The one-minute brief
- New headaches after a crash are common and can come from the neck, from a concussion, or both. The exam sorts that out, not a guess.
- A headache that starts at the base of the skull and wraps forward often tracks with neck strain.
- Sudden severe headache, a headache that keeps worsening, vomiting, or confusion is an emergency room trip now.
- Tell the clinician about the headache even if the neck is the reason you came. It is part of the same injury week.
- Keep a three-line morning log: where, how bad, anything new. It makes the exam more useful.
That is the brief. The longer read follows for anyone who has the time this morning.
Headache is an easy symptom to dismiss, because everyone gets them and because the week after a crash is stressful enough to earn one on its own. That is exactly why it deserves its own edition. A headache that starts after a rear-end hit is information, and the clinician you see this week should hear about it.
Two common sources, sometimes both
The first is the neck. The upper part of the cervical spine and the muscles that attach at the base of the skull are loaded hard in a rear-end collision. When they are strained, the pain often refers forward, starting at the back of the head and wrapping toward the temple or behind the eye. It tends to be worse with certain neck positions and better when the neck is supported. The NINDS headache information page describes headache that arises from neck structures as one of the recognized secondary headache types.
The second is a concussion. A headache is the most commonly reported symptom after a mild traumatic brain injury, and as the concussion edition explains, you do not have to hit your head or lose consciousness for the brain to have been jolted. Post-traumatic headache can come with fog, light sensitivity, and nausea. It can also come alone.
Many crash patients have some of both. That is normal, and it is the reason the desk keeps saying the same thing: an exam sorts it out, a guess does not.
Why it belongs in the record
People leave the headache out of the exam because they came in for the neck and the headache feels like a separate complaint. It is not. A dated note that says "headache beginning at the base of the skull, started day two, worse in the afternoon" is a finding. It tells the clinician something about which structures were loaded, it gives a baseline for whether the plan is working, and if a claim is ever part of your story, it is the kind of detail everyone will ask for later and nobody can reconstruct from memory.
That is a care reason first. The dated record exists so the next clinician works from facts. The headache is one of the facts.
The morning log
Three lines, each morning, in your phone: where the headache is, how bad on a scale you would use with a friend, and anything new. Light bothering you today. Screen time feeling heavier. A stiff neck on one side. Thirty seconds. By the exam, you have a short honest timeline instead of a shrug, and a clinician can do far more with a timeline than with a shrug.
The one action this desk asks for
Bring the headache to the exam.
Missouri Injury Clinic publishes both an auto injury lane and a TBI and concussion rehab lane. Say on the phone that it was a crash and that a headache started afterward. That one sentence gets the right questions asked at the first visit.
What a clinician will want to know
When it started relative to the crash. Where it sits and whether it moves. What makes it better or worse: position, screens, light, sleep. Whether there is nausea, dizziness, or fog with it. Whether you have a history of migraine or other headaches, because a crash can change a familiar pattern and the clinician needs to know what your normal was.
Ask plainly what they found and what the plan is. Ask what would make them send you somewhere else. If the answer involves imaging or a different specialty, that is the system working.
What the desk does not know
It does not know what is causing your headache, and it will not pretend to. It does not know how long a plan takes or what a visit costs; ask the clinic. Joseph L. Hollingsworth, DC, is a chiropractor, and this desk is advertising material for his clinic. Nothing here is medical advice, legal advice, or a comment on anyone's insurance. It is an argument for getting examined by someone who can look at you.
Sources: NINDS, headache; CDC, traumatic brain injury and concussion; NINDS, whiplash.