Headaches After Concussion: Why They Happen and What Can Help
Headaches are common after a concussion, but the word "headache" does not explain why the pain is happening.
You may feel pressure across your forehead, pain behind your eyes, tightness at the base of your skull, or a throbbing headache that becomes worse with light, sound, or activity. Another person may point to the same location but have a different headache pattern and need a different recovery plan.
The encouraging news is that a persistent headache does not mean you are out of options. Understanding the pattern, triggers, and body systems involved can make treatment more specific and recovery feel less confusing.
What Does Post-Traumatic Headache Mean?
A post-traumatic headache is a new headache, or a significant worsening of a previous headache, that begins in close relationship to a head or neck injury. The term explains when the headache started. It does not identify one specific cause or one treatment that works for everyone.
After a concussion, the nervous system may become more sensitive to light, sound, movement, exercise, stress, and sleep changes. The injury may also affect the neck, visual system, balance system, or ability to tolerate physical activity. More than one of these factors can contribute at the same time.
Common Reasons Headaches Happen After Concussion
Migraine-like headache
Many post-concussion headaches resemble migraine. The pain may throb or pulse and may come with nausea, light sensitivity, sound sensitivity, motion sensitivity, or worsening with activity. This pattern can develop after an injury even if you have never been diagnosed with migraine.
Neck-related headache
A neck-related headache may begin near the upper neck or base of the skull and travel toward the temple, forehead, or eye. It may change with neck movement, posture, or time spent in one position.
Visually triggered headache
Reading, computer work, scrolling, tracking moving objects, or shifting focus between near and far targets may trigger a headache when the visual system is not working efficiently or the nervous system is highly sensitive to visual demand.
Other factors that can lower your headache threshold
Poor sleep, dehydration, skipped meals, stress, dizziness, reduced exercise tolerance, jaw problems, and frequent use of some pain-relieving medications may all contribute. Do not change medication on your own. Review frequent medication use with a healthcare professional.
Important: Pain location can provide a clue, but it cannot identify the source by itself. Forehead pain is not automatically a vision problem, and pain at the base of the skull is not automatically a neck problem.
How Long Can Headaches Last After a Concussion?
Many headaches improve as concussion recovery progresses. For some people, they continue for weeks or months. Persistent symptoms do not automatically mean a serious injury was missed, but they do deserve a more specific evaluation.
Recovery time varies based on the headache pattern, personal or family migraine history, sleep, stress, neck injury, activity level, and other concussion symptoms. Your recovery timeline does not need to match someone else's.
Common Mistakes That Can Slow Progress
1.Treating every post-concussion headache the same. Migraine-like, neck-related, and visually triggered headaches may need different strategies.
2.Using pain location as the diagnosis instead of looking at the full pattern and triggers.
3.Returning to complete rest every time a mild headache appears. Long periods of avoiding activity can make it harder to rebuild normal tolerance.
4.Repeatedly pushing through severe or escalating symptoms. Large or lasting flares are a sign that the activity may need to be adjusted or the headache reassessed.
5.Relying only on medication while sleep, neck function, vision, exercise tolerance, or migraine triggers remain unaddressed.
Five Practical Recovery Strategies
1.Track the pattern. Note what the pain feels like, how long it lasts, what triggers it, and whether nausea, dizziness, or light and sound sensitivity occur with it.
2.Find the right clinician. Look for someone who can assess both the headache pattern and possible contributors such as the neck, visual system, balance, and exercise tolerance.
3.Make the basics consistent. Keep a regular sleep and wake time, eat at predictable intervals, stay hydrated, and gradually bring movement back into your day.
4.Use a graded approach. Start with a tolerable amount of screen time, reading, work, or exercise. Increase one variable at a time and use planned breaks before symptoms become overwhelming.
5.Match treatment to the main driver. Neck treatment, visual rehabilitation, migraine care, and graded exercise each address different problems. Your plan may include more than one approach.
When to Seek Urgent Medical Care
Most post-concussion headaches are not emergencies. After a recent head injury, seek urgent medical attention for a rapidly worsening or unusually severe headache, especially when it occurs with:
1.Repeated vomiting
2.Increasing confusion or unusual behavior
3.A seizure
4.New weakness or numbness
5.Slurred speech
6.Unequal pupils
7.Fainting or difficulty waking
8.Rapidly worsening balance
Key Takeaways
1.Headache after concussion is not one single problem.
2.The same pain location can come from different headache patterns or body systems.
3.Track triggers and associated symptoms instead of focusing only on pain intensity.
4.Gradual activity is often part of recovery, but severe or lasting flares should not be ignored.
5.A targeted evaluation can help match treatment to the factors that are actually affecting you.
Frequently Asked Questions
Is it normal to have headaches after a concussion?
Headaches are common after a concussion. They may improve gradually, but a persistent or worsening headache should be evaluated so the pattern and contributing factors can be identified.
Why do screens trigger my headache?
Screens place demands on the visual system, attention, posture, and sensory tolerance. A clinician can help determine which factor is most important instead of assuming the problem is only your eyes.
Can my neck cause pain in my forehead or behind my eyes?
Yes, neck-related pain can travel toward the temple, forehead, or eye. However, migraine and visual demand can create pain in the same area, so location alone is not enough.
Should I rest whenever a headache starts?
A short break or activity adjustment may help, but complete rest for long periods is usually not the goal. A graded plan should balance activity with manageable symptoms and recovery between sessions.
Who should I see for a post-concussion headache?
Depending on your symptoms, your care team may include a medical provider, concussion specialist, physical therapist, vestibular therapist, vision professional, or headache specialist.
A More Targeted Path Forward
Instead of asking only, "Where does it hurt?" ask, "What pattern does this headache follow? What brings it on? Which systems may be contributing?" Those questions can move care away from chasing symptoms and toward a more personalized recovery plan.
Next step: Download the free Brain Recovery Project Post-Concussion Symptom Checklist to organize your symptoms and prepare for your next appointment. For a complete recovery framework, explore the Brain Recovery Project Concussion Recovery Course.
Medical note: This article is educational and is not a substitute for individualized medical care. Seek urgent attention for new or worsening warning signs after a head injury.
Sources and Further Reading
1.International Headache Society. ICHD-3: Headache attributed to trauma or injury to the head and/or neck. Open source
2.Patterson Gentile C, et al. American Headache Society white paper on treatment of post-traumatic headache from concussion in youth. Headache. 2024;64(9):1148-1162. Open source
3.Patricios JS, et al. Consensus statement on concussion in sport: the 6th International Conference on Concussion in Sport. Br J Sports Med. 2023;57:695-711. Open source
