Living with post-traumatic headache (PTH) can be an overwhelming challenge, affecting not only one’s physical well-being but also mental health. Post-traumatic headache (PTH), a type of headache that occurs for the first time in close timeframe following a traumatic brain injury or head/neck trauma. Concussion is a mild traumatic brain injury (mTBI) and many can suffer from PTH. Headache can occur in isolation to a trauma or in combination of other associated symptoms such as dizziness, nausea, sensory sensitivities, cognitive challenges and emotional distress. Generally, PTH emerge within sevens days post injury and can persist up to three months post injury. However, it can persist more than three months developing into a chronic type.

For more information on what other symptoms people can experience after a concussion, read our blog post about 8 domains of a concussion.

Causes of Post-Traumatic Headache

The aetiology of post-traumatic headache is attributed to a combination of injury-related factors and subsequent behavioural/functional and structural changes post-trauma. Potential contributors include:

• Inflammatory responses: Post-injury inflammation in the brain and surrounding tissues may exacerbate headache development.
• Musculoskeletal responses such as whiplash: Neck and shoulder muscle stiffness, often stemming from head trauma, can amplify headache severity.
• Psychological influences: Emotional distress, anxiety, and depression may exacerbate headache intensity and frequency.

How can my neck relate to my head pain?

Interestingly, even though our brain is amazingly clever, with such a complex web of nerves coming together for processing, it can often get the signals wrong. Pain messages from the neck can be read incorrectly by the brain which thinks it is head pain, eye, jaw, or even sinus pain. A similar scenario would be when a patient experiencing a heart attack will complain of arm pain – the problem is in the heart not the arm! The brain can get confused.

Treatment of Post-Traumatic Headache

An individual may present differently to one another, therefore a personalised program will give people the best outcome after a thorough examination. Treatment options can include:

• Neck treatment: Sydney Concussion Centre uses the Watson Headache® Approach which focuses on addressing the underlying mechanical dysfunctions in the upper neck that can be dialling up sensitivity in the brainstem, causing post traumatic headache. Skilled physiotherapists trained in the Watson Headache® Approach utilise specific manual techniques to assess and treat dysfunctions in the cervical spine and related structures. These techniques aim to restore normal movement and reduce the sensitisation of the nervous system, potentially providing relief from migraine symptoms.
• Lifestyle adjustments: Adopting healthy habits such as adequate sleep, dietary changes, stress management, exercise and learning to manage potential triggers can improve headache frequency and severity.
• Medications: discuss with your doctor or a local pharmacist to see what is available to manage your head symptoms

The program carried out at Sydney Concussion Centre uses best practice techniques, established by the latest research to assess each individual’s case. This involves a wide range of assessments to determine where your headaches are originating. Once the areas of dysfunction are determined, a specific treatment and exercise program is developed to address the issues and expedite recovery.

Concussions, commonly known as mild traumatic brain injuries, are increasingly gaining attention due to their potential long-term effects. While many individuals recover well from a concussion, as early as seven to ten days following the event, some experience persistent symptoms that can last for months or even years. This raises a worrying question: will these symptoms be permanent? Will this continue to affect my life? Will I ever feel ‘normal’?

Understanding what a concussion is and its effects on the brain is essential in addressing this question. A concussion is defined as an injury induced from a mechanical force or trauma to the brain leading to temporary impairment of the normal brain function. Commonly classified as a functional injury, a concussion occurs when the neurons in the brain shear and stretch, leading to a neurometabolic cascade. Put simply, during a concussion, the brain releases a large amount of cell energy, which requires time and additional energy to replenish. This results in an energy deficit that requires approximately 22 to 45 days to restore.

While the brain typically metabolically recovers within this timeframe, physiological symptom recovery can vary, as mentioned earlier. If symptoms persist, it’s important to recognize the necessity of a comprehensive assessment to develop a thorough management plan for addressing unresolved physiological symptoms.

Recovery is possible!!!

Read more information by exploring  the 8 domains of a concussion injury. 

 No two concussions are the same – there are always individual variations. Understanding individualized treatment programs and identifying pre-existing or new contributing factors will be essential in preventing PCS from becoming permanent.