What Causes Headaches After a Concussion?
Headaches are one of the most common and lingering symptoms following a concussion. Studies suggest that up to 90% of concussion patients experience headaches in the days and weeks post-injury (1).
But here’s the tricky part: post-concussion headaches aren’t just one type—they’re often a combination of factors:
- Cervicogenic (originating from the neck)
- Migraine-like (with light/sound sensitivity, nausea)
- Tension-type (linked to stress, posture, muscle strain)
- Exertional (worsen with activity)
Understanding the underlying subtype(s) is key to selecting the right treatment.
Note: If you’re looking for more comprehensive information on this topic, please see the in-depth article by Matt Nelson!
Start With a Cervical Spine Assessment
A large proportion of post-concussion headaches are cervicogenic—meaning the issue starts in the neck. This is due to whiplash or neck strain at the time of injury.
Red flags that suggest a cervical component:
- Headache starts at the base of the skull or neck
- Pain worsens with neck movement
- Tenderness in the upper cervical spine or suboccipital muscles
🔎 Research shows that cervical dysfunction is under-assessed in concussion care, despite its strong link to persistent symptoms (2).
What to do:
- Refer to a trained provider for a manual therapy assessment
- Include cervical range of motion testing, joint mobility, and muscle palpation
- Consider rehab that includes manual therapy, stabilization exercises, and postural correction
👉 Find a Certified Concussion Clinic with providers trained in cervical spine involvement.
Migraine-Type Headaches: What to Watch For
Concussions can unmask or trigger migrainous physiology, especially in patients with a personal or family history of migraine.
Common features:
- Throbbing or pulsating pain
- Light/sound sensitivity
- Nausea or vomiting
- Visual disturbances or aura
These types of headaches are often driven by autonomic nervous system dysregulation, hyperarousal of the stress response, and chronic neuroinflammation—especially in individuals with pre-existing migraine tendencies.
They respond best when treatment addresses these root causes through a combination of:
- Nervous system regulation techniques
- Anti-inflammatory lifestyle changes
- Structured exercise and recovery pacing
Learn how to target these root causes step-by-step in our Free 90-Minute Concussion Recovery Workshop — where we walk through exactly how to eliminate headaches by addressing inflammation, autonomics, and more.
Don’t Overlook Nutrition & Hydration
Dehydration, blood sugar crashes, and inflammation can all contribute to post-concussion headaches.
Evidence-based nutrition tips:
- Eat every 3–4 hours to stabilize blood glucose
- Focus on anti-inflammatory foods: berries, leafy greens, fatty fish
- Hydrate adequately (at least half your body weight in oz. per day)
- Limit added sugars, processed carbs, and alcohol
A study by Turner et al. (2022) found that dietary improvements reduced headache frequency and severity in PCS patients within 4 weeks (3).
Other Headache Subtypes to Consider
Tension-type:
Often related to stress, poor posture, or jaw clenching. Treat with:
- Massage, stretching, breathing techniques
- Stress management (CBT, mindfulness)
Exertional:
Triggered by physical activity, even light aerobic exertion. These respond well to graded sub-threshold aerobic exercise guided by the Buffalo Concussion Treadmill Test (4).
Treatment Plan: Layered, Not Linear
Successful treatment typically involves:
- Multidisciplinary assessment (cervical, vestibular, visual)
- Manual therapy for cervical involvement
- Nutritional + lifestyle interventions
- Graded exercise if cleared
- Medical intervention for migraine or complex cases
🧠 Headaches that persist beyond 2–3 weeks should be assessed by a trained provider to identify treatable drivers.
Related Blogs You’ll Find Helpful:
- Free 90-Minute Concussion Recovery Workshop
- Top 5 Evidence-Based Treatments for Concussion
- Is My Neck Causing My Symptoms? Part I
- Nutrition and Inflammation in Recovery
Need Help?
Find a concussion-trained provider near you:
🔍 Use the Clinic Locator
References
- Lucas S, Hoffman JM, Bell KR, Dikmen S. A prospective study of prevalence and characterization of headache following mild traumatic brain injury. Cephalalgia. 2014;34(2):93–102.
- Kennedy JE, Jaffee MS, Leskin GA, et al. Posttraumatic headache and comorbid neck pain: implications for diagnosis and treatment. J Head Trauma Rehabil. 2007;22(6):386–393.
- Turner K, Wilde EA, Schmidt AT, et al. Dietary interventions for post-concussion symptom reduction: a pilot randomized trial. Brain Inj. 2022;36(7):851–861.
- Leddy JJ, Baker JG, Kozlowski KF, et al. Reliability of a graded exercise test for assessing recovery from concussion. Clin J Sport Med. 2011;21(2):89–94.