First: when a headache is an emergency
A severe or worsening headache, confusion, repeated vomiting, or loss of consciousness after a crash needs the emergency room now — not an appointment. Call 911 or go to the nearest ER.
How a neck injury causes a headache
The quick back-and-forth movement of a collision stresses the ligaments, muscles and discs of the neck. The upper neck and the base of the skull share nerve supply with the back and sides of the head, so an injury in one is felt in the other.
A headache that starts in the neck this way is called a cervicogenic headache. The name is worth knowing, because most of what you find when you search for headaches after a crash is about migraines and concussions, and this is neither.
Where it is usually felt
- At the base of the skull, where the neck meets the head — often more on one side than the other
- Spreading forward over the head, sometimes settling behind an eye or across a temple
- Worse after holding one position — a screen, a long drive, a night on the wrong pillow
- Together with a stiff neck, getting worse and better along with it
None of this is a way to diagnose yourself. It is what to notice, and what is worth describing accurately when you are asked.
What else it could be
A head injury. A headache after a blow to the head — especially with confusion, memory trouble or repeated vomiting — is a different problem from a neck injury, and it is outside this practice. Start with the emergency room.
A migraine pattern. A crash can make migraines you already had worse without being their cause. What matters is whether this headache is like the ones you already know, or new since the crash.
These can overlap. One collision can injure the neck and the head at the same time, which is why being examined is more useful than deciding between them from a search result.
When it is worth being examined
- A headache that hasn't eased after a week or so
- One that is getting worse rather than better
- One that comes with pain or numbness running into an arm
- One that is interrupting your sleep
The reason is not that a headache from the neck is dangerous. It is that it is treated by treating the neck, and the sooner it is clear what is actually injured, the less time goes into treating the wrong thing.
What a physician-directed plan looks like
The examination establishes where the pain is provoked from, whether the neck is moving as it should, whether a nerve is involved, and whether the pattern fits a neck origin or points somewhere else. Imaging follows only if the examination raises a question it would answer.
If it is the neck, the plan treats the neck — explained before anything starts, and rechecked against what it was meant to do. What is working continues; what isn't, changes.
Questions people ask
Why did my headache start days after the crash?
For the same reason most crash symptoms do. Adrenaline masks pain in the first hours and then wears off, and inflammation builds over the next one to three days.
Is it a concussion, or my neck?
Often you can't tell on your own — the patterns overlap, and one crash can cause both. A headache after a blow to the head, with confusion, memory trouble or vomiting, belongs in the emergency room first.
Do I need a scan?
Not necessarily. Imaging is ordered when the examination points to something it would answer.
Care here is directed by Miguel Jimenez, MD, an orthopedic spine surgeon — residency at Mayo Clinic, spine fellowship at Hospital for Special Surgery, and 23+ years in practice in Georgia. Full background