Jordan Loewenstein, D.C. | La Jolla Chiropractor
Quick answer: a headache that starts in the days after a car accident is most often coming from the upper neck, not the head: the small joints and muscles just below the skull are strained in a whiplash motion and refer pain up and over the scalp. That type responds well to treatment of the neck. The second common cause is a concussion, which can happen without hitting your head and comes with fog, light sensitivity and poor concentration. A headache that is severe and getting worse, or that comes with vomiting, confusion, slurred speech or weakness, is an emergency department problem first.
The most common one I see. The upper two or three neck joints and the small suboccipital muscles share nerve pathways with the back of the head and the area around the eye. When those joints are strained and the muscles are guarding, the pain is felt in the head. The tell-tale pattern: it starts at the base of the skull on one side, wraps forward over the ear or behind the eye, gets worse with neck movement or a long stretch at a screen, and is reproduced when the upper neck is pressed. It usually travels with neck stiffness, and it often appears a day or two after the crash rather than immediately.
A concussion is a brain injury from acceleration, and the whiplash motion is enough to cause one without any blow to the head. The headache tends to be more global or pressure-like, and it comes with company: mental fog, trouble concentrating, light or noise sensitivity, nausea, fatigue, poor sleep, irritability. Many people have both a concussion and a neck-driven headache at once, and the neck component is often the one that keeps the headache going after the concussion itself has settled.
A band-like ache across the forehead or the whole head, from sustained muscle tension and the stress and poor sleep that follow a crash. It overlaps heavily with the first type and usually improves with the same treatment plus sleep and stress addressed.
Those point to bleeding, a skull or neck fracture, or an artery injury, and they need imaging at the emergency department first. If you are cleared there, I pick up treatment afterwards.
Same reason as the rest of whiplash: adrenaline hides the pain for hours, and inflammation in the strained joints and muscles builds over 24 to 72 hours. A headache that starts on day two or three after a rear-end collision is the typical story, not an unusual one. The full timeline is in what to do after a car accident.
History first: where it starts, what provokes it, what else came with it. Then the exam: range of motion of the neck, especially rotation of the upper segments; palpation of the upper neck joints and suboccipital muscles to see whether the headache is reproduced; neurological screening; and a concussion symptom check. If the picture suggests a concussion with significant or persisting symptoms, that gets co-managed with your physician. If the picture is cervicogenic, the neck is the target.
Neck-driven headaches after a crash respond well to the same staged care as the rest of the whiplash: in the first week or two, gentle mobilisation of the upper neck joints, soft tissue work on the suboccipital muscles and upper trapezius, heat and electrical stimulation to settle guarding, and a couple of home movements. As the inflammation settles, full adjustments of the restricted segments, and strengthening of the deep neck flexors so the upper neck stops being overloaded. Most people notice headache frequency dropping within the first two to three weeks.
The first visit is 45 minutes and includes the exam above and a decision about imaging based on your symptoms. Follow-ups are 30 minutes. I see accident patients same-day when possible, including Sundays.
If you were hurt and the crash was not your fault, I connect you with a local San Diego personal injury attorney at the first visit if you do not have one, and care is available on a lien. Details on my car accident injury page. For headaches more broadly, see my headache page.
Why do I have a headache days after a car accident?
Most often because the upper neck joints and muscles were strained in the whiplash motion and refer pain to the head. Symptoms appear once adrenaline wears off and inflammation peaks, usually one to three days after the crash.
Can you get a concussion in a car accident without hitting your head?
Yes. The rapid acceleration of a whiplash motion can cause a concussion with no direct impact. Fog, light sensitivity, nausea and poor concentration alongside the headache point that way.
When is a headache after a car accident serious?
If it is severe and worsening, comes with vomiting, confusion, drowsiness, slurred speech, weakness, double vision or a seizure, or if you are over 65 or on blood thinners. Those need an emergency department first.
Can a chiropractor help with headaches after a car accident?
Yes, when the headache is cervicogenic, meaning it comes from the upper neck. Treatment of the upper neck joints and muscles has good evidence for that type. Concussion-related headaches are co-managed with your physician.
How long do post-accident headaches last?
Neck-driven headaches usually improve within two to six weeks with treatment. Post-concussion headaches most often settle within a few weeks but can persist longer, especially if a neck component is left untreated.
Headaches since a crash? Call (858) 558-3111 or book online for a same-day evaluation at my UTC San Diego office.
Dr. Loewenstein diagnoses the actual source of your pain before treating it — soft tissue work, adjustment, and rehab in one visit. Most major insurance accepted, no packages or contracts.