Tension and Pain After Self-Inflicted Head Trauma

After hitting both temples, there is tightness in the temples and neck-shoulder area?

Hello Dr.
Jiang: I recently had an argument with my family and, due to emotional instability, I struck the sides of my head with my fists several times with considerable force.
At the moment, I experienced slight headaches but thought nothing serious of it.
However, for the next three days, I have been experiencing tightness on both sides of my temples (a bit above the temples) along with mild headaches and nausea.
I also had trouble sleeping at night.
Now, on the fourth day, I still have tightness and pain on the upper sides of both temples, along with some nausea.
Additionally, I have developed stiffness in my shoulders and neck.
I realized afterward that hitting the temples is really not a good idea...
I feel quite foolish thinking about it.
Should I get this checked out, or would it be sufficient to just rest? Thank you.

Niming, 20~29 year old female. Ask Date: 2018/01/21

Dr. Jiang Junyi reply Neurology

Hello, based on your description, your symptoms are very similar to myofascial pain syndrome in the shoulder and neck region.
This is because the fascia connects at the temples and the temporal lobes of the brain, and clinically, it often presents as pain at the affected area, discomfort, muscle stiffness, or a feeling of heaviness.
Sometimes, you may also feel palpable myofascial trigger points under the skin.
Symptoms tend to worsen in the morning or with changes in weather, but can be alleviated with stretching activities, and they often recur.
During acute episodes, there may be local muscle tension, spasms, and limited mobility.
I recommend that you consult with a rehabilitation or neurology specialist to discuss examination and treatment options.
Wishing you good health and peace.
Dr.
Tao cares about you.

Reply Date: 2018/01/21

More Info

It sounds like you are experiencing a range of symptoms following self-inflicted head trauma, including tension and pain around your temples, headaches, nausea, and neck stiffness. Given the nature of your injury and the symptoms you are describing, it is important to take these concerns seriously.

Firstly, the symptoms you are experiencing could be indicative of a few different conditions. The tension and pain around your temples, along with headaches, may suggest a tension-type headache or even a mild concussion. Tension-type headaches are often characterized by a feeling of tightness or pressure around the forehead or temples and can be triggered by stress, anxiety, or physical trauma. The nausea you mentioned could also be associated with headaches, particularly if they are tension-type or related to a concussion.

A concussion is a type of traumatic brain injury that can occur even with a relatively minor impact to the head. Symptoms of a concussion can include headaches, dizziness, nausea, sensitivity to light or noise, and difficulty concentrating. While you mentioned that your initial headache was not severe, the persistence of your symptoms over several days raises some concerns. The fact that you are experiencing ongoing tension and pain, along with nausea and neck stiffness, suggests that you should seek medical attention.

Neck stiffness can also be a sign of muscle strain or tension, which may have developed as a result of the impact or due to compensatory postures you may have adopted to alleviate pain. It is not uncommon for individuals who experience head trauma to also develop tension in the neck and shoulders, leading to further discomfort.

In terms of management, while rest is crucial, it is equally important to monitor your symptoms closely. If you notice any worsening of your condition, such as increased headache severity, persistent nausea, vomiting, confusion, or any new symptoms like visual disturbances or difficulty walking, you should seek immediate medical attention.
Given that you are on the fourth day of experiencing these symptoms, it would be advisable to consult a healthcare professional, such as a neurologist or an emergency physician. They can perform a thorough evaluation, which may include a neurological examination and possibly imaging studies (like a CT scan) to rule out any serious injuries, such as intracranial bleeding or other complications.

In summary, while rest and self-care are important, your ongoing symptoms warrant a professional evaluation to ensure there are no serious underlying issues. It is always better to err on the side of caution when it comes to head injuries. Please take care of yourself and consider seeking medical advice as soon as possible.

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