While most of us have had a headache of some sort in our lives, post-traumatic headaches can feel and behave differently than a normal tension headache. When a headache is the result of car accident injuries, the root cause is usually rooted in something the body doesn’t often experience, causing different symptoms that may last for a long time. In a situation like concussion headaches, the duration can be extended by a complex medical situation, and it is important to actively seek treatment while recovering from the injury. Read on for information on these headaches and how you can ensure the pain resolves as quickly as possible.
About Concussions
A concussion is a mild form of traumatic brain injury that can have a temporary impact on brain function. They generally occur when someone suffers a blow to the head or in instances where the head is shaken violently enough that the brain hits the skull, causing blows within the head to the brain. The most common cause of this is a fall, but car accidents and sports injuries are also linked to concussions.
Most people fully recover from concussions, and some people may never know they have suffered one. They are a mild form of brain injuries because they rarely cause permanent damage; however, any brain injury should be treated seriously, including a concussion.
Common symptoms of concussions include headaches, loss of memory, and confusion. They can also impact vision, hearing, balance, and other general functions of the body as a result of damage to the autonomic system. The autonomic system controls heart rate, respiration rate, vascular constriction, and many other bodily functions. A concussion can cause prolonged dysregulation in the autonomic system, which can cause a number of issues, including headaches.
While some headaches resolve with time, many people experience them for a long period of time in what is called post-concussion or post-traumatic headaches. These are different than a normal headache and may indicate a more severe underlying problem.
About Post-Concussion Headaches
Just like headaches in normal life can present in a variety of forms, post-concussion headaches can have a variety of causes and manifest in different ways. It is even possible for one person to experience multiple types of post-concussion headaches at the same time. There are three categories of these headaches that are most common:
- Autonomic Nervous System (ANS) and Cervicogenic Headaches
- Migraine Headaches
- Other Concussion Headaches
ANS and Cervicogenic Headaches
While they can occur in other scenarios, ANS and Cervicogenic headaches are typically distinctly reported in those who have recently suffered a head injury. While both can occur at once, each is a separate category of post-traumatic headache.
The primary symptoms are neck tension, neck pain, and a pulling feeling along the neck due to impact in the cervical spine, or neck bones and discs, and the surrounding musculature, including the shoulders. Most commonly, this is related to whiplash-associated injuries, but they can also be tied to ANS dysfunction.
The reason for ANS headaches can be complex and usually result from the control the autonomic nervous system has over the body’s functions such as heart rate, breathing, temperature, and many others. Cerebral blood flow problems in the head and vascular issues in the blood vessels can both cause these headaches, leading to the distinct feeling of pressure, which many patients describe as the feeling of a clamp or band being tightly placed on the head.
Headaches based in the autonomic nervous system can present as a pain that starts in the back of the neck and spreads up around the back of the head and to the temples. This sensation is caused by a gradual buildup of blood flow paired with muscle tension in the neck. They may also feel like sinus pressure headaches or even be accompanied by soft bumps on the head.
Migraine Headaches
Migraines are headaches that can be born out of many issues, with certain individuals suffering from them on a chronic basis. However, a migraine itself is a headache that presents as an extreme, stabbing pain on one side of the head, often near the top of the head. While anyone can suffer a migraine following a concussion, they are more likely to occur after a concussion if the person is already disposed to migraines or has a family history of them.
Another sign of a migraine is an aura, or a sensory change or disturbance that appears right before the pain sets in. This may show up as colored spots, a strange odor, or tingling hands.
The exact cause of migraines is not understood, but there are neurovascular elements at play that tie it to concussions and other injuries and make them closely related. Migraines can also present similarly to ANS headaches, making it difficult to determine which one you are suffering from or if both are at play.
Other Headaches
There are other potential headache types that someone can experience in a post-traumatic state. One primary type is related to vision and the vision problems that are common after a concussion, like trouble focusing and light sensitivity. When you experience vision issues, it is common to overcompensate and experience tough and pulsing headaches, with the pain often in or around the eyes.
Tension-type headaches related to the jaw can also occur, sometimes as a result of autonomic dysregulation or because of muscular issues. Tension headaches symptoms may begin at the back of the jaw, moving across the face and to the top of the head. Patients with jaw-related headaches can notice increased jaw musculature, teeth grinding, or symptoms similar to TMJ.
Post-Concussion Headache Symptoms
It is common for people suffering from post-traumatic headaches to say they feel different from other headaches without being able to explain exactly why or how they are different. However, some common signs of these headaches include:
- A feeling of tension, tightness, or pressure
- The feeling of a “clamp tightening around the head”
- Pain that starts in the neck and spreads up to the top of the head
- Pain that starts behind the eyes and spreads to the back of the head
- A sharp, stabbing pain in one side of the head
- Teeth grinding or increasing pain in the jaw
- Sinus pressure that is constant, regardless of illness or exposure to allergens
- Soft spot bumps on the head, or edema
- Headaches that worsen during periods of stress
A person can suffer from one or multiple types of these headaches, meaning some symptoms may overlap or not be present at all. If you aren’t sure whether your headaches may fit these categories, it can be helpful to keep a diary and log the timing of each headache, duration, and anything that helps or exacerbates the pain.
Diagnosis of Post-Concussion Headaches
Like concussions, post-concussion headaches are usually diagnosed based on symptoms and discussions with your doctors. They may ask you for a log of your headaches, family and personal medical history, and any information you can provide about the event that caused the concussion itself. This can often help them determine whether you have a concussion or a related issue like post-concussion headaches.
The same is true when determining the type of post-concussion headache you are dealing with. There is no simple test that answers these questions, so it is important that the providers you work with understand the nuanced differences in each type and how to identify which one(s) are at play.In some cases, diagnostic imaging may be a part of the diagnosis of your headaches. These scans can show activity during headaches or highlight other damage that provides information helpful to a doctor.
Length of Post-Concussion Headaches
Post-concussion headaches are not defined or diagnosed in terms of their duration, and the length can be highly dependent on factors such as the injury severity and what type of headache it is. There is a misconception that the headache will last longer if you experience a loss of consciousness or memory loss at the time of the trauma, but this is not true.
Any headache after an accident or injury should be examined by a doctor as soon as it appears. However, if your headaches are not resolving after a few days, it is unlikely the problem will resolve on its own. Post-traumatic headaches are less likely to respond to home remedies, though you may experience on and off periods of relief. In most cases, the headaches return at the first sign of a trigger.
As a general rule, headaches after a concussion can be expected to last about 3 to 6 months, with variation possible.
Treating Post-Traumatic Headaches
When it comes to these headaches, it is important to treat the concussion or underlying injury rather than merely trying to manage or mask the symptoms. For example, an ANS headache will never resolve until the autonomic nervous system is properly regulated, which does not happen over time without proper headache treatment. There are a variety of ways the root of these issues can be addressed.
Medication
While most medications don’t treat the source of a headache, they can be useful for managing initial symptoms and pain. NSAIDs also offer anti-inflammatory properties, which can reduce swelling and subsequently improve blood flow and relieve tension.
Another common medication is amitriptyline, which can help with migraines as well as depression and sleep issues that may be caused by a concussion. To address blood flow, beta blockers can be helpful. However, none of these options will address the root cause of the issue in the same way that other treatments will.
Treating the ANS
When it comes to ANS headaches, in particular, treatment can often involve focusing on neuroplasticity and helping the brain learn to adapt. This may include cardiovascular exercise as well as cognitive exercises in a continuous cycle that is tailored to each person, with the ultimate goal of helping any interrupted pathways to recover and improve neurovascular coupling. When this connection between the neurons and the blood vessels is repaired, it addresses the vascular issues that can be at the root of ANS headaches.
Managing Post-Concussion Headaches at Home
Along with medications, there are some ways you can manage post-concussion headaches at home during treatment. We’ve compiled our best tips to help alleviate as much pain as possible.
- Avoid stimulants as much as possible, like caffeine. Reliance on caffeine can cause headaches on its own and make existing headaches worse.
- Avoid depressants like alcohol, which can affect the autonomic nervous system and exacerbate existing issues.
- Reduce stress and focus on relaxation and self-care.
- Practice mindful breathing, which can help decrease the sympathetic nervous system and improve blood flow in addition to relieving stress.
- Manage sinus pain and pressure by placing a hot pad on the sinuses.
- Stretch the neck gently to alleviate muscle tension and pain.
- Practice good screen hygiene to avoid straining the eyes.
- Eat a generally healthy diet, including vitamins and supplements as needed.
- Stay active (with the guidance of your medical team). Movement may make some pain worse in the short term, but consistent exercise can contribute to relief over time, improving your ANS balance and cardiovascular health.
Even with proper treatment and these remedies, you may notice the severity of your symptoms changing from day to day, which is common. However, if you notice your symptoms becoming progressively worse, it can be a sign that there are additional unresolved issues. For example, it could indicate muscle tension and a disc issue which will lead to spinal damage without treatment.
Whether you notice symptoms worsening or you have just experienced a concussion, AICA College Park can help. Our team includes neurologists, chiropractors, physical therapists, pain management specialists, and more experts who can work together to create a comprehensive treatment plan. Our expertise lies in helping car accident victims, which means we see a lot of concussions and treat the short and long-term effects of these injuries. For any concussion-related concerns, including headaches, contact AICA College Park today to begin finding relief.