A concussion is a mild traumatic brain injury, typically resulting from a blow to the head or a jolt to the body that causes the brain to move rapidly inside the skull. This sudden movement initiates chemical changes and sometimes minor damage to brain cells, leading to a temporary loss of normal brain function. Neck pain is an extremely common, yet often overlooked, symptom that follows this type of injury. A significant number of individuals who sustain a concussion experience neck discomfort, validating the connection between the two conditions. This co-occurrence is important to recognize, as neck involvement can complicate recovery and prolong symptoms.
The Direct Link Between Concussion and Neck Pain
The forces that cause a concussion—rapid acceleration and deceleration of the head—rarely affect the brain in isolation. These forces are mechanically transmitted through the neck, often causing a simultaneous soft tissue injury known as whiplash. Neck pain is one of the most frequently reported physical symptoms following a head injury, reported by a majority of patients with a mild traumatic brain injury. This high frequency confirms that the head and neck function as a single unit during trauma. The violent movement strains the muscles, ligaments, and joints of the cervical spine, linking the structural neck injury directly to the neurological concussion injury.
Anatomical Mechanisms of Co-Occurrence
Mechanical Injury
The primary reason for neck pain after a concussion is the mechanical soft tissue injury to the cervical spine that occurs at the moment of impact. The extreme whipping motion can strain muscles and ligaments, leading to instability and pain in the neck structures. The force required to cause a mild traumatic brain injury is significantly higher than the force needed to cause a neck injury, making co-occurrence highly probable.
Cervicogenic Headaches and Dizziness
The upper part of the neck, specifically the first three cervical vertebrae (C1-C3), plays a unique role in headache and dizziness following a concussion. Nerves originating from this upper cervical region converge with the trigeminal nerve, which transmits sensory information from the face and head. Irritation or dysfunction in the C1-C3 area can send pain signals that the brain interprets as a headache originating from the head itself, known as referred pain or a cervicogenic headache. Damage to the proprioceptive organs in the neck muscles and joints can also send misinformation to the brain about head position. This faulty sensory input contributes to symptoms like dizziness, balance issues, and disequilibrium.
Differentiating Concussion Symptoms from Neck Symptoms
Distinguishing between symptoms caused by the brain injury and those caused by the neck injury is important for effective treatment. A concussive headache is typically accompanied by neurological symptoms like sensitivity to light and sound, cognitive fog, and memory issues.
Conversely, a cervicogenic headache originates from the neck and has distinct features. Key differentiating symptoms include pain that begins at the base of the skull and radiates to the front of the head, often worsening with specific neck movements or sustained postures. Restricted range of motion or a feeling of stiffness in the neck strongly suggests a cervical component to the pain.
Physical examination is a primary tool for making this distinction. If applying pressure to certain points in the neck recreates the patient’s headache, it indicates a mechanical, cervical origin. Identifying the true source of the symptom allows for targeted interventions.
When to Seek Medical Attention and Initial Steps
Immediate medical attention is necessary if you experience any clear “red flag” symptoms following a head or neck injury. These signs indicate a potentially more serious complication requiring emergency care. Red flag symptoms include severe or worsening headache, repeated vomiting, increasing confusion, double vision, or weakness/tingling in the arms or legs.
For mild neck pain without these immediate warning signs, initial self-management involves rest and avoiding activities that aggravate the pain. Applying ice to the painful area can help reduce inflammation and discomfort.
A thorough clinical assessment can confirm the diagnosis, rule out a more severe injury, and determine if the neck is contributing to persistent symptoms. A specialized provider can then recommend appropriate therapies, which may include physical therapy to restore neck mobility and strength. Prioritizing a comprehensive evaluation ensures that both the brain and the neck injuries are addressed for a complete recovery.