Pain management in traumatic brain injury recovery is a lot more complicated than you might think.
Unfortunately, common pain-management solutions, such as opioids and other painkiller drugs, can be dangerous for people with TBIs.
Which means pain management in traumatic brain injury recovery has to get creative sometimes.
If that sounds overwhelming, don’t worry! This article is here to walk you through some of the best ways to manage pain after a TBI.
Let’s dive in.
Pain Management in Traumatic Brain Injury Recovery
After a brain injury, you will most likely experience both acute and chronic pain.
Acute pain is caused by tissue damage in the brain and usually disappears after a few months once the brain has had time to heal.
Chronic pain lasts longer than three months, and the causes can vary.
In this article, we’ll be focusing on chronic pain management.
The types of chronic pain that people with brain injury usually suffer are:
- Migraines and headaches
- Neck, back and shoulder pain
- Muscular pain
- Neuropathic pain
Sometimes the pain might not present itself until several months after injury.
Why Painkillers are a Bad Idea after Brain Injury
While opioids and narcotics are usually prescribed to treat severe pain, these medications can be dangerous in the long run for TBI patients.
That’s because most painkillers suppress brain function, and as a result, can worsen the cognitive side effects of TBI.
This is why opioids are not usually the answer for pain management in traumatic brain injury recovery.
Instead, if you feel you need to take medication to relieve your pain, non-narcotics like Tylenol or Aleve are much safer. If you need something stronger, you should consult your doctor first.
Causes of Pain After Brain Injury
It’s important to get your pain under control as soon as possible. Pain makes it much more difficult to participate in therapy, and avoiding therapy will slow your recovery.
But to get your pain under control, you’ll first need to figure out the cause of your pain.
The causes of chronic pain after brain injury can be broken down into two categories: Nociceptive pain and neuropathic pain.
Nociceptive pain occurs when something external is triggering your pain receptors.
Neuropathic pain happens when your nerve cells become damaged. These cells then start sending pain signals to your brain, even though there is nothing actually wrong.
Of the two, nociceptive pain is easier to manage than neuropathic pain, so we will look at how to manage that type first.
Nociceptive Pain Management in Traumatic Brain Injury Recovery
Here are some different types of nociceptive pain and how to treat them.
Headaches and migraines are the most common type of chronic pain after brain injury.
Most headaches resolve on their own, but here are some things you can do to manage them if they don’t.
- Exercise. Light exercise such as walking, stretching and swimming releases endorphins (which are basically your body’s natural painkillers) and improves blood flow to the brain. This helps prevent headaches from occurring, and lessens their severity when they do.
- Stay hydrated. Keeping your body hydrated helps your brain function efficiently, which will reduce headache frequency.
- Reduce stress. Stress often triggers headaches and makes them much more severe. Relaxation therapy and meditation can reduce stress and help your brain stay calm, which will help with headaches.
- Try acupuncture. Acupuncture is a great alternative to pain meds and can relieve headaches and other pain related to brain injury.
If none of these techniques work, the problem might be stemming from your neck. Massage therapy has helped many TBI patients relax their neck and find relief from their chronic headaches.
Pain from Spasticity
Spasticity is another source of chronic pain in brain injury patients.
Spasticity after TBI is caused by an interruption in the communication between your brain and your muscles.
Normally, your brain can send messages through the central nervous system to tell your muscles when to contract or relax, which helps your body maintain a comfortable muscle tone.
But sometimes after a brain injury, this message flow is interrupted, and your muscles no longer know whether they are supposed to tighten or relax.
As a result, the muscles stay in a constant state of flexion, which we call spasticity.
Because your muscles are continually flexing, this can cause serious pain and soreness. It’s like you’ve been constantly working out and never have had a chance to rest!
Botox injections can relax your muscles and provide relief from spasticity pain, but they’re not a permanent fix.
The only way to really treat spasticity is to reestablish muscle-brain communication, which you can do by activating neuroplasticity.
Neuroplasticity is the mechanism your brain uses to form new neural connections, and the best way to activate it is through repetitive practice.
So to lessen spasticity, you’ll need to practice moving your affected muscles. The more you move it, the more connections will be formed, until eventually your spasticity subsides.
This might be hard to do if your spasticity is severe though. In these cases you should consider a botox shot.
The Botox should allow you to move enough to activate neuroplasticity and reconnect your brain messages to your muscles.
Neuropathic Pain Management in Traumatic Brain Injury Recovery
Neuropathic pain is a shooting, tingling, or burning pain that is a result of nerve damage or a malfunctioning nervous system.
Treating neuropathic pain is difficult, but not impossible. Most treatments only reduce neuropathy and make it bearable. They don’t eliminate it completely.
Here are a few methods doctors might use to treat neuropathic pain after brain injury.
Antidepressants are surprisingly very effective at treating neuropathic pain.
If you decide to give this treatment a try, you should talk to your doctor to figure out which antidepressant would be best for you. Not all antidepressants are as safe for brain injury patients as others.
Transcutaneous Electrical Nerve Stimulation (TENS)
A TENS machine works by producing mild electrical impulses that block pain signals to the brain and help muscles relax.
The great thing about TENS is that you can self-administer it at home; however, it’s a good idea to have a physical therapist give you a supervised trial before doing it yourself.
Acupuncture originated from Chinese medicine and uses needles to stimulate the nervous system and the body’s own healing response which in turn helps with pain management.
The data supporting acupuncture’s effectiveness in treating neuropathic pain is somewhat inconsistent. Some people find it greatly reduces their pain, and some people don’t feel any effects.
Still, acupuncture is a safe, natural remedy for brain injury patients, and is another option for those looking to avoid using opioids and other painkillers to manage neuropathy.
In severe cases, a doctor can inject nerve blocking agents directly into the pain site. These sometimes contain opioids, so you will need to be careful.
In the short-term, they won’t do too much harm to your brain. But in the long-run, they will have a negative impact on your recovery. So try to only use them as a last resort.
And never, ever self-medicate.
Traumatic Brain Injury Pain Management
Pain management after brain injury is complex. No single therapy or treatment is usually enough.
The methods in this article should help manage your pain and symptoms. But as always, consult your doctor before trying any of them.
Finally, dealing with chronic pain often leads to depression and can make you feel alone. And depression in turn can exacerbate the symptoms of your pain.
That’s why an important aspect of pain management in traumatic brain injury recovery is to make sure you are also addressing any emotional problems you might have.
If you can keep depression at bay, you will have that much more energy to take the actions you need to manage your chronic pain.
You’ll also want to try to find a support system that will encourage you to keep working on your recovery, despite the pain.
The only real way to eliminate pain after TBI is to help your brain recover. And the only way to do that is to continue with your therapy.
If you can persevere with your traumatic brain injury treatment, your brain will keep healing, and hopefully you will notice your pain decreasing.