Managing Post-Traumatic Headaches After Brain Injury

Managing Post-Traumatic Headaches After Brain Injury

A traumatic brain injury (TBI) is a sudden jolt to your head that changes the way your brain works. It’s not surprising that headache would be a common symptom after a brain injury. Because a jolt to your head also causes a jolt to your neck, headaches with neck pain are the most common types of pain after a TBI. About 50 percent of people with a TBI suffer from headaches. 

The type of headache you get does not depend on how bad your TBI is. That’s because symptoms after a TBI are unpredictable. You could have a mild TBI but still have very painful headaches. Also, having headaches can make your other TBI symptoms worse, and other TBI symptoms can make your headaches worse. Because of this, it’s important to learn how to manage your headaches.

Types of Headaches After a TBI

Your headaches may be mild or severe. They may come and go, or you may have them all the time. TBI symptoms, such as trouble sleeping, anxiety, fatigue, depression, slowed thinking, and memory loss, can all be made worse by headaches.

Here are some common types of TBI headaches:

  • Headaches that start with pain in the back of your neck and spread to your head. These headaches get worse as the day goes on. They are more likely if your TBI includes a neck injury. This type of headache is often called a tension headache. It is probably the most common type of TBI headache.
  • Migraine headaches. These may be triggered by TBI, especially if you have a family history of migraines. A migraine headache is a pounding headache, usually on one side of your head. It’s caused by abnormal blood flow to your brain. Stressful symptoms of a TBI may trigger a migraine attack. Studies show that about 30 percent of TBI headaches are the migraine type. 

Managing TBI Headaches

Strong pain medications, called opiates or narcotics, are usually not the answer for TBI headaches. These medications can make other TBI symptoms worse. They also can have unpredictable side effects in a person with a TBI.

If pain medications are needed, the first choice is a nonnarcotic medication. Examples include over-the-counter pain relievers like acetaminophen or ibuprofen (Tylenol or Advil are examples). If you use pain relief medication for a headache more than three days a week, you need to watch if your headaches are getting worse. This is called rebound headache.

The best way to manage your headaches is with self-care, also called headache hygiene. Here are some self-care tips:

  • Take medications only as your doctor prescribes them. Don’t take any medications on your own.
  • If you start getting a headache, try to find a dark, quiet place where you can lie down.
  • Wear dark glasses if bright lights seem to trigger your headaches.
  • Avoid any foods and beverages that seem to trigger a headache.
  • Learn to avoid stress and relax by using techniques like listening to music, meditating, or deep breathing. If needed, work with a mental health expert to reduce stress and anxiety.
  • Get daily exercise. This helps your body and your brain.
  • Go to bed and get up at the same time every day.
  • Avoid caffeine, alcohol, and tobacco.
  • Take part in physical therapy to stretch and strengthen your muscles. Learn how to do these exercises at home.
  • Think about trying alternative treatments like acupuncture or massage therapy.
  • Keep a headache journal to share with your doctor. Write down every time you get a headache, how severe it is, and what seemed to have triggered it. 

TBI headaches usually go away with time. How long it takes your brain to recover depends on the type of injury you had. Managing headache pain with self-care can help you heal faster. Call your doctor if your pain is getting worse. And remember, never try to treat headaches on your own with drugs or alcohol.

Posted on BrainLine August 15, 2018.
Veterans Health Library, U.S. Department of Veterans Affairs