What is a post-traumatic headache?

A post-traumatic headache is a headache that begins, or clearly worsens, after a trauma to the head or neck – typically within seven days of the injury or of regaining awareness. It frequently follows a concussion, but it can also arise from a neck injury alone. These headaches often take on the features of more familiar headache types: some resemble tension-type headaches with a band-like tightness, while others behave like migraines with throbbing pain, nausea, and light sensitivity. A common driver is the upper neck (cervicogenic headache), where injured joints and muscles refer pain into the head.

Post-traumatic headache symptoms

Presentation varies because more than one headache mechanism can be at play. Identifying the pattern helps direct treatment.

• A dull, pressing, band-like ache around the head (tension-type pattern)
• Throbbing or pulsing pain, sometimes one-sided, with nausea or light and noise sensitivity (migraine pattern)
• Pain that starts at the base of the skull or neck and spreads forward (cervicogenic pattern)
• Headache triggered or worsened by neck movement or sustained postures
• Associated dizziness, neck stiffness, or difficulty concentrating
• Headaches that increase with screen time, reading, or visually busy settings

How post-traumatic headache is diagnosed

Diagnosis is clinical and rests on the timing – a headache that appeared or worsened after the injury – combined with characterizing the headache pattern. A clinician examines the neck and its joints, screens for concussion-related and visual contributors, and reviews triggers and frequency. Imaging is generally normal and is used to exclude a more serious cause when red-flag features are present, not to confirm the headache. Sorting out whether the pain is primarily neck-driven, migraine-like, or concussion-related is what makes treatment effective rather than trial-and-error.

Post-traumatic headache treatment

Care is non-surgical and is matched to the underlying mechanism. Because the neck is so often involved, treating it directly resolves many post-traumatic headaches that medication alone does not.

• Physical therapy – manual therapy and strengthening for the upper neck when the headache is cervicogenic, plus posture correction
• Chiropractic care – gentle mobilization aimed at the neck joints contributing to the pain
• Pain management – a structured medication plan, attention to avoiding medication-overuse headache, and targeted injections such as occipital nerve blocks or trigger-point injections when appropriate
• Migraine-style strategies and trigger identification when the headache has migraine features
• Hydration, sleep, screen pacing, and gradual return to activity

Recovery & when to see a doctor

Post-traumatic headaches often ease as the underlying concussion or neck injury heals, but the timeline varies and some become persistent, which is when structured treatment helps most. See a physician if a new headache follows a car accident or work injury, if it is frequent or worsening, or if over-the-counter medication is being used often – frequent use can itself perpetuate headaches. Seek emergency care for a sudden, severe “worst ever” headache, headache with fever and a stiff neck, repeated vomiting, seizures, new weakness or numbness, vision loss, or escalating confusion.

Related care at Injury Recovery MD

• car accident injury care
• neck pain

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We treat patients across Nassau and Suffolk County from offices including Medford, Islandia, East Islip, Mineola, Bohemia, Smithtown and Stony Brook. Find your nearest office →

Not near one of our offices? We can help arrange transportation to your appointment, or coordinate your care with providers in our Long Island network — call (631) 560-8357 to ask.

Post-traumatic headache FAQ

Why did my headaches start after my car accident?

A crash can injure the brain, the upper neck joints and muscles, or both, and any of these can generate headaches. Neck injury in particular often refers pain into the head, which is why post-traumatic headaches frequently appear alongside whiplash and concussion.

Can frequent painkiller use make my headaches worse?

Yes. Using over-the-counter or prescription pain medication too often can lead to medication-overuse (rebound) headache, which keeps the cycle going. A structured plan helps treat the headache while limiting that risk.

Are post-traumatic headache visits covered by No-Fault or Workers’ Comp?

Headache care after a car accident is generally billed to New York No-Fault, and after a work injury it is billed to Workers’ Comp, meaning $0 out of pocket for eligible visits. Coverage depends on your claim and eligibility, and our team can help you confirm your benefits.

Why does my headache start at the base of my skull?

Pain that begins at the top of the neck and spreads forward is the classic pattern of a cervicogenic headache, generated by injured upper-neck joints and muscles rather than by the head itself. It is the reason treating the neck directly resolves many post-traumatic headaches that medication alone does not touch.

Do I need a CT or MRI for headaches after my accident?

Usually not to diagnose the headache — imaging after trauma is normal in most cases and is used to exclude a more serious cause when red-flag features are present. The diagnosis rests on the timing and the pattern of your headache plus the neck and neurological exam. A sudden “worst ever” headache, repeated vomiting, seizures, new weakness, or vision loss are reasons to go to an emergency room.