taking pills. My still hurts, and in fact, almost like a nicotine craving in the brain when you quit smoking, the head goes ballistic with pain because it's not getting any pills, and because you can't take any pills, the pain doesn't go away or decrease when you need or want it to. Slowly, this pain does subside, and the dependence dissipates. Eventually, hopefully, cycle broken.
I am hopelessly reliant on painkillers. It used to be ibuprofen, but more recently it is paracetamol, because (inevitably, really) ibuprofen wasn't really doing the trick. And at first, paracetamol did too. And to some extent, paracetamol still works because it often takes the edge off the worst headaches (and I now reserve painkiller usage to when I can't move without my head or face searing with pain).
The chiropractor I saw for my second opinion reminded me of these findings/recommendations, and after I saw him, I decided to give two weeks a go. I had already accidentally managed a week, so I decided to try for another week. Needless to say, this second week has not been as breezy (because my headache is self-aware and resists any attempts to remove it?) From Sunday through to Tuesday, I was in quite a lot of pain. Alcohol dulled the pain, but left me open to dehydration related agony the following day, so I kept that at a glass or two in the evening.
By Tuesday (1st Jan) I couldn't do it. I couldn't move without my head being in agony, and I couldn't get to sleep to try and make it go away. So I gave in and took a triptan tablet. This isn't strictly forbidden, from my understanding, since my dependence is on regular painkillers. And it certainly helped take most of the headache away, and I was able to actually get stuff done and be myself again. As I commented to a friend, Monday was "just one of those days that no matter what, I am my headache. There's no happiness, sadness, excitement, nothing." And that was only day two. So by day three, even though I was willing myself to be strong, I'm not made of stone, and I took a pill.
But today is the last day of two weeks without paracetamol, ibuprofen or aspirin. Tomorrow, I'll embark on another two weeks and hopefully be able to negotiate any agony with resistance.
The end goal is freedom. If I keep that in mind, I think I'll be able to do it.
But I reserve the right to have a duvet day if I feel like my head is expanding from the inside out.
