• Treating Post-Traumatic Headaches After Concussions

    on Nov 22nd, 2017

The pounding just won’t stop. You can’t seem to get any relief from those debilitating headaches that prevent you from getting through your day.

Well, it may be only a small comfort if your head is pounding right now – sorry if it is! – but you should know that you’re not alone. Far from it, actually. Each year, about 1.7 million Americans suffer from a traumatic brain injury that leads to chronic headaches, according to the National Center for Biotechnology Information. Traumatic brain injuries commonly cause headaches that range from mild to severe in those who have suffered from such injuries. This is known as post-traumatic headache, and it occurs within seven days of suffering a traumatic brain injury (like a concussion) or after you regain your consciousness after experiencing some form of head trauma.

The National Center for Biotechnology Information estimates that those who experience such injuries have anywhere from a 47 to 95 percent chance to suffer from mild headaches and a 20 to 38 percent chance to be stuck with moderate-to-severe headaches. And if you’re reading this and thinking that 38 percent or lower doesn’t sound so bad, tell that to the hundreds of thousands of individuals who are plagued by serious post-traumatic headaches. Plus, even suffering from mild headaches is no fun at all, as anyone reading this can surely relate to.

Why Is This Happening?

As mentioned, brain and head injuries are most likely the culprit if you’re experiencing post-traumatic headaches, but certain people are more likely to experience them after an injury than others. If you’re a woman, if you had a pre-existing chronic headache condition, if your family has a history of migraines or if you suffered a post-traumatic seizure or traumatic intracranial hemorrhage then there is a higher likelihood that you’ll end up suffering from post-traumatic headaches.

Types of Post-Traumatic Headache

What do your headaches feel like? OK, we get it – they hurt. You probably don’t want to spend too much time thinking about the exact feeling you get. It’s unpleasant, we know, so we’re sorry to have to bring it up. But there are different types of headaches, and not all of them are associated with concussions and other head/brain injuries, so it’s important to take some time to think about this.

Most commonly, post-traumatic headaches feel like tension-type or migraine headaches, with about a third of all patients experiencing one of those types. You’re probably thinking, “Wait a minute. That still leaves an entire third unaccounted for!” You’re right, and you should thank a math teacher for that fact. Anyway, the point is that they are more likely to be related if they’re tension type or migraines. Got it? Great.

But how do you know if it’s a tension type or migraine headache? That’s a good question. You probably just know it hurts and haven’t spent a lot of time thinking about how it hurts. We feel you. So, let’s run down what it means to have these different kinds of headaches.

The National Center for Biotechnology Information describes tension-type headaches as making people feel “bilateral pain of mild to moderate intensity, which is described as pressing and dull in quality and is aggravated by emotional stress and tension.” Meanwhile, they refer to migraines as “unilateral pain of moderate to severe intensity, pounding, throbbing, drilling and piercing in quality, which is aggravated by physical activity.” Additionally, migraines can involve sensitivity to light and/or noise.

What about that other one-third? Don’t worry. We haven’t forgotten about you. The last third of post-traumatic headache sufferers experience a mix of both migraines and tension-type headaches. And if you fall into that category, you have our sympathy.


But sympathy won’t make your head stop pounding, so what will? Unfortunately, the Food and Drug Administration has yet to approve one single treatment option to cure your headaches. But that doesn’t mean there’s nothing that can be done, so don’t lose hope!

“In clinical practice, we may use some of the abortive and preventive migraine medications off label, but we don't know how this can impact the brain's recovery from injury,” Assistant Professor of Neurology and Director of Headache Services at New York University Langone Medical Center in New York Mia T. Minen told Neurology Advisor. “We also tend to use nonpharmacologic treatments traditionally used for migraines: cognitive behavioral therapy, biofeedback and progressive muscle relaxation therapy.”

Other options include a careful assessment of the cervical spine involving diagnostic imaging and injections to possibly provide more insights on how to move forward with treatment. For other patients, a clinical evaluation may be the best way to determine their treatment options. Finally, atlas-orthogonal chiropractic treatments, and after craniosacral therapy are rising in popularity as potential options.

If you think you’re suffering from post-traumatic headaches, call Dr. Pinto today at 908.224.2408 to discuss your evaluation and treatment options.

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