Medical management of posttraumatic headaches: Pharmacological and physical treatment

Posttraumatic headache can be a very difficult syndrome to manage, especial ly if chronic. As with most other types of headache, medications are the pr imary treatment modality, although there is very limited evidence-based dat a to support any given approach. A number of physical interventions also ar e available to be used in conjunction with medication. particularly for hea daches with a musculoskeletal component. This article will review the gener al principles of pharmacological treatment for headache and the physical ap proach to treatment of headaches and head and facial pain. The major catego ries of medications commonly used for treatment of many varieties of headac he will be discussed. in addition, the problems encountered in diagnosing a nd treating chronic daily headache and analgesic rebound headache are addre ssed. The approach to treatment of such syndromes as myofascial pain, cervi co-zygapophyseal joint pain, neuritic pain, and craniocervical somatic pain are outlined.