So just over a year ago and I’ve fortunately recovered quite well.
I have suffered and still suffer severe headaches but not as frequent as before. They begin with a pain in the base of my skull/neck and then seem to radiate through my head causing severe headaches
I’m taking over the counter co-codamol when it starts and for instance last night I caught the pain it seems before it caused a headache but they still occur at random times. Does anyone else have this problem and could maybe advise me if it’s just a problem due to my injury or something can prevent this happening?
I realise it’s trivial really in comparison with a lot of peoples reoccurring problems but it’s very uncomfortable and can keep me awake all night or just ruin my normal day.
I would appreciate your comments please
Paul
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Lottierose1
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Hi this sounds very familiar, and is very common after TBI, have you had vestibular therapy or neck exercises? These are tension headaches and seem to be caused by inflammation in the neck and cranial region, nerve damage and also anxiety. There may be other causes but these seem to be the common ones. May be worth getting a GP referral for vestibular therapy as a starter, (or just pay private if there's a waiting time).
Thanks I have tried a private physio due to waiting list and I continue to carry out neck excercises. My GP actually recommended physio but I will ask about vestibular therapy,Thanks for your help
Hello Paul, I was told that you can have more than one cause of headaches post TBI possibly all at the same time. I had continuous headaches for ages, which have just resurfaced in a more minor way in the last month when I started doing more, and getting more fatigued on a regular basis - so look at your activity and fatigue levels also.
Ok...so you can get post traumatic migraine - which isn't chronic like regular migraine, and is treatable - after some uncomfortable trial and error with a neurologist prescribing, mine responded to Duloxetine which is an antidepressant used for fibromyalgia pain. I weaned of it this year, but notice I am now a bit more prone to headaches ( and mood swings) but I can cope with this level. There are also other treatments possible, for example botox. The neuropsychiatrist, who prescribed Duloxetine, mentioned an 'over sensitivity to stress' which I think I still have. Have recently started a voluntary office job for just two hours on one morning a week (doing a miniscule fraction of what I did pre MTBI) and have been rewarded by splitting 24hr headaches each time - though this (fourth) week wasn't so bad and didn't last so long ( and I'm not going to persist at this if the headaches do, of course).
Second is cervicogenic headache where the nerves in your neck that go straight to the brain rather than via the spinal cord are under pressure - a concussion specialist sports physio worked on mine successfully - the regular physio I got to work on my neck previously didn't manage to alter it. This was a more continuous right sided headache. The physio could prod a point at the base of my skull and trigger it.
Thirdly, headaches can be caused by vestibular issues (and possibly oculomotor problems - I'm not sure what the overlap is between these two - because I had both). Basically you can be relying heavily on your eyesight to maintain your balance, which is a strain. Daily progressive balance and eye exercises to retrain yourself are the way you resolve this So check your balance - can you for example walk heel to toe for a few yards without toppling over? ( I was shocked when I couldn't in the neurologists office - I literally could not stay upright, but can do this again now)
A headache diary is a very useful tool, both to track your triggers and to demonstrate severity and frequency to your medics. Also fab for showing if a treatment is working - with an overall reduction in severity, length, or frequency for example. I successfully used the Migraine Buddy app on my android phone. It can even export reports to pdf format - which were very useful for appointments. It also asks at one point what things relieved your headache - which I find is a useful reminder of some proactive steps you can take, at the point when you wouldn't be able to think of anything useful - icepacks, yoga, showers and walks can help me, for example.
And finally you need to find some solutions that aren't based on paracetamol and ibuprofen, because regular use of these can actually produce a rebound headache.
On drugs for migraine prophylaxis, be aware that not every drug works for everyone, and that after a TBI we need to 'start low and go slow' on prescription meds. Don't persevere with unpleasant side effects. From my experience, it is possible to find a drug that you can tolerate and is effective, but it was the neuropsychiatrist that found it, where my neurologist didn't (he wasn't a post concussion expert/ specialist). Amitriptyline is often prescribed, and I got some limited benefit from this - but the neuropsychiatrist said that in new studies, the main benefits come from its impact on sleep - and there's better options than Amitriptyline for sleep. Plus it's one of the anticholinergic drugs, so I question whether any of us should use it long term.
Hope that this mega long post hasn't given you a headache! Let us know how you get on
Hi Paul, good point! 😆My second neurologist who had a keen interest in post concussion referred me to the neuropsychiatrist. The neuropsychiatrists are the medical consultants who are experts in what drugs affect the brain and how - so are really good people to use. Presumably there's nothing to stop you being asked to be referred direct by your GP to a neuropsychiatrist with an interest in post TBI issues?
Neurologist number 2 also referred me to the concussion specialist physio Theo Farley who was brilliant for the work in my neck, all the oculomotor and vestibular exercises, and also the graded exercise using the Buffalo treadmill protocol pioneered by John Leddy and his team at Buffalo university, plus fatigue management strategies - actually, with the benefit of hindsight - if I had to choose just one specialist it would be him.
(oh and keep a fatigue diary too, in case that's a headache factor, log your fatigue levels three times a day out of 10, and jot down what you did, beforehand, helps to spot and address patterns).
I went to this chap ( on insurance) but it gives an idea on the specialisms that might be useful. He was very clear that my fatigue was the result of my (mild) traumatic brain injury
As others have mentioned there may bevmore than one cause or more than one thing going on. So, you may have to try a few different things.
Vestibular therapy just made things worse for me over time, for example, and for some it does the trick.
I ended up having injections in my back and neck, in any sore spots. Some use a sugar solution and some a homeopathic thing. The idea being the signals are jammed and the process if getting the injections sort of resets things. It turned out this was the only relief I could find - and yes I had the same sort of sense of starting in the neck area and then spreading.
I agree with consulting a neuropsychiatrist as they can rx for migraines (some do not have the typical symptoms) and also will know of other therapies people have tried, and are generally a good resource. A referal to elsewhere from them can make a big difference.
Keep trying til you find what works. They may also subside over time as well, as you are still in early days. I am so glad your recovery is going well, and yes you still need to seek the help you need, and not minimize it.
I have had daily migraine type headaches since my concussion began. It is important to note that if you were a migraine sufferer prior to having a TBI, you are more likely to have regular occurrences of migraines. I have tried a number of different treatments - tablets, nerve block, botox and none of them worked effectively. I was offered the new style injection for migraines but decided against this. However, what I have found is that acupuncture or dry needling is very effective but needs to be done regularly which may be cost prohibitive. The vestibular exercises I was given by a vestibular physio helped with the nausea too.
Someone may be able to help with a question I have. I only need to wear reading glasses when I'm tired or when the light isn't good but since my TBI I have not been able to wear them without feeling like I'm going to throw up. Has anyone else experienced this problem and overcome it?
Hi,My head injury was July10, 2020. I still have headaches. I get Botox injections to the head once every three months. This has lessened the intensity for the most part, however, I still do get headaches almost daily. What I have learned is that when I sleep on my right side the headaches are more intense, therefore, I have been trying my best to not do so. My injury occurred on my left, all my debilitating symptoms exhibited on my right (leg weakness etc). My eyes also hurt a lot which triggers even more headaches. I recently received Prism glasses which have been helping with the eye pain and visual weaknesses. I am also in vision therapy with an occupational therapist twice a week. I recently saw the specialist who has recommended Occipital nerve block injections which I will get in December.
I have many, many prescribed meds including Namenda, Sumatriptan, Nurtec, Amitriptyline and none rid the headaches. Excedrin with caffeine helps to reduce the intensity and bottled Pepsi. I use these with much caution as excedrin has acetaminophen in it and that affects the liver. Pepsi can irritate the stomach and the sugar content is a concern, however, it helps temporarily along with ice to the back of my head, neck area. I also use ace wrap to wrap my head and that gives me some relief. I have also started taking Nordic DHA capsules along with Life extension Neuro mag two caps once daily, these are beneficial with brain fog if you experience it.
Morning. I had my TBI back in July. My recovery has been better than expected. My headaches were initially bad due to the crystals in my ear being dislodged, after having treatment to have those done they headaches got a lot better.
The issue now is there is no rhyme or reason to getting them and how severe. I have cut down on the amount of Cocodamol I am taking, just because a) I can seem to survive without them all of the time and b) I don’t want to become dependant and the occupational therapist said they can cause headaches to become worse. I have spoken to the doctor and they have prescribed me a dose with a lower level of codene
The only thing I have noticed is on the days that I don’t drink enough water that seems to make them worse, and bending down to pick things up in the evening often triggers them if like you I haven’t had a tablet to cut the headache off before it happens. I will have a go with the new tablets next week and see how that goes. Frustratingly I managed to go for a run last week which was fine, I have then been twice since and have had to stop after a short while as the pain was too much.
Sorry also I have just read my first sentence, I don’t want this to sound smug as that is not the intention. I do have to walk around with a plastic crash hat all of the time as I am missing some skull.
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