Head Injury from Diving: Pain and Muscle Tension

Diving injury resulting in sharp pain in the right occipital region?

Hello doctor, two weeks ago I was diving in a pool with a depth of about 1.2 meters and hit my head, specifically on the top right side.
The wound has healed, but in the first few days, I experienced sneezing and discomfort during sexual arousal.
I have been feeling sharp pain in the right lower part of my occipital region, and there is muscle soreness in my neck and both shoulder areas, resembling a stiff neck.
Now, two weeks later, I occasionally feel tightness in the muscles at the right occipital area.
During these two weeks, I have been taking anti-inflammatory medications and even received muscle relaxants.
I had a neck X-ray done in neurology, which did not show any issues in the occipital region, but they mentioned that my posture is poor and my cervical spine is straight without curvature.
The top of my head has healed, but I still occasionally feel slight sharp pain in the right occipital area along with muscle tightness.
What could this situation be, and how should I handle it? Thank you.

Su, 20~29 year old female. Ask Date: 2018/07/22

Dr. Cai Zongzhang reply Neurology

Based on your description, it is highly recommended that you go to the hospital for an examination immediately to accurately assess the impact of the trauma on your brain through imaging.
It is advisable for you to follow up with outpatient care for further evaluation and treatment, which will surely provide you with satisfactory answers.

Reply Date: 2018/07/22

More Info

Experiencing persistent pain and muscle tension after a head injury, such as the one you described from diving, can be concerning and warrants careful consideration. Based on your symptoms, it seems you may be dealing with a combination of post-traumatic headaches, muscle tension, and possibly some underlying cervical spine issues.

Firstly, it's important to understand that head injuries, even those that seem minor, can lead to a variety of complications. The impact from diving into a pool, especially at a depth of only 1.2 meters, can cause not just superficial injuries but also deeper issues such as concussions or cervical spine injuries. The symptoms you describe—pain in the right posterior part of your head, muscle tension in the neck and shoulders, and discomfort during certain activities—could be indicative of a few different conditions.

1. Post-Traumatic Headaches: After a head injury, it is common to experience headaches that can vary in intensity and frequency. These headaches can be tension-type or migraine-like in nature. The fact that you experience pain during sneezing or sexual excitement suggests that there may be increased intracranial pressure or muscle tension contributing to your discomfort.

2. Cervical Strain or Sprain: The neck pain and muscle tightness you describe could be due to a strain or sprain of the cervical muscles or ligaments. Poor posture, as noted in your X-ray results, can exacerbate these symptoms. The alignment of your cervical spine is crucial for proper function and can influence pain levels.

3. Muscle Tension: The ongoing muscle tension in your neck and shoulders may be a result of compensatory mechanisms following your injury. When one area of the body is injured, other muscles may tighten to protect the injured area, leading to a cycle of pain and tension.

4. Nerve Irritation: If there was any injury to the cervical spine or surrounding structures, it could lead to irritation of the nerves that supply the neck and head, contributing to your symptoms.

Given that you have already sought medical attention and received muscle relaxants and anti-inflammatory medications, it is crucial to continue monitoring your symptoms. Here are some recommendations for managing your condition:
- Rest and Recovery: Ensure you are allowing your body adequate time to heal. Avoid activities that exacerbate your symptoms, such as heavy lifting or strenuous exercise.

- Physical Therapy: Consider consulting a physical therapist who can provide targeted exercises and stretches to improve your neck posture and strengthen the surrounding muscles. They can also help with manual therapy techniques to relieve muscle tension.

- Pain Management: Continue to use over-the-counter pain relief as needed, but consult your healthcare provider if you find that you need to rely on medication frequently.

- Follow-Up Imaging: If your symptoms persist or worsen, it may be beneficial to have further imaging studies, such as an MRI of the cervical spine, to rule out any underlying issues that may not have been visible on the initial X-ray.

- Lifestyle Modifications: Pay attention to your posture, especially if you spend long hours sitting or using electronic devices. Ergonomic adjustments can help reduce strain on your neck.

- Hydration and Nutrition: Ensure you are well-hydrated and consuming a balanced diet, as dehydration and poor nutrition can exacerbate muscle tension and headaches.

In conclusion, while your symptoms may be common following a head injury, they should not be ignored. If you experience any new symptoms, such as dizziness, visual changes, or worsening headaches, seek medical attention promptly. Your health and well-being are paramount, and ongoing communication with your healthcare provider will ensure you receive the best care possible.

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