Doctors are being urged to improve diagnoses of headaches by experts concerned that around 50% of patients approaching their GPs with migraines have their symptoms misinterpreted.

Doctors are being urged to improve diagnoses of headaches by experts concerned that around 50% of patients approaching their GPs with migraines have their symptoms misinterpreted.

Guidance drawn up for family doctors also highlights the large proportion of those with recurrent forms of headache whose conditions are exacerbated by using the wrong treatment.

Around 4% of the population have a chronic, or regularly recurring, form of headache and roughly 50% of these cases are thought to be "rebound headaches" - those caused by the over-use of painkillers.

The Scottish Intercollegiate Guidelines Network (Sign), which advises doctors on treatment, now wants GPs to discuss over-use of medication with their patients in an effort to cut down on the numbers who take the wrong drugs for their condition.

It is also attempting to raise the profile of migraine sufferers, whose symptoms can be debilitating, amid warnings that they are regularly misdiagnosed as suffering from less serious forms of headache.

There are estimated to be 190,000 people in the UK suffering from migraines, which typically cause sharp pains in the head, nausea and sensitivity to light. But despite the development of effective treatments which can target the symptoms or prevent their onset, patients groups believe that few actually take advantage of these, instead opting for painkillers, either prescribed or over-the-counter.

Sign, which is part of NHS Quality Improvement Scotland, a body which aims to increase clinical effectiveness, recommends that cutting down on painkillers can result in an improvement.

Dr David Watson, chair of the Sign development group which drew up the guidelines, said that GPs frequently mistook migraines for tension headaches or a result of a sinus condition.

He said: "Around 50% of people will be incorrectly diagnosed on their first visit to a GP.

"Doctors often do not diagnose a migraine unless several different symptoms are all present, whereas a lot of patients only develop some of those symptoms."

Dr Watson, who is a GP in Aberdeen, said that GPs ability to diagnose headaches properly was limited by the short time available for consultation and that migraines were often missed because they are presented alongside other symptoms.

"GPs are acting in the best faith and are prescribing what they think will help patients," he said. "But for some of those patients the prescription will turn headaches into a chronic headache.

"I'm not saying that there is any deliberate over-prescribing but that people don't appreciate how over-using medication can cause the headache.

"If you're not getting the diagnosis right the first time, you're more likely to be prescribed the wrong medicine."

The Sign guidelines, which are being circulated to GPs, pharmacists, opticians, dentists and other healthcare professionals, acknowledges that healthcare professionals often find the diagnosis of headaches to be difficult and that both they and patients worry about serious and rare cases where there is an underlying cause such as brain tumour.

The guidance recommends that patients use a diary to chart their headaches in an effort to improve diagnosis.

Painful and complex condition

Headaches are usually referred to as primary or secondary, the latter being the result of some other condition.

If headaches occur suddenly and severely, patients are recommended to seek medical advice urgently.

Migraines affect up to 15% of the UK population and around two thirds of sufferers are women. An attack can last from four to 72 hours, although sufferers may feel drained for a couple of days after that.

Around 10% of migraine sufferers also experience aura symptoms. These are neurological disturbances, lasting between 15 minutes and one hour before the commencement of the headache.

A migraine sufferer can experience an average of 13 attacks a year, though this can vary from person to person.Source: Migraine Action