A concussion, or mild traumatic brain injury (mTBI), is a functional disturbance to the brain caused by a blow to the head or an indirect force to the body. While immediate symptoms are neurological, such as headaches, dizziness, and cognitive difficulties, the effects are not confined solely to the head. A clear link exists between a head injury and the subsequent development of back pain. Understanding this connection requires considering the full mechanical and neurological impact on the body.
The Direct Link: Associated Neck and Spinal Trauma
The most straightforward connection between a concussion and back pain is the simultaneous injury to the cervical spine (neck) during the initial traumatic event. The forces that cause the brain to accelerate and decelerate are the same forces that violently strain the neck. This mechanism, known as whiplash, often injures the muscles, ligaments, and joints of the neck and upper back.
Because the neck and upper back are injured at the same moment as the brain, it is difficult to distinguish symptoms arising from the concussion versus those originating from the spine. The symptoms of whiplash—including neck pain, headaches, and dizziness—significantly overlap with concussion symptoms. Therefore, the back pain co-occurs due to the shared mechanism of injury rather than being caused by the concussion itself.
Postural Changes and Movement Mechanics
Back pain can develop as a secondary consequence of neurological symptoms, impacting the body’s movement mechanics. The brain injury disrupts the body’s system of balance and coordination, which relies on vestibular, visual, and somatosensory inputs. When a person experiences dizziness or instability, they often adopt altered movement strategies to avoid falling or aggravating symptoms.
This behavioral change includes holding the head and neck stiffly, a protective response known as “guarding,” and developing an unsteady walking pattern (gait disturbance). These unnatural postures shift the body’s center of gravity and place unaccustomed strain on the lower back muscles (lumbar spine). This chronic muscular overcompensation and imbalance can eventually lead to persistent musculoskeletal back pain.
Altered Pain Perception Following Concussion
A complex neurological link involves how the brain processes pain signals after an injury, even without new structural damage. Traumatic brain injury can disrupt the central nervous system’s ability to filter and modulate sensory input, a phenomenon known as central sensitization. This lowers the threshold for pain, causing the nervous system to become hypersensitive and amplify pain signals.
This hypersensitivity manifests as hyperalgesia, where a normally painful stimulus is perceived as more intense, and allodynia, where a non-painful stimulus causes pain. For the back, this means minor muscle tension or normal bodily sensations can be interpreted by the sensitized nervous system as severe, chronic pain. High levels of central sensitization are often observed in patients who develop chronic pain following a concussion.
Managing Concurrent Symptoms
When back pain occurs alongside concussion symptoms, a comprehensive assessment addressing both the neurological and musculoskeletal systems is required. Effective management involves a multidisciplinary approach to identify and treat all contributing factors. Specialists such as neurologists, physical therapists, and sports medicine physicians create individualized treatment plans.
Treatment focuses on restoring normal function through controlled exercises that address balance deficits and postural instabilities. Complete bed rest is avoided in favor of a gradual return to activity, including light aerobic exercise as tolerated. Addressing concurrent symptoms of the head and spine simultaneously promotes recovery and helps prevent chronic back pain.