Headache Doctor in Manchester, MO

MANCHESTER, MISSOURI

Manchester patients see our headache doctor at the Natural Bridge Road office, roughly 15.1 miles and about 24 minutes via I‑270 and Manchester Road. After a head injury, treatment follows the headache type: migraine‑like headache gets migraine treatment, and neck‑driven components get targeted physical therapy and blocks where the presentation supports them.

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Headache is the most common symptom after a concussion and the most common one to persist. When it lasts beyond three months it is called persistent post‑traumatic headache, and it is treated according to the headache type it resembles rather than as a category of its own.

Getting here from Manchester

Manchester is roughly 15.1 miles from the Natural Bridge Road office, about 24 minutes via I‑270 south and Manchester Road. Patients arriving from here after a head injury frequently come months in, having been told the imaging was normal and to give it time — both true, and neither a plan.

What is a post-traumatic headache?

The definition is largely temporal: a headache that develops within seven days of head trauma, of regaining consciousness, or of being able to report symptoms. Beyond three months it is called persistent.

The severity of the injury does not predict the headache. Mild traumatic brain injury produces persistent headache more often than severe injury does, which is counterintuitive and consistently found. Loss of consciousness is not required and most patients never had it.

Normal imaging is expected rather than reassuring in a specific way. CT and MRI are looking for structural injury, and their normality does not argue against the diagnosis. Post‑traumatic headache covers the criteria.

What does a post-concussion headache feel like?

This is the practical key to treatment. Post‑traumatic headache is not a single phenotype; it takes the shape of an existing headache type, and the treatment follows that shape:

Migraine‑like, which is the most common presentation, with throbbing pain, nausea and light sensitivity — treated on migraine principles
Tension‑type‑like, with bilateral pressure and no autonomic features
Cervicogenic, where the neck was injured alongside the head, which is extremely common in the mechanisms that cause concussion
Occipital neuralgia, particularly after a blow to the back of the head
Mixed, which is the most common of all

Classifying it is therefore not a labeling exercise. It determines the treatment, and treating an undifferentiated post‑traumatic headache without classifying it is why so many go untreated.

Can a neck injury cause headaches after a concussion?

Any mechanism sufficient to concuss the brain has also loaded the cervical spine, and the upper cervical segments refer pain into the head through the trigeminocervical complex.

Yet the assessment after a head injury focuses on the head, and the neck is examined superficially or not at all. A meaningful share of persistent post‑traumatic headache has a cervical component that responds to treatment directed there.

Cervicogenic headache covers the mechanism, and it is worth assessing specifically in anyone whose headache started with a collision, a fall or a sporting impact.

Medication overuse is the second most common missed factor

The pattern is predictable. A headache starts after an injury, over‑the‑counter analgesics are taken daily because the headache is daily, and within a few months a medication overuse headache is layered on top of the original one.

At that point nothing works, the patient concludes the injury caused permanent damage, and the reversible component goes unrecognized.

Establishing the actual number of days a month that acute medication is taken is one of the highest‑value questions in this history. Medication overuse headache covers unwinding it.

How do you treat a post-traumatic headache?

It follows the phenotype. Migraine‑like post‑traumatic headache gets migraine treatment, both acute and preventive. Cervicogenic components get physical therapy directed at the upper cervical segments, and confirmatory or therapeutic blocks where the presentation supports them.

Occipital nerve blocks have a role where there is occipital tenderness or a clear occipital distribution, which is common after a posterior impact.

Sleep, which is disturbed after concussion in most patients, is addressed directly rather than being left to settle. So is the medication pattern. Neither is glamorous and both change outcomes.

Is it normal to have headaches months after a concussion?

Most post‑traumatic headache resolves within weeks to a few months. The group that persists past three months is smaller, and it is the group that benefits most from active treatment rather than further waiting.

Being told to give it more time at six months is not a plan, and it is the most common thing patients from this group arrive having been told. By that point the useful work is classification and treatment.

What chronic headache means covers the longer arc, and second opinion for headache covers what a fresh assessment should include.

Frequently asked questions from Manchester patients

My CT was normal. Does that rule out damage from the injury?

It rules out structural injury of the kind CT detects, which is what it was ordered for. Post‑traumatic headache occurs with normal imaging as the rule rather than the exception, so a normal scan neither confirms nor excludes it.

How long should I wait before seeking treatment?

If headache is still significant at four to six weeks, that is a reasonable point to be assessed rather than to keep waiting. Sooner if daily analgesic use has started, because that is the window in which medication overuse becomes established.

I did not lose consciousness. Can I still have this?

Yes. Most patients with concussion never lose consciousness, and loss of consciousness is not required for either the concussion diagnosis or persistent post‑traumatic headache.

Will it ever go away?

Most do, within weeks to months. For the group that persists, active treatment directed at the specific phenotype changes the picture for a substantial proportion, which is why classifying it matters more than waiting.

Can a mild concussion cause a lasting headache?

Yes, and more often than a severe injury does. That sounds backward, but it is found again and again: mild traumatic brain injury produces persistent headache more often than severe injury. How hard you were hit does not predict how long the headache lasts, and you did not need to be knocked out. What matters is which headache type it has become.

Can taking painkillers every day make a post-concussion headache worse?

Yes. A daily headache after an injury leads to daily over‑the‑counter pills, and within a few months a medication overuse headache sits on top of the original one. Then nothing seems to work, and it feels like permanent damage when part of it is reversible. Counting how many days a month you take acute medication is one of the most useful things we ask.