Where's your pain?

Pain can strike anywhere in the body. Wherever you feel pain, whether it's in your hip, back, foot or head, use this guide to find the information you need.

Head and neck

• Headache
• Ear pain
• Sore throat
• Sore lips
• Painful tongue
• Toothache
• Neck pain

Chest, shoulders and back

• Back pain
• Shoulder pain
• Breast pain
• Chest pain
• Rib pain

Arms and hands

• Arm or elbow pain
• Hand pain

Abdomen, pelvis and genitals

• Stomach ache and abdominal pain
• Pelvic pain
• Ovulation pain
• Period pain
• Anal pain
• Vaginal pain

Legs and feet

• Hip pain
• Knee pain
• Foot pain
• Heel pain

20 painful health conditions

Here are 20 health conditions known to cause pain so disabling that they can prevent you performing daily tasks.

They're not ranked in any particular order.

• Shingles
• Cluster headaches
• Frozen shoulder
• Broken bones
• Complex regional pain syndrome (CRPS)
• Heart attack
• Slipped disc
• Sickle cell disease
• Arthritis
• Migraine
• Sciatica
• Kidney stones
• Appendicitis
• Trigeminal neuralgia
• Acute pancreatitis
• Gout
• Endometriosis
• Stomach ulcer
• Fibromyalgia
• Pain after surgery

Where does it hurt?

• Head
• Sinuses
• Ear (children)
• Tongue
• Teeth
• Neck
• Shoulder
• Arm
• Chest
• Breast
• Back
• Stomach
• Pelvis
• Bottom
• Knee
• Heel
• Foot

1. Shingles

Shingles typically appears as a rash or crop of blisters on one side of your body, often around the waistline.

The pain of shingles tends to be burning or tingling, and often affects only one side of your body. You may feel stabs of pain when someone simply brushes lightly against the affected skin or a breeze wafts over it.

Some people who have had shingles can develop a persistent pain called post-herpetic neuralgia.

Cluster headaches are excruciating attacks of pain on one side of the head, often felt around the eye.

They begin quickly and without warning. The pain is very severe, and is often described as a sharp, burning or piercing sensation.

People often feel restless and agitated during an attack because the pain is so intense, and they may react by rocking, pacing, or banging their head against the wall.

Read more about cluster headaches.

Find your local headache clinic.

This condition not only is extremely painful but also can last for several years if not properly treated.

In frozen shoulder, the joint becomes so tight and stiff that it's virtually impossible to carry out simple movements, such as raising your arm. Daily activities like taking off a T-shirt, lifting a kettle, putting on a coat or even combing your hair become an ordeal.

It's not clear what causes frozen shoulder, but it can happen after a shoulder or arm injury, and is more common in people with diabetes.

Read more about frozen shoulder.

A broken or cracked bone is known as a fracture. Common examples are a broken ankle, broken hip, broken arm or broken nose.

If the break is small, it's possible you might not feel any pain at all but, usually, a broken bone really hurts, especially when you try to move it. The pain is often described as feeling like a deep ache.

Broken bones can heal by themselves, but they may need to be lined up and fixed in position so they set properly. As a general rule, the older you are and the bigger the bone that's broken, the longer it will take to heal.

CRPS is a severe, long-lasting pain that can appear shortly after an injury, such as a fracture, burn or cut.

The burning pain of CRPS is continuous and intense, and often completely disproportionate to the severity of the original injury.

The pain is usually confined to the previously injured limb but can sometimes spread to other parts of the body.

The skin of the affected body part can become so sensitive that just a slight touch, bump or even a change in temperature can provoke intense pain.

Read more about CRPS.

If you have a heart attack, you usually get a pain in the centre of your chest – often described as a sensation of heaviness, tightness or squeezing – that can be so bad it causes you to collapse.

The pain can feel like really bad indigestion, and sometimes spreads to your jaw, neck, back, arms or stomach.

If you suspect that you or someone else is having a heart attack, call for emergency help immediately.

Find out more about heart attack and read 64-year-old Derek's real-life description of what it feels like to have a heart attack.

One of the most common causes of back pain is a slipped disc. It's often the result of a twisting or lifting injury. One of the discs in the spine ruptures, and the gel inside leaks out.

Most people with a slipped disc experience sudden and severe lower back pain. It's usually eased by lying down, and often made worse by moving your back, coughing or sneezing. A slipped disc can also cause leg pain.

Read more about slipped disc.

A sudden episode of pain, known as a pain crisis, is one of the most common and distressing symptoms of sickle cell disease.

The pain, which usually occurs in the bones and joints, can vary from mild to severe and last for up to seven days.

Some people may have an episode every few weeks, while others may have fewer than one a year.

Read more about sickle cell disease.

People with arthritis endure constant and often disabling joint pain, usually in the hips, knees, wrists or fingers. The pain can come on suddenly or over time, and is often linked with muscle aches and stiffness in the joints.

Various different types of arthritis – including rheumatoid arthritis, osteoarthritis and lupus – can cause joint damage.

Read more about arthritis.

Find your local arthritis support services.

A migraine typically feels like an intense headache on one side of the head. The pain is usually a moderate or severe throbbing sensation that gets worse when you move and prevents you from carrying out normal activities.

In some cases, the pain can occur on both sides of your head, and may affect your face or neck.

Migraines can cause vomiting and extreme sensitivity to light and sound. Sometimes, in cases of severe migraines, the best thing to do is find a dark, quiet place to lie down until the pain passes.

Find out more about migraine and read a true-life account of what it's like to have migraine.

Find your local migraine clinic.

11. Sciatica

Sciatica is the name given to an aching pain running down the leg. It's caused when the sciatic nerve – the longest nerve in the body, which stretches from your back to your feet – has been pinched or irritated by damage to the back.

Sciatica is different to general back pain. The pain of sciatica hardly affects your back at all – instead, it radiates out from your lower back, down the buttocks and into one or both of the legs, right down to the calf.

Read more about sciatica.

Passing a kidney stone can produce a sudden, sharp, cramping pain in your lower back or the side of your abdomen, or occasionally in your groin. The pain may last for minutes or hours, with pain-free intervals in between.

The pain often begins in the middle of the night and can be so severe that those who experience it may feel the need to go to A&E.

Most kidney stones are small enough to pass out in your urine, and the pain disappears once the stone has been passed.

Read more about kidney stones.

Appendicitis is a painful swelling of the appendix, a finger-like pouch attached to the gut wall. It's most common in children, who typically complain of pain in the middle of their tummy that comes and goes. The pain then shifts to the lower-right side of the tummy and gets worse.

Appendicitis is a medical emergency that usually needs an urgent operation to remove the appendix before it bursts.

Read more about appendicitis.

Watch this animation to learn about the causes and treatment of appendicitis.

14. Trigeminal neuralgia

Trigeminal neuralgia, also known as Fothergill's disease, involves bouts of severe pain on one side of the face that comes and goes unpredictably in sudden attacks.

Some people say the pain feels like an electric shock shooting through the face, while others describe intense sensations of burning or stabbing.

Read more about trigeminal neuralgia.

Acute pancreatitis is the swelling of the pancreas, a banana-sized organ that's part of the digestive system. The most common symptom is severe abdominal pain that appears suddenly.

This dull aching pain often gets steadily worse and can travel along your back or below your left shoulder blade.

Eating or drinking, especially fatty foods, may also make you feel worse very quickly. Leaning forward or curling into a ball may help to relieve the pain, but lying flat on your back often increases it.

Read more about pancreatitis.

Gout is where swelling and severe pain develops in a joint, often the base of the big toe, to the point where moving or even touching the toe can be agony. It's one of the most painful forms of arthritis.

During an attack of gout, the joint starts to ache, before swelling up and becoming red, hot and extremely painful. Attacks can last between 1 and 10 days.

Read more about gout.

Endometriosis is the spread of womb cells outside the womb, mainly around the lower abdomen.

While some women with endometriosis have no symptoms at all, others have lots of pain, including pelvic pain, period pain, and pain during and after sex.

Michelle, a mum of two, describes life with endometriosis.

Read more about endometriosis.

An ulcer is a sore or hole that forms in the lining of the stomach. A stomach ulcer can cause a burning pain in the abdomen, often between meals.

An untreated ulcer can burn through the stomach wall, letting digestive juices and food leak into the abdominal cavity, causing disabling pain.

This is called a perforated ulcer and is a medical emergency that usually needs to be operated on immediately.

Read more about stomach ulcer.

20. Pain after surgery

Sex advice for people with chronic pain

Sexual intercourse can cause discomfort for people living with long-term pain.

But living with chronic pain should not mean that the pleasures of sexual activity are beyond your reach.

Sexual activity, when comfortable, can provide a certain amount of temporary pain relief. The key is to return to some form of sex as soon as possible.

The longer you avoid it, the bigger the fear of resuming sex becomes, and a downward spiral can set in.

Also, a loss of intimacy can drive couples apart and harm their relationship in the long-term.

Plan ahead for sex

If you live with chronic pain, spontaneous sex is never going to be easy.

Planning and preparing for sex may not sound as romantic, but is a better way of achieving a satisfying sex life.

People often experience more pain at certain times of day. So it may help to have sex when your body is at its best, when your muscles are the least painful and your joints not so stiff and when you're least tired.

Many people are most intimate just before going to sleep at night, but for people with chronic pain this can be the worst time.

Instead, plan to spend time with your partner in the afternoon, or whichever time of day you feel the least pain.

Tips for more comfortable sex

If you take medication to control your pain, try to time sex for when your medicine's therapeutic effect is at its peak.

Experiment with different positions that lessen physical strain, such as lying side by side. Here are some suggestions from Arthritis Research UK.

It can help to warm the bed in advance with an electric blanket to ease muscle and joint discomfort.

Also, do some gentle stretches and use polyester or silk sheets to make it easier to turn and move in bed.

Alternatives to intercourse

If intercourse is not an option, there are alternatives such as:

• masturbating each other
• oral sex
• sex toys

Don't underestimate the pleasure and the feeling of intimacy you can get from:

• touching and being touched
• cuddling
• massaging
• kissing

For example, you could take a shower together or massage each other in turn if one of you has a bath.

Talk openly to your partner

Talk openly and honestly to your partner about how pain affects your enjoyment of sex and what you want from your relationship.

Pick the right moment to have this conversation. It may be better to talk about it over dinner or while out walking, for example, rather than while in bed or in an intimate situation.

When to get help

If your pain is so severe that it is affecting your ability to have a satisfying sex life, talk to your doctor.

You may need a different or stronger pain control plan.

Some types of medication have side effects which can affect your sex drive and your ability to have sex. Your doctor may be able to recommend an alternative or adjust your current medication.

If necessary, your doctor can refer you for professional sexual counselling.

Read 10 self-help tips to beat pain.

10 ways to reduce pain

Whether your pain has just come on or you've lived with it for years, these tried-and-tested self-help steps can bring you relief.

Where does it hurt?

• Head
• Sinuses
• Ear (children)
• Tongue
• Teeth
• Neck
• Shoulder
• Arm
• Chest
• Breast
• Back
• Stomach
• Pelvis
• Bottom
• Knee
• Heel

Get some gentle exercise

Simple, everyday activities like walking, swimming, gardening and dancing can ease some of the pain directly by blocking pain signals to the brain.

Activity also helps lessen pain by stretching stiff and tense muscles, ligaments and joints.

It's natural to be hesitant if exercise is painful and you're worried about doing more damage. But if you become more active gradually, it's unlikely you will cause any damage or harm. The pain you feel when you start gentle exercise is because the muscles and joints are getting fitter.

In the long term, the benefits of exercise far outweigh any increase in pain.

Read our articles on getting exercise.

Breathe right to ease pain

Concentrating on your breathing when you're in pain can help.

When the pain is intense it's very easy to start taking shallow, rapid breaths which can make you feel dizzy, anxious or panicked. Instead, breathe slowly and deeply. This will help you to feel more in control of the situation and will keep you relaxed and prevent any muscle tension or anxiety from worsening your pain.

Read books and leaflets on pain

The Pain Toolkit is a free NHS-endorsed booklet packed with simple practical advice on how to live better with long-term pain. Download the booklet (PDF, 5.4Mb).

There is also a list of suggested self-help books and leaflets on The British Pain Society's website.

Counselling can help with pain

Pain can make you tired, anxious, depressed and grumpy. This can make the pain even worse, making you fall into a downward spiral. Be kinder to yourself. Living with pain isn't easy and you can be your own worst enemy by being stubborn, not pacing your activities every day and not accepting your limitations.

Some people find it useful to seek help from a counsellor, psychologist or hypnotherapist to discover how to deal with their emotions in relation to their pain. Ask your GP for advice and a referral, or read this article on getting access to counselling.

Distract yourself

Shift your attention on to something else so the pain isn't the only thing on your mind. Get stuck into an activity that you enjoy or find stimulating. Many hobbies, like photography, sewing or knitting, are possible even when your mobility is restricted.

Share your story about pain

It can help to talk to someone else who has experienced similar pain themselves and understands what you're going through.

Pain Concern, Action on Pain, Arthritis Care and BackCare all have telephone helplines manned by people with long-term pain, who can put you in touch with local patient support groups.

The healthtalk.org and youthhealthtalk websites let you watch or listen to videos of other people's experiences of pain.

The sleep cure for pain

"Many people with chronic pain dread going to bed as that's when the pain is worst," says Heather Wallace from Pain Concern. But it's important to try to stick to a normal sleep routine so you've got the best chance of sleeping through the night.

Also, "sleep deprivation can worsen pain", says Heather. Go to bed at the same time each evening, and get up at a regular time in the morning and avoid taking naps in the day. If sleep problems persist, see your GP.

Read 10 tips to get a good night's sleep.

Pain Concern has produced a useful leaflet on getting a good night's sleep.

Take a course

Self management courses are free NHS-based training programmes for people who live with long-term chronic conditions such as arthritis and diabetes to develop new skills to manage their condition (and any related pain) better on a day-to-day basis.

Many people who have been on a self-management course say they take fewer painkillers afterwards.

The best examples are:

• Pain Management Programmes (PDF, 734kb)
• Self Management UK – offers support to people with long term conditions
• Pain Toolkit workshops

Keep in touch with friends and family

Don't let pain mean that you lose contact with people.

Keeping in touch with friends and family is good for your health and can help you feel much better. Try shorter visits, maybe more often, and if you can't get out to visit people, phone a friend, invite a family member round for a tea or have a chat with your neighbour.

Aim to talk about anything other than your pain, even if other people want to talk about it.

Relax to beat pain

Practising relaxation techniques regularly can help to reduce persistent pain.

There are many types of relaxation techniques, varying from breathing exercises to types of meditation.

Ask your GP for advice in the first instance. There may be classes available locally or at your local hospital's pain clinic.

Read about the top 10 stressbusters.

Seven relaxation tips to help headaches

Stress makes headaches worse and can even make you develop a headache in the first place. Learning how to relax can help you keep headaches under control.

There are many different ways to relax or reduce stress. Here are seven relaxation techniques that headache sufferers have found useful. Try to do one each day:

Massage to ease head pain

Research suggests that massage can reduce the frequency of headaches.

In a study, people with a history of migraines who had a 45-minute weekly massage had fewer headaches than those who didn’t receive massages.

It’s thought that massage works by relaxing tight muscles that can trigger headaches, and also by reducing sensations of pain and stress.

Breathing exercises for headache

Deep breathing can prevent headaches.

Imagine a point just below your belly button. Breathe into that spot, filling your stomach with air. Let the air fill you from the stomach up, then let it out like deflating a balloon. With every long, slow breath you breathe out, you should feel more relaxed.

Slowing down your breathing will also help you relax. Do this by taking long, slow breaths. Count slowly to five as you breathe in and then count slowly to five as you breathe out. Your body will naturally relax as your breathing slows.

Guided imagery

A technique called mental imagery relaxation, or guided imagery, is a way of relaxing and coping better with stress and pain.

Conjure up a calm, peaceful image in your mind, such as a tropical beach scene or clouds floating across the sky, and hold that scene in your head as a sort of mental escape.

Try doing this as soon as you feel a headache developing and you could find it’s less painful and over more quickly than usual.

Listen to this podcast on how to take control of your anxiety.

Listen to music

Combine your relaxation exercises with your favourite music in the background and you’ll relax even more.

Go for music that lifts your spirits or that you find soothing and calming. You can buy specially made relaxation tapes or DVDs that usually include music and relaxation instructions.

Muscle-relaxing exercise

Try this simple 10-minute exercise to ease muscle tension.

While lying down, take a few deep breaths, breathing out slowly.

Scan your body in your mind, starting at your toes and moving up to the top of your head. Recognise any areas that feel tense.

Relax these areas, releasing as much tension as you can. Rotate your head in a smooth, circular way once or twice and roll your shoulders forwards and backwards several times. Let all your muscles relax completely.

Recall a pleasant thought for a few seconds. Take another deep breath and breathe out slowly to finish off.

Yoga

Attending a yoga class at your local gym, or doing yoga at home, could help your headaches. Yoga combines stretching, breathing and meditation exercises, and will help you feel more relaxed.

Other exercise techniques, such as tai chi and meditation (a type called mindfulness meditation has been shown to be helpful for stress), are good alternatives to yoga.

Read how to get started with yoga.

Read how to get started with tai chi.

Regular exercise

Headache researchers have found evidence that, in some people, moderate exercise can reduce the number and severity of headaches, and that regular exercise can even prevent some people from getting headaches.

This is probably because exercise releases endorphins, which are natural substances that help you feel better.

Choose an exercise you enjoy (jogging, swimming, dancing, cycling, aerobics classes, and brisk walking are ideal), and try to exercise for at least 150 minutes (2 hours and 30 minutes) every week.

Read more about how much exercise to aim for each week.

Painkiller headaches

Painkillers are a good way to relieve headaches, but if you take them more than two or three times a week, they could become the cause of your headaches.

Find and read about your local pharmacy here.

Up to 1 in 10 people who have frequent headaches do so because they take painkillers too often, says Dr Fayyaz Ahmed, consultant neurologist at Hull Royal Infirmary.

“Around 5% of the patients in my headache clinic have what we call medication-overuse headaches, from taking painkillers regularly over a long period.

"This statistic is probably even higher in the general population, with 5-10% of people with headaches getting them from taking too many painkillers."

Painkiller headaches

Painkiller, or rebound, headaches are frequent or daily headaches that develop after taking painkillers for tension headaches or migraines over several months.

Strangely, painkiller headaches only become a problem for people who take painkillers to treat headaches. They don’t happen to people who take painkillers for long periods for other painful conditions, such as arthritis and back pain.

What causes painkiller headaches?

Painkiller headaches are usually caused by taking painkillers for too long and not because of exceeding the recommended dose.

“Most people who get medication-overuse headaches aren’t taking more than the recommended dose on the painkiller packet,” says Dr Ahmed.

“The problem begins when you take advantage of the recommended dose to take painkillers for long periods, often for months on end.

“If you take painkillers for your headaches more than twice a week for more than three months, you'll be at very high risk of getting rebound headaches,” says Dr Ahmed.

What happens is that your body gets used to the painkillers.

A rebound headache develops if you don’t take a painkiller within a day or so of the last dose. You assume it’s just another tension headache or migraine and take a further dose of painkiller.

When the effect of the painkiller wears off, another rebound headache develops and the cycle continues.

Some people even start to take painkillers every day to prevent headaches, which only makes matters worse.

Painkillers to avoid

All the common painkillers available from chemists can cause this problem. They include:

• codeine
• paracetamol
• non-steroidal anti-inflammatory drugs (NSAIDs) – painkillers such as aspirin and ibuprofen
• a group of specific anti-migraine medicines known as triptans, such as sumatriptan

However, some painkillers are more likely to cause medication-overuse headaches than others.

“Painkillers containing codeine are most likely to lead to overuse headaches,” says Dr Ahmed. His advice to prevent painkiller headaches is:

• Don't take painkillers for headaches on more than two days in each week.
• Don’t take painkillers for headaches for two or more consecutive days.
• Avoid codeine or codeine-containing painkillers such as Syndol and Solpadeine.

Treating painkiller headaches

The treatment for medication-overuse headaches is simple – stop taking painkillers.

According to Dr Ahmed, if you've been dependent on painkillers for months rather than years, the best approach is to stop abruptly.

“Your headaches will probably get worse immediately after stopping, and you may feel sick or sleep badly, but after 7 to 10 days, when the painkillers are out of your system, you'll feel better,” he says.

If you’ve been getting painkiller headaches for several years as a result of taking codeine-containing products, it can be dangerous to stop abruptly. Instead, gradually reduce the number of painkillers you take. This is best done under the supervision of a doctor.

Hormone headaches

Most headaches in women are caused by hormones. At least 5 million women experience hormone headaches each month, say researchers.

According to Dr Anne MacGregor, formerly of the National Migraine Centre, more than half of women who get migraines notice a link with their periods. These so-called "menstrual migraines" tend to be particularly severe.

“Migraine is most likely to develop in either the two days leading up to a period, or the first three days during a period. This is because of the natural drop in oestrogen levels at these times. The attacks are typically more severe than migraines at other times of the month and are more likely to come back the next day,” she says.

Periods aren’t the only trigger of hormone headaches. Other causes include:

• The combined oral contraceptive pill. Some women find their headaches improve while they’re on the pill, but others report more frequent attacks, especially in the pill-free week when oestrogen levels drop.
• The menopause. Headaches usually worsen as you approach the menopause, partly because periods come more often and partly because the normal hormone cycle is disrupted.
• Pregnancy. Headaches can get worse in the first few weeks of pregnancy, but they usually improve or stop completely during the last six months. They don’t harm the baby.

Signs of hormone headaches

It’s worth keeping a diary for at least three menstrual cycles to help you check whether your migraines are linked to your periods. If they are linked, a diary can help to pinpoint at what stage in your cycle you get a migraine.

The Migraine Trust has an online headache diary, which may be a useful tool.

Self-help tips for hormone headaches

If keeping a diary reveals that your headaches develop just before your period, you can take these steps to help prevent a migraine:

• Eat small, frequent snacks to keep your blood sugar level up. Missing meals or going too long without food can trigger attacks. Have a small snack before going to bed and always eat breakfast. Here are five healthy breakfasts.
• Have a regular sleep pattern. Avoid too much or too little sleep. Find out how to get a good night's sleep.
• Avoid stress. If this proves difficult, find ways to deal with stress, such as taking regular exercise and using relaxation strategies. Use these 10 stress busters.

Treatments for hormone headaches

Oestrogen therapy

If you have regular periods, menstrual migraines may be eased by taking extra oestrogen before your period is due and for a few days during your period.

A doctor has to prescribe oestrogen supplements, which can be a gel to rub into your skin or a patch to stick on.

Migraine treatments

Your doctor can also prescribe anti-migraine medicines for you to take around the time of your period. These don’t contain hormones, but they can help stop the headaches developing. They include tablets called triptans and a type of painkiller called mefenamic acid.

Continuous contraceptive pills

Talk to your doctor if you think your contraceptive pills are making your migraines worse. If you have headaches during the days you don't take the pills, you can avoid the sudden fall in oestrogen by taking several packs continuously without a break.

Read more about the contraceptive pill.

Hormone replacement therapy

The hormone changes that happen as women approach the menopause mean that all types of headache, including migraines, become more common.

Hormone replacement therapy (HRT) can be helpful to treat hot flushes and sweats, but if you have migraines it’s best to use patches or a gel, as these types of HRT keep hormone levels more stable than tablets and are less likely to trigger migraines.

Read more about HRT.

10 headache triggers

It's not just stress and nasty colds that cause headaches. Cleaning your home or sleeping in late can cause them too. We reveal 10 headache triggers and how to fix them.

1. Relaxing after stress

You put in 10-hour days from Monday to Friday and you feel fine, only to wake up after a lie-in on Saturday with a pounding headache. Why is that?

It’s because as the tension of the week subsides, your levels of stress hormones drop, which causes a rapid release of neurotransmitters (the brain’s chemical messengers). These send out impulses to blood vessels to constrict and then dilate, which causes a headache.

How to fix it: Avoid the temptation to sleep in at weekends. More than eight hours' sleep at a time can bring on a headache. Introduce some relaxation time, such as a yoga class, into your working week, rather than squeezing it all into the weekend.

2. Pent-up anger

When you’re angry, muscles in the back of your neck and scalp tense up, causing a tight band-like sensation around your head. This is a sign of a tension headache.

How to fix it: When you start feeling angry, breathe deeply and slowly. Breathe in through your nose and out through your mouth, This should relax your head and neck muscles.

Read more about how to control your anger.

3. Poor posture

Poor posture causes tension in your upper back, neck and shoulders, which can lead to a headache. Typically, the pain throbs in the base of the skull and sometimes flashes into the face, especially the forehead.

How to fix it: Avoid sitting or standing in one position for a long period of time. Sit up straight and support your lower back. Consider using a special headset if you spend a lot of time on the phone, as holding a handset between your head and shoulder can strain muscles and cause headaches.

You could also see a physical therapist, such as an osteopath or Alexander technique practitioner. They may be able to help you identify and correct any posture problems.

Read more about osteopathy and the Alexander technique.

4. Perfume

If you think housework is giving you a headache, you could be right. Household cleaners, along with perfumes and fragranced air fresheners, contain chemicals that can bring on headaches.

How to fix it: If you’re susceptible to headaches brought on by certain smells, avoid heavy perfumes and strong-smelling soaps, shampoos and conditioners. Use fragrance-free air fresheners and household cleaners, and keep your doors and windows open as much as possible at home. If a colleague’s perfume is bothering you, put a fan on your desk at work.

5. Bad weather

If you’re prone to getting headaches, you could find that grey skies, high humidity, rising temperatures and storms can all bring on head pain.

Pressure changes that cause weather changes are thought to trigger chemical and electrical changes in the brain. This irritates nerves, leading to a headache.

How to fix it: There’s not much you can do to change the weather. However, by looking at the forecast, you can predict when you’re likely to have a headache and take a preventative painkiller a day or two in advance.

Check the weather forecast here.

6. Grinding teeth

Grinding your teeth at night (the medical name is bruxism) makes your jaw muscle contract, causing a dull headache.

How to fix it: Your dentist can fit you with a mouth guard to protect your teeth while you sleep. They cost around £50.

Read more about teeth grinding.

7. Bright lights

Bright lights and glare, especially if flickering, can induce migraines. This is because bright and flickering lights boost the levels of certain chemicals in the brain, which then activate the migraine centre.

How to fix it: Sunglasses are great at reducing light intensity, and you can wear them inside and outside. Polarised lenses can also help to reduce glare.

At work, adjust your computer monitor or attach a glare screen. You may be able to turn off certain lights or move them. If you can't, change where you sit in the office. Fluorescent lighting tends to flicker, so if you’re able to, substitute it with some other form of lighting.

8. Food triggers

Your turkey and cheese sandwich and small bar of dark chocolate might be a tasty lunch, but beware of the headache that could follow it. All these foods contain chemicals that can bring on a migraine. Other culprits include aged cheeses like stilton and brie, diet fizzy drinks, and processed meats and fish.

How to fix it: Keep a migraine trigger diary and once you suspect a certain food may be the cause of your headaches, eliminate it from your diet for a couple of months to see if you get fewer headaches.

If you're concerned about avoiding any food-related trigger factor, see your GP or practice nurse or ask to be referred to a dietician for specialist advice.

Remember to eat regularly, because skipping meals can bring on a headache.

The Migraine Trust offers an online migraine trigger diary here.

9. Sex headaches

It's a standing joke that headaches are used as an excuse to avoid sex, but for many men and women coital headaches that come on at the height of passion are a real and distressing problem.

Doctors think sex headaches are due to pressure building up in the head and neck muscles. The headaches can happen during foreplay or just before orgasm, and can last for a few minutes or up to an hour.

How to fix it: They’re inconvenient, but these headaches are usually harmless and don't mean you have to avoid sex. Take a painkiller a few hours beforehand to block the headache.

10. Ice cream

Do you get a sharp, stabbing pain in your forehead when you bite into an ice cream cone? Then you’re susceptible to ice cream headaches, caused by cold material moving across the roof of your mouth and the back of your throat. Ice lollies and slushy frozen drinks have the same effect.

How to fix it: The good news is that ice cream headaches don’t need treatment. In fact, they’re over in a flash, rarely lasting more than a minute or two.

Which painkiller?

The type of medicines that you need to treat your pain depend on what type of pain you have.

For pain associated with inflammation, such as back pain or headaches, paracetamol and anti-inflammatory painkillers work best.

If the pain is caused by sensitive or damaged nerves, as is the case with shingles or sciatica, it is usually treated with tablets that change the way the central nervous system works.

The aim of taking medication is to improve your quality of life. All painkillers have potential side effects, so you need to weigh up the advantages of taking them against the disadvantages.

This page covers:

Paracetamol

Ibuprofen

Aspirin

Codeine

Soluble painkillers

Amitriptyline and gabapentin

Morphine

Where does it hurt?

Paracetamol

Paracetamol is used to treat headaches and most non-nerve pains.

Two 500mg tablets of paracetamol up to four times a day is a safe dose for adults. Side effects are not common and this dose can be taken regularly for long periods.

Overdosing on paracetamol can cause serious side effects, however, so don't be tempted to increase the dose if your pain is severe.

If the pain lasts for more than three days, see your GP.

More on paracetamol.

Ibuprofen

So-called non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, diclofenac and naproxen, seem to work better when there is clear evidence of an inflammatory cause, such as arthritis or an injury.

They should not be used for long periods unless you have discussed it with your doctor.

If you take them for long periods, there's an increased risk of stomach upset, including bleeding, and kidney and heart problems.

Don't take more than the recommended dose, as this will increase the risk of serious side effects.

More on ibuprofen.

Aspirin is another type of NSAID.

It produces the same kind of side effects as other NSAIDs, but is not as effective as a painkiller, which means it's not usually prescribed for pain.

It is dangerous for children under 16.

Codeine

Codeine doesn’t work very well on its own. It works better when combined with paracetamol in a single pill.

You can buy co-codamol (paracetamol and low-dose codeine) over the counter. Higher-dose codeine has to be prescribed.

Codeine and other medium-strength prescribed painkillers can cause dependency, which means that when you stop taking them you may feel unwell for a short period.

If you need more and more of these drugs, contact your GP or other healthcare professional for advice.

Soluble painkillers

Effervescent painkillers are high in salt, containing up to 1g per tablet.

Too much salt can raise your blood pressure, which puts you at increased risk of health problems such as heart disease and stroke.

You may want to consider switching to a non-effervescent painkiller, especially if you've been advised to watch or reduce your salt intake.

Amitriptyline and gabapentin

Amitriptyline is a drug for depression and gabapentin is a drug for epilepsy.

Each of these medicines can also be used to treat pain caused by nerve sensitivity or nerve damage, such as shingles, diabetes nerve pain and sciatica.

You don’t have to have depression or epilepsy for these tablets to help your nerve pain.

Amitriptyline and gabapentin both have to be prescribed by a GP.

Side effects include drowsiness and dizziness.

Morphine

Morphine and morphine-like drugs (such as oxycodone, fentanyl and buprenorphine) are the strongest painkillers there are.

Some come as a patch, but they all work in similar ways and should only be used for severe pain.

They will only be prescribed after consultation with your GP or a pain specialist. The dose and your response will be closely monitored. These drugs should only be used as part of a long-term plan to manage your pain.

Read about the NHS help on offer if you have persistent pain.

Further advice on painkillers

Talk to your pharmacist or GP, or call NHS 111 if you need more advice on painkillers.

Find a pharmacy near you

Common questions about medicines

Ways to manage chronic pain

The old-fashioned treatment for persistent pain, also known as chronic pain, was bed rest for weeks or months on end. We now know this is the worst possible approach. Exercise and continuing to work are key to recovery.

Forget resting if you have a painful condition like back pain.

Lying in bed for long periods may actually make the pain last longer, because inactivity makes you stiffen up, your muscles and bones get weaker, you don't sleep well, you become lonely and depressed, and the pain feels worse.

You'll also find that it becomes harder and harder to get going again.

A better approach to reducing pain is a combination of:

• exercise
• staying at work
• physical therapy
• painkillers

Exercise to beat pain

Choose an exercise that won't put too much strain on yourself. Good options include:

• walking
• swimming
• exercise bike
• dance/yoga/pilates
• most daily activities and hobbies

Activity and stretching needs to become part of your lifestyle so you routinely do exercise little and often.

Try to be active every day, instead of only on the good days when you're not in so much pain. This may reduce the number of bad days you have and help you feel more in control.

But try and avoid overdoing it on good days and then paying for this by having more and more bad days.

Try these flexibility exercises and sitting exercises that you can do at home.

Read the NHS Choices beginner's guide to swimming and beginner's guide to dancing.

Go to work despite the pain

It's important to try to stay in work even though you're in pain. Research shows that people become less active and more depressed when they don't work.

Being at work will distract you from the pain and won't make your pain worse.

Talk to your supervisor or boss about the parts of your job that may be difficult to begin with, but stress that you want to be at work.

If you have to stay off work for a while, try to get back as soon as possible.

If you've been off work for four to six weeks, plan with your doctor, therapist or employer how and when you can return.

You could go back to work gradually. For instance, you might start with one day a week and gradually increase the time you spend at work.

You could also agree changes to your job or pattern of work, if it helps – a health and safety rep or occupational health department may be useful here.

Physical therapy for pain

Pain experts often recommend a short course of physical therapy.

This helps you to move better, relieves your pain, and makes daily tasks and activities, such as walking, going up stairs, or getting in and out of bed, easier.

Physical therapy for persistent pain can involve manipulation, stretching exercises and pain relief exercises.

Physical therapy is usually delivered by an osteopath, chiropractor or a physiotherapist.

Acupuncture is also offered across the UK by some healthcare providers, including physiotherapists, especially for back pain and neck pain.

Physiotherapists can give you advice on the right type of exercise and activity.

Occupational therapists can support you with environmental changes that can help you remain in work and function better at home.

If you have physical therapy, you should begin to feel the benefits after a few sessions.

Your GP may be able to refer you for physical therapy on the NHS, though in some areas physical therapy is only available privately.

In some areas, there is direct access to NHS physiotherapy without the need for a GP referral.

Find physiotherapy services in your area.

Your GP can also refer you for exercise on referral classes, and some centres have specific classes for low back pain.

Painkillers for long-term pain

It's safe to use over-the-counter painkillers to reduce your pain so you can be more active. But it's important to use painkillers carefully, as they have side effects.

Paracetamol is the simplest and safest painkiller. You could also try anti-inflammatory tablets like ibuprofen, as long as you don't have a condition (like a stomach ulcer) that prevents you from using them.

It's important to take painkillers at the recommended dose and to take them regularly every four to six hours, preferably to overcome a flare-up of your pain or to help get you through an impending activity.

Don't wait until your pain is severe before you start taking painkillers, as they won't work as well.

If a two-week course of over-the-counter painkillers doesn't work, ask for help from your GP or pharmacist.

Read more about choosing a painkiller.

Online help for pain

There's a lot of online information if you're living with pain.

General pain websites

• Action on Pain
• Pain Concern

Self help tips

The Pain Toolkit is a collection of helpful tips and strategies for persistent pain put together by a fellow sufferer:

• The Pain Toolkit

Meditation for pain

This 20 minute guided meditation course from Meditainment is easy-to-follow, free and proven to help people cope with chronic pain.

It's part of the Pathway through Pain online course which is provided by the NHS in some areas for people with persistent pain. Ask your GP or pain specialist how to access the course.