When it comes to treating headaches, some treatments may not be worth your time or money. In a new study, researchers from the American Headache Society (AHS) reviewed over 100 tests and therapies that may do more harm than good. Their analysis suggests five overused procedures that doctors should avoid at all costs.

The study responds to a growing concern that many therapies targeting chronic head pain may be both unproven and counterproductive. To investigate, the researchers asked physicians and members of the AHS to submit procedures they believed to be used incorrectly, too often, or without a clear clinical outcome. The team then assessed the medical evidence surrounding each item.

"The article and recommendations identify situations that are felt by experts to be cases where patients and doctors should think very carefully before they decide to use that particular treatment or intervention," lead author Elizabeth Loder told Reuters. "The purpose is to start a conversation about situations, tests, procedures, and interventions that do not necessarily benefit the patient, and sometimes can even cause problems."

The researchers were particularly skeptical of non-essential neurological imaging and long-term use of painkillers. For patients with symptoms that clearly align with known migraine profiles, computed tomography (CT) scans may result in unnecessary radiation. Similarly, prescription medication as well as over-the-counter pills may exacerbate symptoms by creating dependence.

The AHS’s 5 Recommendations to Physicians Treating Head Pain:

  • Don't perform neuroimaging studies in patients with stable headaches that meet criteria for migraine;
  • Don't perform computed tomography imaging for headache when magnetic resonance imaging is available, except in emergency settings;
  • Don't recommend surgical deactivation of migraine trigger points outside of a clinical trial;
  • Don't prescribe opioids like oxycodone and drugs containing butalbita like Fioricet — for patients who get headaches often;
  • Don't recommend prolonged or frequent use of over-the-counter pain medications for headache.

According to the National Institutes of Health (NIH), about 12 percent of Americans suffer from chronic migraine headaches. The condition, which is characterized by episodes of severe head pain, is thought to be related to the genes that control certain brain cell activity. Aside from throbbing pain, symptoms include nausea, vomiting, and light sensitivity.

Source: Loder E, Weizenbaum E, Frishberg B, et al. Choosing Wisely in Headache Medicine: The American Headache Society's List of Five Things Physicians and Patients Should Question. Headache. 2013.