To: Dr. Suwan

Having a headache may have become the universal excuse for all of humanities’ failings, but our most common treatment for this pain may be masking a wealth of problems.

Thanks to the deluge of advertising, both on television and in print material, Americans may be the most self-medicated people on earth. And experts say that treating headaches only with over-the-counter medications may be compromising your personal health care in ways you can not imagine.

That’s the opinion of Dr. Nesreen Suwan, a board-certified neurologist and pain management specialist who operates the Advanced Pain & Spine Physician Center and Advanced Headache Clinic & Dignostics in suburban Lisle. The pain specialist blames the media, in part, for making patients believe they can manage their headache pain themselves.

“Someone watching television during the morning will see dozens of ads about over-the-counter medications things that people feel they can just take themselves,” Suwan said. “People watch TV, and then they go to the drug store and maybe start reading the labels and buy what they think will work. My belief is that these pains are symptoms of other things, and that patients should be checked by a physician first.”

Too many medical decisions, Suwan believes, are left in the hands of patients, who lack enough insight or experience to truly evaluate their condition. The fact is that blocking pain with over-the-counter medications may serve to cover up something more serious.

“One time I saw a patient who was self- treating his headaches with aspirin, and one of his headaches turned out to be related to ’brain bleed’ which meant that the aspirin was actually making him worse,” Suwan said. “We know for a fact that many other medical conditions can co-exist along with a headache.”

Four of the major culprits for self-medicating include products such as ibuprofen, Aleve, Tylenol, and Excedrin Migraine. While these products may relieve headache symptoms, overuse of them could lead to stomach irritation, bleeding ulcers, or kidney and liver damage.

Other experts, including Dr. Sunil Matthews, a Baylor neurologist, believe that a growing body of knowledge suggests that, over time, headaches may be actually caused by the medications people take to get rid of them. Research in publications like the Journal of Neurology supports Baylor’s claim, where a study showed that pain medications can cause MOH or medication overuse headaches.

Suwan refers to this problem as a “rebound headache.”

“Patients who are medicating themselves without a physician’s guidance will sometimes take Tylenol or Aleve and it ’fixes’ their headache for two or three hours, and then the pain comes back and they take more medication,” she said. “The fact is there are many different types of headaches, and people need to have an evaluation to find out what they are dealing with.”

Suwan likens headaches to other conditions like chest pain, which she said can be triggered from many causes. The problem with headaches is that, for most of us, they are much more common and we assume an over-the-counter medication will make them go away.

“Someone with chest or muscular pain or shortness of breath might be more inclined to seek medical attention, but often because of the advertising we see or someone’s previous habits, we treat a headache with a medication,” Suwan said. “I’m not saying every person with a headache should run immediately to the doctor. I’m suggesting that patients seek a medical expert for an evaluation and have the doctor come up with a management program to evaluate the cause and handle the pain then people will know what to take, how much and when, and not just be treating themselves.”

The goal of every physician, Suwan believes, is to determine the cause behind the symptoms not mask them with self-medication. The perspective of the physician, she notes, is very different from that of the patient, and therefore even an insignificant issue should be evaluated, especially if it continues to occur.

“There was a patient we saw during my residency who came to the hospital with a slight cough that wouldn’t go away,” Suwan said. “He had been treating it with over-the-counter medications. One day when he came in, they did an X-ray and a CT on him, and found he had cancer in his lung. The point is that every medical complaint needs to be evaluated, even if the issue seems small.”