Headaches are one of the most common challenges after a concussion. They can also be present after brain injury. They can be debilitating, frustrating, and be a long-term effect for your friend or family member. It can be helpful to understand headaches, the potential causes, and how to help the person manage them.
Topics in this section include:
- Causes of headaches
- Diagnosing headaches
- Types of headaches
- Tips for managing headaches without medication
Causes of headaches
Headaches can be triggered by a variety of causes.
- Damage to the brain or nerves
- Pain due to neck or muscle
- Fatigue/lack of sleep
If your friend or family member is experiencing any headaches after their brain injury, you should share this information with their doctor. These headaches could be related to other brain injury symptoms that may need medical attention .
To help keep track of headaches, they can use this printable headache diary from the Ontario Neurotrauma Foundation. This headache diary will help doctors work with the patient to determine treatment by tracking the length, severity and time of headaches as well as other important factors.
Types of headaches
Headaches come in a variety of types. While they are all true to their name, they can cause different effects.
- Tension headaches
- Tension headaches often feel like a tight, squeezing sensation that can last for long periods of time. They can cause mild to moderate levels of pain. They are the most common type of headaches for all adults and do occur often in people with brain injury. They are usually related to stress.
- Migraine headaches
- Migraines are severe and can be incredibly debilitating. Migraines may be one-sided (classic) or both sides (common) and are notable because they are more severe than other types of headaches. Migraines can also cause light and sound sensitivity and nausea/vomiting.
Migraines can make it harder to complete activities of daily living (ADLs), interfere with sleep, and impact overall health and wellbeing. While they can often be treated with over the counter headache medication, migraines may be long-term challenges for people with brain injury .
- Cervical headaches
- Cervical (or cervicogenic) headaches are caused by nerve damage in the neck, shoulders, or back of the head. These nerves are often connected to the head. Cervical headaches will commonly start in the neck, shoulders or back of the head and can be made worse when standing/sitting in certain positions .
- Rebound headaches
- Rebound headaches can happen as a result of headache medication. If a person uses the medication too frequently and then miss a dosage, or decrease the dosage, they may experience headaches (particularly if their medication has caffeine).
Doctors can answer any questions they may have about rebound headaches, as well as provide information about headache medication.
- Cluster headaches
- Cluster headaches are short-term, painful headaches that gather behind one eye or one side of the head. While cluster headaches themselves don’t last long, there may be periods of time where cluster headaches happen frequently. Cluster headaches aren’t as common as other types of headaches.
Medication and medical treatment for headaches
If a person requires medication to help with headaches, the doctor will prescribe preventative or rescue medication. Preventative medication keeps headaches from happening: doctors will perform an evaluation to determine whether this is something the person needs. Rescue medication helps when a person already has a headache. Examples of these medications include triptans, ibuprofen and acetaminophen. They should not be used daily for extended periods of time as they will result in medication overuse headaches. Other rescue medications, such as opiates, should rarely if ever be used and only for short periods under the close supervision of a physician .
Any questions or concerns about medications for headaches should be brought to a doctor.
Tips for managing headaches (without medication)
There are steps a person can take to prevent and manage headaches.
- Apply a cold or hot pack to the neck or head 
- Avoid alcohol and caffeine
- Complete deep breathing exercises
- Do visualization or other mindfulness-based exercises
- Drink plenty of water to stay hydrated
- Eat healthy foods
- Focus on improving sleep
- Get regular exercise
- Go outside to get fresh air
- Go to a quiet place, lie down or take a break from activities
- Stretch and self-massage the head, neck, and shoulders
Please note: while these resources are designated for concussion recovery because headache is a common symptom of concussion, the tips may be applicable to those with moderate to severe traumatic and non-traumatic brain injury.
- The Ontario Neurotrauma Foundation’s Guidelines on Post-traumatic Headaches
- Vancouver Coast Health Concussion Guide
- The Migraine Buddy app – this is an application you can find on your smart phone or tablet’s app store. It is an app that helps track migraines, record triggers, and more
Disclaimer: There is no shortage of web-based online medical diagnostic tools, self-help or support groups, or sites that make unsubstantiated claims around diagnosis, treatment and recovery. Please note these sources may not be evidence-based, regulated or moderated properly and it is encouraged individuals seek advice and recommendations regarding diagnosis, treatment and symptom management from a regulated healthcare professional such as a physician or nurse practitioner. Individuals should be cautioned about sites that make any of the following statements or claims that:
- The product or service promises a quick fix
- Sound too good to be true
- Are dramatic or sweeping and are not supported by reputable medical and scientific organizations.
- Use of terminology such as “research is currently underway” or “preliminary research results” which indicate there is no current research.
- The results or recommendations of product or treatment are based on a single or small number of case studies and has not been peer-reviewed by external experts
- Use of testimonials from celebrities or previous clients/patients that are anecdotal and not evidence-based
Always proceed with caution and with the advice of your medical team.