A post-traumatic headache is a headache caused by a traumatic head injury, such as a fall from a height, a sports-related trauma, or a motor vehicle accident. A post-traumatic headache can follow a minor head injury, such as a concussion, or a major head injury in which the patient suffered from hours to days of unconsciousness.
This is a type of headache that may persist for days, months, or even years following the injury and even mild injuries can lead to headaches that last for many years. Besides the post-traumatic headache, the patient often has a variety of associated symptoms including insomnia, problems concentrating, dizziness, mood changes, and personality changes. The combination of symptoms can disable an individual for a long time, even if the headache can be controlled with medications.
Fortunately, the post-traumatic headache is one that begins severe and gradually dissipates over several months to a year in many cases. The severity of the headache and the severity of the head injury have no particular relationship to one another. Patients with apparently minor head trauma can have a severe, long-lasting headache.
Most people with chronic post-traumatic headaches are suffering from muscle contraction headaches–spasms of the muscles of the head and neck. Other people can suffer from headaches that are more vascular in origin. In such cases, the headache is similar to a migraine, with severe pulsating pain that is difficult to get rid of. Such headaches are often made worse by looking at bright lights. Because they are not true migraines, they do have a tendency to pass over time.
Post-traumatic headaches are perhaps the most serious post-traumatic phenomena people can experience. Broken bones heal but the headache is often an enigma that takes over the patient’s entire life. The experience of having post-traumatic headaches is often one of increased anxiety, resentment, and fear that exceeds the patient’s experience of other bodily injuries. It truly is a symptom that interferes with a person’s quality of life and can have lifelong consequences.
These types of headaches are self-perpetuating cycles. The anxiety and mood changes facilitate worsened muscle contraction, which makes the headache worse and the rest of the symptoms worse. The goal of treatment is to break the cycle of pain and mood changes so that the patient can function better in life and in society.
The treatment of post-traumatic headaches includes using non-narcotic pain medications and sometimes muscle relaxants to ease the concomitant neck pain and muscle contraction pain. Physical therapy sometimes helps this type of headache and massage can make a difference in the degree of headache experienced. Chiropractic can help some patients with post-traumatic headache and people have used acupuncture to relieve this type of head pain.
There is a small subset of patients that simply do not improve after sustaining a trauma to their head that leads to post-traumatic headache. These people tend to need narcotic pain relief or ongoing manipulative therapies to have the best chance of functioning without extreme pain.