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Medical Management of Posttraumatic Headaches: Pharmacological and Physical Treatment

Bell, Kathleen R. MD; Kraus, Eric E. MD; Zasler, Nathan D. MD

Journal of Head Trauma Rehabilitation: February 1999 - Volume 14 - Issue 1 - p 34–48
Posttraumatic Headache

Posttraumatic headache can be a very difficult syndrome to manage, especially if chronic. As with most other types of headache, medications are the primary treatment modality, although there is very limited evidence based data to support any given approach. A number of physical interventions also are available to be used in conjunction with medication, particularly for headaches with a musculoskeletal component. This article will review the general principles of pharmacological treatment for headache and the physical approach to treatment of headaches and head and facial pain. The major categories of medications commonly used for treatment of many varieties of headache will be discussed. In addition, the problems encountered in diagnosing and treating chronic daily headache and analgesic rebound headache are addressed. The approach to treatment of such syndromes as myofascial pain, cervicozygapophyseal joint pain, neuritic pain, and craniocervical somatic pain are outlined.

Associate Professor, Department of Rehabilitation Medicine, University of Washington, Seattle, Washington (Bell)

Assistant Professor, Department of Neurology, University of Washington, Seattle, Washington (Kraus)

Medical Director, Concussion Care Centre of Virginia, Medical Director, Tree of Life, Glen Allen, Virginia (Zasler)

Address correspondence to K.R. Bell, Department of Rehabilitation Medicine, Box 356490, University of Washington, 1959 Pacific, Seattle, WA 98195.

© 1999 Lippincott Williams & Wilkins, Inc.