Managing Headache and Neck Pain After TBI

Why does it hurt?

After a blast exposure, jump injury, car accident or other way that you might get a head injury, your neck may have experienced some trauma as well. Some people recover quickly from this type of injury while others continue to have pain or stiffness in their necks related to poor posture. This neck pain can become head pain.

Ice/Heat

Ice your neck and head at least 2-3 times a day. Leave it there as you relax for about 20 minutes (or until the pack is no longer cold).

Heat is good for relaxing muscles. You can use a warm gel pack. A 10-20 minute shower works just as well. Most respond to ice better than heat. Try both to see which one works best for you. When using heat or ice with neck stretches (below), use heat to relax muscles before stretching, then use ice after stretching to calm the muscles.

Neck stretches

Before stretching in any direction, pull up your spine as straight as possible, then "retract" your chin towards your neck. The muscles you are stretching are small and delicate: start low, and go slow. Tips: keep your head level (not bending forward or back), do not tug or shove neck, and gently press on your chin for a deeper stretch.

Directions: Start by holding for only about 5-10 seconds, then more each day:

Pull up: pullup.jpg	Retract: retract.jpg	Deeper stretch: deeperstretch.jpg
Flexion: (chin to chest) flexion.jpg	Lateral flexion: (ear to shoulder) lateralflexion.jpg	Rotation: (turn) rotation.jpg

Sleep posture

Consider how you sleep: on your stomach, back, side? Now take away the pillow, bring your arms to your sides, and sit up. How does your neck position look? Is it twisted and strained? Does it look or feel like a good position to keep your neck for 6-8 hours every night? And, keep in mind, flipping to the other side doesn’t make it "even!"

First, lying on your side is where to start. Then, consider your pillow. Neutral is the key:

Next, as you lie on your side on your neutral pillow, pull your entire body completely straight. Once your neck is straight, rest your arms, bend your knees, relax your body to a comfortable position. But RECHECK your neck position. Most people tend to curl up once they relax. If you have tucked your chin, pull your neck back up. This might feel awkward to start, but will become part of your bedtime routine and natural after about 1-2 weeks. Here’s how it looks:

Too fluffy: toofluffy.jpg	Too flat: tooflat.jpg
Just right: justright.jpg

Massage

Massages can be relaxing. Ask for a therapeutic massage. Explain that you get headaches from neck tension. Relax and enjoy.

Medication

Be sure to tell your health care provider about all of the medications and supplements you are taking. Consult with a health care provider prior to using any over-the-counter (OTC) medications. Be advised that OTC medications may make your headaches worse. If you are prescribed headache and/or neck pain medication, take it only as directed and be aware that it may take 2-4 weeks to show improvement.

What next?

If these conservative approaches are not effective after 2-4 weeks of consistent use, talk to your healthcare provider.

If you have thoughts or feelings of hurting yourself or others, seek emergency care. Call the Military/Veterans Crisis Line: 800-273-TALK (8255), send a text to 838255 or chat online at veteranscrisisline.net. Another helpful resource is Military OneSource at: 800-342-9647 or MilitaryOneSource.mil.