When someone experiences a head or neck injury, headaches often emerge as a common symptom. This can happen whether the injury is from a fall, sports incident, or car accident. While many people associate headaches primarily with concussions, fewer realize that whiplash-related injuries can also trigger significant and persistent headaches.
Understanding the overlap between concussion and whiplash is essential. Focusing on shared symptoms, such as headache, is necessary for accurate diagnosis. This understanding leads to effective treatment and long-term recovery.
Shared Symptoms, Different Origins
Concussion and whiplash are often thought of as separate injuries. A concussion is a traumatic brain injury caused by a blow or jolt to the head. Whiplash, by contrast, is a neck injury. It is typically caused by rapid back-and-forth movement of the head. This movement is often seen in rear-end vehicle collisions.
But in reality, these two conditions often co-occur, and their symptoms often look strikingly similar.
Common symptoms of both include:
- Headache
- Dizziness
- Fatigue
- Difficulty concentrating
- Sleep disturbances
- Irritability
- Light and/or sound sensitivity
Because of this overlap, it’s not always clear whether a patient is dealing with a concussion, whiplash, or both. This is especially true when headache is the main complaint.
Why Headaches Occur in Both Conditions
In concussions, headaches are believed to result from changes in brain chemistry, inflammation, and altered blood flow following the injury. These can manifest as pressure-like headaches. They can also present as migraine-type headaches or even pain worsened by light, noise, or physical activity. However, many systems are affected during a concussion. Headaches can arise from other issues like visual, vestibular, and autonomic impairments.
In whiplash, headaches often stem from cervical spine dysfunction, particularly irritation of the upper cervical joints, muscles, or nerves. These are typically referred to as cervicogenic headaches, which start in the neck and radiate to the head.
In cases where both injuries are present, the headache may be multifactorial, involving both neurological and musculoskeletal components.
Why This Matters for Diagnosis and Treatment
Relying solely on symptom reporting can be misleading. For instance:
- A study in Pediatrics found that 32.5% of children referred for concussion also had cervical spine dysfunction.
- In both pediatric and adult patients presenting to the emergency department, 9–13% had a coexisting neck injury.
- Neck injuries were nearly 3 times more likely in motor vehicle crash (MVC)–related concussions.
Research shows that up to a third of individuals with concussion do not report obvious neck pain. They might also overlook stiffness. These individuals may attribute their headache entirely to a concussion.
Failing to identify and treat the cervical component can lead to prolonged symptoms, missed opportunities for rehabilitation, and unnecessary suffering.
What You Can Do
If you or someone you know is dealing with a concussion and continues to experience headaches, especially beyond the typical recovery window, consider the possibility of cervical involvement. A thorough assessment by a physical therapist trained in concussion and cervical spine evaluation can help differentiate the sources of headache and tailor a treatment plan accordingly.
Treatment may include:
- Manual therapy for cervical joints and soft tissues
- Postural and mobility exercises
- Vestibular or visual rehabilitation
- Education on pacing and symptom triggers
Final Thoughts
Headaches are common after concussion and whiplash injuries, but the cause isn’t always just “in your head.” Understanding the interplay between concussion and whiplash opens the door to more effective, holistic care.
The Headache Therapist 