Hi all,
New poster here, though I've been following threads for about 6 weeks looking for help and mostly reassurance I wasn't dying!
I'm 3 1/2 months post concussion after having 2 minor head bumps in 7 days
( they weren't my first). The first 3-4 weeks were awful and I've never had so many anxiety inducing symptoms in my life!

My current and pretty much only lingering issue is a 24/7 headache/pain/pressure that came back and got much worse about 6-7 weeks after my first bump( tetherball to back of head, though not very hard) It was so bad for a few days I went back to ER.

It took 4 more agonizing weeks to get in with a Neurologist. Tylenol/ibuprofen did very little.
She spent about 20 min going over MRI(normal) and reassuring me it was PCS and not something else(I wasn't quite convinced!) i couldn't believe all this was from 2 minor head bumps, but she explained the reason my head hurt so bad and was not getting better like this:

1) I never took time off work to sufficiently rest- mental and physical
2) I was not taking adequate Tylenol/ibuprofen in the beginning to abort headaches.
3) I returned to work ( at 5 weeks after) without being symptom free( dizziness leading to mild headaches with activity)
4) history of prior head injuries-hit in face with soccer ball '07, a few minor bumps since then.

She suggested Amitriptyline( not surprised) and that it would help to 'calm my brain down'. I was started at 10mg to increase by 10 each week as needed, but was expected to need around 40mg to get relief. I slowly upped to 20 mg over 3 weeks and after 3 days at 20, I got tachycardia and was switched to Nortriptyline with same result at 20 mg. I was told to quit and come back in, but Dr out for 2 weeks!

So my primary Dr prescribed SERTRALINE( Zoloft)25mg a day since I can't tolerate anything in the tricyclics or anything that would most likely give me tachycardia.

Has anyone tried Zoloft for their headaches?
I'm skeptical, but at this point I'll try anything at least until I see Neuro again. I can only do things in small amounts and then I have to lay down. Also, I've been off Ami/Nort for 3 days and I've just realized my head felt different when I was on them. Hard to describe but kind of like my head/ scalp were numb but if lightly pressed with , fingers I could still feel pain. I was getting some relief at 20mg, so I'm frustrated I couldn't stay on them.

Thanks for letting me vent! This forum has gotten me through the past 6 weeks

Holly26,

Welcome to NeuroTalk. I'm sorry to hear you are struggling so with head aches. It would help to understand all of your head impacts.

It does not sound like you have done anything regarding a possible upper neck injury. I would encourage you to look into diagnostics and treatment for your upper neck. Your neck may not be sore but it can still cause muscle spasms that can cause head aches.

My best to you.

Thanks Mark,

My past injuries are things like bumping head on a car door, hitting it on a treadmill arm, stepping back into a half open door, a closet shelf. No car accidents or major trauma .
I did have a neck X-ray in Feb which showed mild whiplash.
I was given a muscle relaxer but did not take it.

I do sometimes get soreness at base of skull, which makes the rest of my head worse, which is usually brought on sometimes when driving or over exerting for the day. I noticed it did go away while on Ami/Nort. I have been getting weekly massages. I will ask my Neuro about it in 2 weeks .

Your neuro will not likely be concerned about your neck. I don't think you have a head injury as much as you have an upper neck injury.

If a neck x-ray showed mild whiplash, you likely have much more. For an x-ray to show whiplash, you must have quite an injury because X-rays are not good at showing such injuries.

You must have been not reading much these past few weeks on NT. I have discussed the issues of upper neck injuries and the problems they cause for years and a number of times recently. A massage can be moderately helpful for short term but not usually helpful for the long term. You need to find someone with more specialized skills at treating subtle neck injuries plus you need to learn posture discipline, especially during rest and sleep and stick to it consistently for a few months.

Personally, I would not waste time with a neuro. Instead, I would find a Physiatrist (Physical Medicine and Rehabilitation) who is good with whiplash or maybe just a Physical Therapist who is good with whiplash and the upper neck. An upper cervical chiropractor would also be worthwhile. See the sticky above about Vitamins for links to upper cervical chiros. The treatment you find should be gentle until you start to show substantial improvement. No extreme range of motion efforts. (PT's like to do this).

The cervical vertebra need to get into proper position and stay there. It takes 6 weeks and longer for the ligaments to strengthen and tighten.

btw, The muscle relaxer may be helpful but you must only use it when you can rest with good straight neck and head posture.

Hopefully, with discipline and good therapy, your should be able to heal.

My best to you.

Mark,
After your response to me in the prolotherapy thread I have been doing some thinking and self assessment and I believe that I may in fact have a neck/whiplash injury rather than a neurological issue. What kind of doctor should I look to first to investigate the possibility of a whiplash injury? I have found a local upper cervical chiropractor that I can go to but should this be my first stop? I know the upper cervical chiro works with the atlas and axis but could it be a muscle or nerve problem that is causing my symptoms? What kind of doctor would specialize in the muscles/nerves/etc of the neck?

An upper cervical chiro can be a good start. If you can find a PT who is good with whiplash that would be worth a try. Also, a Physiatrist (Physical Medicine and Rehabilitation in the yellow pages) if you can find one with goos skills with whiplash.

As I have said many times before, getting good treatment to help the neck settle into place also requires discipline with posture, especially during sleep and rest. For me, I also needed to reduce the height of my computer monitor so I did not tilt my head back to look at the monitor through the lower lens of my glasses.

My neck is now 80% better. I still have to be cautious with posture. My neck is noisy in the C-1 and C-2 joints.

The muscle problem is usually a muscle spasm from radiculopathy from nerve irritation/inflammation due to C-1 and C-2 being out of place. They are bone on bone, no cartilaginous disk to lube the joints. Thus, the cervical vertebra do not move as smoothly.

In my case, I believe I injured the occipital condyle where C-1 mates into the skull. Some gentle chiro and PT plus months of discipline with posture lead to improvements.

The chiro and PT were just a small part of the equation. Disciplined posture made the most difference after the others helped the joints settle into proper position.

Well I tried out NUCCA and everything about it seems like a scam. The actual treatment consisted of him putting his hands on my neck very gently and then vibrating his hands for a couple of seconds. I have very little faith in this treatmet being effective so I am already looking ahead to my next plan.

Thank you Mark for recommending a physiatrist. I have found what seems to be a very good doctor who has a lot of experience and even wrote a textbook on whiplash injuries. Hopefully he will be able to help.