A concussion is a mild traumatic brain injury that results from a blow, bump, or jolt to the head that causes the brain to move rapidly inside the skull. This forceful movement temporarily disrupts normal brain function, leading to a variety of neurological symptoms. A common consequence of this injury is the development of systemic pain, which frequently includes discomfort in the joints and muscles, sometimes far removed from the site of impact. This joint and muscle pain stems from changes in the central nervous system, rather than necessarily indicating an injury to the limb itself. Understanding the different origins of this pain is the first step toward effective management and recovery.
The Direct Connection: Altered Pain Processing
The injury to the brain tissue can directly alter the way the entire nervous system processes and responds to pain signals. This neurological change is known as central sensitization, where the central nervous system becomes hyper-responsive, essentially winding up the pain volume control. The result is that normal, non-painful stimuli can be perceived as painful (allodynia), or painful stimuli are amplified (hyperalgesia). This heightened sensitivity can lead to widespread body aches and stiffness.
Disruption to the brain also commonly affects the autonomic nervous system (ANS), the body’s involuntary control center that manages heart rate, breathing, and digestion. Concussion can push the ANS into a state of sympathetic overdrive, the body’s “fight-or-flight” response. This persistent state of arousal can increase muscle tension throughout the body, contributing to chronic pain and fatigue.
Chemical changes within the brain following injury also play a role in altered pain perception. The concussive event can disrupt the balance of key neurotransmitters that regulate pain signaling pathways. These disruptions can create a chronic cycle of pain independent of ongoing tissue damage in the muscles or joints. This pain originates from the brain’s altered signaling and requires different management strategies than typical musculoskeletal injuries.
Secondary Causes: Biomechanical Compensation
Joint and muscle pain can also arise indirectly as the body compensates for primary concussion symptoms like dizziness or visual problems. Since the impact often involves a sudden forceful movement of the head and neck, a whiplash-type injury to the cervical spine frequently occurs simultaneously. This neck injury itself can be a direct source of pain, which radiates into the shoulders and upper back.
The balance system, controlled by the inner ear and the brain’s vestibular system, is often temporarily impaired after a concussion. Dizziness and spatial disorientation cause a person to unconsciously adopt a more cautious and stiff walking pattern, known as a conservative gait strategy. This altered movement involves decreased walking speed and an increased sway, placing abnormal strain on the hips, knees, and lower back.
Visual disturbances also force the body to compensate physically. Issues like blurred vision, difficulty tracking objects, or poor depth perception can cause a person to tilt their head or maintain rigid posture to stabilize their gaze. This continuous tensing of the neck and shoulder muscles can lead to chronic tension headaches and muscle knots, which are a secondary source of widespread discomfort.
Recognizing Symptoms and Seeking Assessment
The joint and muscle pain experienced after a concussion often manifests as generalized soreness rather than localized injury pain. Patients may report diffuse, widespread pain that seems to move or migrate across different joints and muscle groups over time. This generalized discomfort is frequently exacerbated by activities that require cognitive effort, such as reading or working on a computer, due to the brain’s heightened state of sensitivity.
A comprehensive medical assessment is necessary to determine the specific source of the pain for effective treatment. A neurological evaluation helps differentiate pain stemming from central sensitization from pain that has a clear biomechanical or musculoskeletal origin. It is important to rule out other severe issues, such as a fracture or spinal injury, that may have occurred during the initial trauma.
Management for this pain is highly targeted, focusing on the specific mechanism at play. Pain rooted in central nervous system dysfunction may benefit from medication aimed at regulating nerve signaling, along with gradual exercise that helps reset the autonomic nervous system. Musculoskeletal pain is best addressed through targeted physical therapy, including manual therapy for the neck and exercises to correct altered posture and gait. Consulting with a specialist is advisable if pain persists for weeks or months after the initial injury, as this extended duration requires specialized care.