Headaches after a car accident are one of the most common crash injuries, and they often show up hours or even days later. Most of them are not coming from the head at all. They start in the neck. The sudden back-and-forth motion of a collision, known as whiplash, strains the joints, discs, muscles, and nerves of the upper neck. Pain from those structures travels along shared nerve pathways into the base of the skull and spreads upward, which is why so many post-accident headaches feel like they begin at the back of the head. Even a low-speed rear-end collision can cause this kind of injury.
Why does my head hurt at the base of my skull after a crash?
The upper neck and the back of the head share nerve connections. Two small nerves called the occipital nerves run from the top of the neck up over the back of the scalp. When the tissues around them are strained or inflamed after whiplash, those nerves become irritated. The result is pain that starts at the base of the skull, often on one side, and moves up and over the head toward the temple or behind the eye.
Other neck structures cause the same pattern. The facet joints, the small joints on the back of each vertebra, are a frequent source of post-accident headache. A disc in the neck that bulged or tore during the crash can also cause pain to travel upward. A concussion can add its own headache on top of the neck pain, which is one reason to get a proper evaluation.
What does a whiplash headache feel like?
Whiplash headaches are usually a dull, pressing, or throbbing ache at the back of the head that gets worse with neck movement, long screen time, or sleeping in an awkward position. They often come with a stiff neck, tenderness at the base of the skull, and sometimes dizziness or trouble concentrating. Pain that spreads from one side of the neck into the same side of the head is a strong sign that the neck is the source.
Signs that mean you should be seen right away rather than waiting:
- A headache that is the worst you have ever had, or one that came on like a thunderclap
- Confusion, repeated vomiting, slurred speech, or trouble staying awake
- Weakness, numbness, or tingling in the arms or hands
How long does a whiplash headache last?
For many people, headaches fade over a few weeks as the soft tissues heal. But a meaningful number of patients still have headaches months after the accident, and some develop chronic daily headaches if the neck injury is never treated. Headaches that last longer than a few weeks, that are getting more frequent, or that return years later usually mean a joint, disc, or nerve problem is still active and should be evaluated.
How are headaches after a car accident treated?
Treatment starts with a careful exam of the neck and imaging when needed, because the plan depends on which structure is generating the pain. Early on, gentle range-of-motion work, physical therapy, heat, and short-term anti-inflammatory medication help most patients. Long stretches in a soft collar are no longer recommended, since keeping the neck moving supports healing.
When headaches persist, targeted injections can bring relief that medication cannot. An occipital nerve block places numbing medicine and a small amount of steroid around the occipital nerves at the base of the skull. Many patients feel relief within minutes, and the block also confirms that those nerves are the source. For headaches coming from the facet joints, a medial branch block numbs the tiny nerves that carry pain from those joints. If that works, radiofrequency ablation can quiet the same nerves for months at a time. Cervical epidural steroid injections are an option when an injured disc is irritating a nerve root.
Our board-certified neurosurgeons and interventional pain physicians perform these procedures in the office with image guidance and use the results to guide the next step. Surgery is reserved for the small group of patients with a disc or nerve injury that does not respond to these measures.
Getting checked after an accident in Florida
Even if you felt fine at the scene, a headache that appears in the days after a car accident deserves attention, and documenting the injury early also matters for your auto insurance claim. Florida Surgery Consultants accepts auto insurance and treats car accident injuries at all of our locations. If headaches have followed you home from an accident, schedule an appointment at Florida Surgery Consultants so our team can find the source and start treatment.
