A concussion is a mild traumatic brain injury (mTBI) caused by a bump, blow, or jolt to the head that disrupts normal brain function. Post-Concussion Headache (PCH) is one of the most frequently reported symptoms following this type of injury. This condition results from a complex neurobiological disruption and often presents similarly to tension-type headaches or migraines. Understanding the expected duration of PCH is a common concern for those recovering, though the timeline is highly variable.
The Typical Timeline for Post-Concussion Headaches
The majority of post-concussion headaches follow an acute timeline, typically resolving relatively quickly as the brain heals. For adults, symptoms, including headaches, generally clear within two to four weeks following the injury. For children and adolescents, the recovery period can be slightly longer, often taking up to four weeks for full resolution.
A post-traumatic headache is defined as one that begins within seven days of the concussion or an existing headache that significantly worsens after the injury. The vast majority of people (80% to 90%) see their concussion symptoms resolve within two to three weeks with appropriate management and a gradual return to activity. Headaches that persist beyond the expected recovery time are classified as Persistent Post-Traumatic Headache (PPTH). This persistence is defined as symptoms lasting longer than three months, though some individuals may experience them for a year or more.
Variables That Influence Headache Duration
The duration of a post-concussion headache is not solely determined by the severity of the initial injury, as even mild impacts can lead to prolonged symptoms. One significant factor influencing duration is a pre-existing history of headaches or migraines. Individuals who had frequent headaches before the concussion are more likely to experience a prolonged recovery and develop PPTH.
The presence of other post-concussion symptoms also affects recovery, as a higher overall symptom load immediately following the injury is associated with longer recovery times. Emotional symptoms like anxiety, depression, and stress can complicate the recovery process and may worsen headache frequency and intensity. A delay in seeking initial medical care or a worsening of symptoms between the time of injury and the first physician visit can predict a more protracted recovery. Female sex and older age have also been linked to a longer duration of post-concussion symptoms in some studies.
Lifestyle Adjustments for Headache Relief
Managing post-concussion headaches often involves non-pharmacological strategies that focus on supporting the brain’s natural healing process. Maintaining excellent sleep hygiene is important, as sleep is when the brain undergoes much of its repair work. This involves going to bed and waking up at consistent times, while ensuring the sleep environment is dark and quiet.
Structured rest is recommended, but this does not mean complete isolation or sensory deprivation. After a short initial period of rest, a gradual return to light cognitive and physical activity, known as controlled aerobic exercise, is often beneficial. It is important to stay well-hydrated by consuming four to six non-caffeinated drinks per day, and to avoid skipping meals, as hunger and dehydration can act as headache triggers.
Stress management techniques, such as mindfulness, deep breathing exercises, or progressive muscle relaxation, can help to calm the nervous system, which may reduce the severity of headaches.
Warning Signs Requiring Medical Consultation
While most post-concussion headaches are part of a normal recovery, certain symptoms are considered “red flags” and require immediate medical attention. A headache that suddenly worsens, becomes severe, or does not go away is a cause for urgent concern. This is especially true if the headache is accompanied by repeated vomiting or nausea.
Changes in neurological function, such as seizures or convulsions, slurred speech, or new weakness or numbness in the arms or legs, warrant an emergency room visit. Any change in the level of consciousness, including increasing drowsiness, an inability to wake up, or significant confusion, indicates immediate evaluation. For headaches that persist beyond three months, a follow-up with a specialist, such as a neurologist or an interdisciplinary concussion clinic, is necessary to develop a targeted treatment plan for PPTH.