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  • Writer's pictureSam Kelokates

Overcoming Post-Traumatic Headaches After Head or Neck Injury

Updated: Feb 15

Post-Traumatic Headaches (PTH) is a condition that can occur following a concussion and whiplash injury. This persistent headache, often overlooked, carries a significant impact on the daily lives of those affected.

male physical therapist, standing next to male patient sitting on edge of exam table, touching back of patient's neck
Neck Exam

Post-Traumatic Headaches are a type of headache that occurs after a head injury, such as a concussion or as a result of whiplash—a neck injury commonly caused by a sudden, forceful back-and-forth movement of the neck.

These headaches can manifest as a dull, throbbing pain, often accompanied by sensitivity to light and noise, and can significantly affect one’s daily routine and quality of life. Sometimes people refer to this a headache with migraine-like features.

While concussions, a form of mild traumatic brain injury, are mostly associated with sports or high-impact activities, they can occur in various everyday situations, leading not only to headaches but also to symptoms like dizziness, fatigue, and neck pain.

Whiplash, on the other hand, often results from vehicular accidents or falls, and can cause a range of neck-related discomforts, further contributing to the onset of post-traumatic headaches.

Understanding the intricacies of PTH, its connection to concussions and whiplash, and the resulting neck pain and other symptoms, is crucial for effective management and recovery.

This blog aims to provide valuable information and guidance for individuals navigating the challenges posed by post-traumatic headaches and related conditions.


Understanding Post-Traumatic Headaches

Post-Traumatic Headaches (PTH) are more common than many might think, affecting a significant portion of those who have suffered head injuries. Studies reveal that nearly half of individuals with a history of traumatic brain injuries, including concussions, experience PTH.

Interestingly, these headaches can persist for more than six months in about 50% of these cases, and a notable 20% continue to struggle with symptoms for over a year. This prevalence highlights the need for increased awareness and understanding of PTH.

But what exactly happens in the body to cause these post-traumatic headaches? In simpler terms, when the brain experiences a sudden jolt or impact - like in a concussion or whiplash - it can cause a temporary disturbance in the brain's normal functions. Think of it like a short circuit in a complex electrical system.

This disruption can lead to changes in how our brain perceives pain, making it more sensitive and reactive, resulting in persistent headaches. Additionally, the muscles and nerves in the neck can also be affected during a whiplash injury, contributing further to headache development.

The key to managing PTH effectively lies in its early and accurate diagnosis. It's essential to recognize the symptoms early and consult a healthcare professional. A prompt diagnosis not only helps in addressing the headaches more effectively but also aids in ruling out other potential causes of the pain. Early intervention can significantly impact the course of recovery, helping individuals manage symptoms better and potentially reducing the long-term impacts of PTH.

Understanding these aspects of Post-Traumatic Headaches – their prevalence, the underlying bodily changes they involve, and the importance of early diagnosis – is crucial. This knowledge empowers individuals to seek timely and appropriate care, paving the way for a smoother recovery journey.

The Role of Physical Therapy in Post-Traumatic Headache, Concussion, and Whiplash

Physical therapy stands at the forefront of treating Post-Traumatic Headaches (PTH), concussions, and whiplash. Physical therapists play a crucial role in not just treating but comprehensively managing these conditions. The focus is on holistic care that addresses both the symptoms and the root causes of post-traumatic headaches.

Comprehensive Evaluation: The First Step in PTH Management

One of the key elements in the treatment of PTH is the comprehensive evaluation process conducted by physical therapists. This involves a detailed assessment of various bodily systems that could be influencing the headaches.

First, an evaluation of the cervical spine is conducted. Since the neck and spine are often affected in traumatic injuries like whiplash, understanding their condition is essential.

Physical therapists look for any signs of muscle strain, joint injuries, or nerve irritations that might be contributing to the headache pain.

The vestibular system, which is responsible for maintaining balance and spatial orientation, is also assessed. Concussions can disrupt this system, leading to symptoms like dizziness or balance problems that often accompany post-traumatic headache.

A thorough vestibular assessment helps in identifying these issues and formulating a targeted treatment plan. Moreover, neurological assessments are crucial, especially following a concussion.

These evaluations focus on neurological function and can reveal any changes in reflexes, strength, sensation, or coordination, all of which can influence headache severity and frequency.

Emphasizing a Patient-Centric Approach

Central to the physical therapy approach is its patient-centric nature. This means that every treatment plan is tailored specifically to the individual’s needs and symptoms.

As a physical therapist, I work closely with patients to understand their specific challenges and goals. This collaborative approach ensures that the therapy is not just about alleviating symptoms but also about empowering patients with the knowledge and strategies to manage their condition in the long term.

Physical therapists play a pivotal role in managing post-traumatic headache, especially when related to concussions and whiplash.

Their comprehensive evaluation and patient-centered approach provide a solid foundation for effective treatment, helping individuals on their journey to recovery and improved quality of life.

Comprehensive Treatment & Empowerment in PTH Management

The treatment of Post-Traumatic Headaches and related symptoms in physical therapy is a dynamic and individualized process, that focuses on addressing the impairments found during the comprehensive evaluation discussed earlier.

Recognizing the unique nature of each patient's condition, makes development of targeted interventions tailored specifically to address the distinct challenges presented by each case.

Innovative Treatment Strategies

A cornerstone of these treatment strategies is the use of manual therapy techniques. These hands-on approaches focus on the delicate structures of the neck and head, particularly targeting the suboccipital muscles located at the base of the skull.

These muscles are often implicated in post-traumatic headaches. By applying gentle and precise manual therapy techniques, physical therapists work to restore normal muscle tone and decrease the tension that may contribute to headaches.

In conjunction with manual therapy, exercises designed to improve neuromuscular control and proprioception are integrated into the treatment plan. These exercises are not just random physical activities.

They are carefully chosen to strengthen the neuromuscular connections, particularly in the cervical spine region. By enhancing stability and control in this area, these exercises help in reducing symptoms like dizziness and neck pain, which often accompany PTH.

An important aspect of these interventions is addressing any mobility deficits in the upper cervical spine. Over-guarding or excessive tightness in this area can be a potential source of persistent headaches following a concussion or whiplash.

Through a combination of manual therapy and neuromuscular control exercises, therapists work to restore balance in muscle tone and joint movement, alleviating the strain that might be causing headaches.

Once significant progress is achieved in restoring function and alleviating symptoms, the focus shifts to developing a maintenance program. This program is designed to sustain the normal function and control of the cervical spine, ensuring long-term relief and preventing the recurrence of symptoms.

The importance of symptom provocation cannot be overstated in this treatment process. By carefully inducing symptoms in a controlled environment, physical therapists can gain invaluable insights into the specific triggers and patterns of a patient’s headaches. This information is critical in refining the treatment plan, ensuring that it is as effective and targeted as possible.

Patient Education and Home-Management Techniques

Education provided to patients on managing their condition outside the clinic is vital to long-term success. As treatment progresses, therapists identify which interventions are most effective for each individual and develop customized home-management strategies.

These strategies may include specific exercises, posture correction techniques, and relaxation exercises to maintain the improvements achieved during therapy sessions.

Consistent adherence to these home-management techniques is emphasized for lasting relief. Patients are also educated on recognizing early signs of symptom exacerbation, enabling them to manage their condition proactively.

This empowerment allows patients to make informed decisions about their activities and lifestyle, playing a crucial role in their overall recovery and quality of life.

This comprehensive strategy ensures not only immediate relief from symptoms but also equips patients with the tools and knowledge for sustained health and well-being.

The Journey to Recovery from Post-Traumatic Headache

The journey to overcome Post-Traumatic Headaches (PTH) is a path marked by the harmonious blend of professional physical therapy guidance and personal commitment from patients.

Understanding that recovery is a continuous process, adapting to various challenges, and celebrating each milestone is essential in this journey.

The Role of Professional Physical Therapists in Treating Post-Traumatic Headache

Professional guidance from skilled physical therapists, like myself, is the cornerstone of this journey. Our expertise in diagnosing, treating, and managing post-traumatic headache ensures that patients receive care that is not only effective but also personalized.

At Kelos Physical Therapy, I provide the necessary tools and techniques, such as specific exercises and manual therapy, tailored to each individual's unique condition.

This professional support is invaluable in navigating the complexities of PTH and related conditions.

The Importance of Patient Commitment in the Recovery Process

However, the success of this journey is also reliant on personal commitment from the patient themselves.

The willingness to follow through with prescribed treatment plans, engage in home-management techniques, and make necessary lifestyle adjustments plays a crucial role in the effectiveness of the recovery process.

It's this active participation and dedication from patients that truly drives the progress and leads to meaningful improvements in their condition.

The Power of a Supportive Therapeutic Relationship

Beyond the treatments and exercises, the journey to recovery from post-traumatic headache is significantly enhanced by a supportive therapeutic relationship. You, the patient and therapist form a strong team

This relationship is not just about medical treatment. It's about having someone there to help guide you, listen to your concerns about treatments, and empathize throughout the recovery process.

The importance of this supportive connection cannot be overstated, as it often makes a significant difference in how patients perceive their journey and their overall outcomes.


The journey to recovery from PTH is a collaborative one, requiring both professional guidance and personal commitment.

As a physical therapist, I am deeply committed to this journey, offering my expertise, support, and care to guide patients through the challenges of PTH and related headache conditions.

The goal is not just to alleviate symptoms but to empower each individual to regain their quality of life.

If you or someone you know is struggling with Post-Traumatic Headaches or related conditions, I encourage you to reach out.

Take the first step in your journey to recovery and wellness. Contact me for personalized care and support tailored to your unique needs.

Together, we can navigate the path to recovery and restore the balance and comfort you deserve in your life.

About Me:

Hi, my name is Sam Kelokates, PT, DPT. I am a licensed physical therapist and owner of Kelos Physical Therapy, located in Philadelphia, PA. I specialize in the non-pharmacological management of headache and migraine disorders.


This blog post is for informational purposes only and should not replace professional medical advice or treatment. Always consult with a qualified healthcare provider for personalized guidance and recommendations.

**I may earn commissions for purchases made through the links in this post**

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