Why does my head hurt after an injury?
When struck, the brain is displaced inside the skull, which leads to stretching of nerve fibers, temporary biochemical disturbances and changes in the functioning of systems that regulate pain sensitivity. An additional contribution is made by injuries to the muscles and ligaments of the neck, which almost always accompany head impacts. This is why pain often begins in the back of the head and neck. Over time, sleep disturbances, anxiety and muscle tension join the physical mechanisms, which themselves maintain pain. All this explains why, with normal photographs, complaints can be pronounced and real.
- Functional changes after concussion
- Damage to the muscles and ligaments of the neck
- Sleep and routine disturbances
- Anxiety and fear of re-injury
- Excessive use of painkillers
- Exacerbation of pre-existing migraine
How does it manifest itself?
Most often, the pain is compressive, covering the head like a hoop, of moderate intensity, intensifies in the evening, with mental stress and working behind a screen. In some patients, it takes on the features of a migraine: pulsating, one-sided, with nausea and intolerance to light and sound. Other symptoms are usually present: dizziness, tinnitus, decreased concentration, forgetfulness, irritability, fatigue, difficulty falling asleep. This complex is called post-concussion syndrome; it does not mean brain damage, but it does require attention.
- Hoop-type squeezing pain
- Sometimes - migraine with nausea
- Dizziness and unsteadiness
- Difficulty with concentration and memory
- Irritability and fatigue
- Sleep disorders
- Increased sensitivity to light, sound and screens
When is tomography needed?
Not everyone needs visualization. In the acute period, CT scans are performed for loss of consciousness, repeated vomiting, seizures, focal neurological symptoms, suspected skull fractures, the elderly, and those taking blood thinners. Delayed MRI is considered if pain persists for more than a few weeks, changes in nature, or is accompanied by new symptoms. An important and dangerous situation is chronic subdural hematoma in the elderly, which can manifest weeks after a minor blow with increasing pain, drowsiness and weakness.
- CT scan in the acute period with alarming signs
- MRI for persistent or changing pain
- EEG for suspected seizures
- Examination of the cervical spine for neck pain
- Fundus examination
- Reassessment if worsening
Treatment
The basis is a properly structured regime. Relative rest with limited screens and mental stress is needed in the early days, but complete isolation in a dark room for weeks is harmful: it slows down recovery. After just a few days, it is recommended to gradually return to light activity, increasing it as tolerated. Painkillers are used for a short course; Taking them more than 10–15 days a month itself becomes the cause of daily headaches. In case of migraine and frequent pain, a neurologist can select preventive therapy. Working with the cervical spine, breathing practices and normalizing sleep are useful.
- Relative rest for the first days, then gradual activation
- Limiting pain medications to no more than 10–15 days per month
- Preventive therapy as prescribed by a neurologist
- Working with neck muscles and physical therapy
- Normalization of sleep and daily routine
- Dosed aerobic exercise
- Psychological support for anxiety
Return to study, work and sports
You need to return to exercise in stages: first light household activity, then short periods of mental work, then full-time study or work, and only at the end sports. If at any stage the symptoms noticeably intensify, take a step back for a day and continue more slowly. Particular caution is required in contact sports: repeated injury before full recovery is much more dangerous than the first and can lead to long-term consequences. The period of admission to training is determined by the doctor individually.
- Stepwise increase in load
- Return to sports as a last resort
- Complete ban on contact sports until recovery
- Limiting screen time at the beginning
- Discussing light duty at school or work
- Follow-up examination by a neurologist if complaints persist