Headache Education Center

HEADACHE ATTRIBUTED TO TRAUMA OR INJURY TO THE HEAD AND/OR NECK


Description
Treatment
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Treatment


  1. Since this is a continuous daily headache, the goal of treatment is focused on preventive therapy: What to take on a daily basis to try to lessen the frequency and/or severity of the headaches. Preventive medicines generally take 4-6 weeks to start working and 2-3 months for full effect, assuming the correct dose of the medication is reached. These are the medications used most commonly and tend to have the most benefits, although this is not an all-inclusive list.
    1. Conservative therapy:
      ---Neck physical therapy
    2. Anti-depressant/Anti-anxiety medications:
      ---Amitriptyline (Elavil)
      ---Nortriptyline (Pamelor)
      ---Venlafaxine XR (Effexor XR)
      ---Desvenlafaxine (Pristiq)
      ---Duloxetine (Cymbalta)
    3. Anti-convulsant (Anti-seizure) medications: (If there are associated concussion symptoms such as cognitive dysfunction, it is better to try other categories first since side effects of these medicines can sometimes worsen cognitive or memory symptoms.)
      ---Gabapentin (Neurontin)
      ---Topiramate (Topamax)
      ---Divalproex sodium (Depakote)
      ---Zonisamide (Zonegran)
    4. Anti-hypertensive (blood pressure) medications:
      ---Propranolol (Inderal)
      ---Timolol (Timol)
      ---Metoprolol (Toprol)
      ---Atenolol (Tenormin)
      ---Nadolol (Corgard)
      ---Lisinopril (Zestril)
      ---Candesartan (Atacand)
      ---Verapamil (Calan)
      ---Acetazolamide (Diamox)
    5. Others:
      ---Occipital nerve blocks
      ---Cervical facet blocks or cervical epidural injections if there is a strong neck pain component (especially if sharp pain radiates down an arm)
    6. Biologics:
      ---Onabotulinum Toxin A (Botox)