Neck Pain After Concussion

The concussion-neck connection most people miss

Here's something that often surprises patients: the force required to cause a concussion is significantly lower than the force required to injure the neck. This means that virtually every concussion involves some degree of cervical spine stress.

Yet neck injuries are frequently overlooked in concussion care. The focus goes to the brain — understandably — while the neck is treated as secondary. The problem is that untreated cervical dysfunction can produce headaches, dizziness, visual disturbances, and cognitive difficulties that mimic or compound concussion symptoms.

If your recovery has plateaued and you haven't had your neck properly assessed, this may be the missing piece.

How neck dysfunction contributes to concussion symptoms

The cervical spine — particularly the upper segments — plays a critical role in head position sensing, visual coordination, and balance. When these structures are injured, they can drive symptoms that are often attributed to the concussion itself:

Cervicogenic headaches

Dysfunction in the upper cervical joints and muscles refers pain into the head, temples, behind the eyes, and across the forehead. These headaches are often mistaken for migraine or purely concussion-related. The distinguishing feature is that they respond to manual therapy targeting the neck.

Cervicogenic dizziness

The upper neck contains dense proprioceptive receptors that communicate with the vestibular system. When these receptors are disrupted by injury, they send inaccurate signals — creating a sense of imbalance, lightheadedness, or spatial disorientation that closely resembles vestibular dizziness.

Visual disturbances

The cervical spine coordinates with the eyes through the cervico-ocular reflex. Neck dysfunction can impair smooth visual tracking and create symptoms like blurred vision, difficulty reading, or visual fatigue.

How we treat the cervical spine after concussion

Our concussion assessment includes a thorough cervical spine evaluation to distinguish cervicogenic symptoms from vestibular or neurological ones. Treatment may include:

• Manual therapy — gentle joint mobilization and soft tissue techniques targeting the upper cervical spine
• Deep neck flexor retraining — strengthening the stabilizing muscles that support the upper neck and reduce strain on pain-sensitive structures
• Cervical proprioceptive exercises — restoring accurate head-position sensing to address cervicogenic dizziness
• Postural correction — addressing forward-head and rounded posture patterns that often develop after injury and perpetuate symptoms
• Integrated vestibular-cervical treatment — when both the neck and vestibular system are involved, treatment addresses both simultaneously

Concussion and whiplash: the overlap

In motor vehicle collisions, falls, and contact sports, concussion and whiplash-associated disorder frequently co-occur. When they do, symptoms from each condition can layer on top of each other, making it difficult to determine what's coming from where.

A thorough assessment that evaluates both the brain and the neck is essential. Without it, treatment may address one source of symptoms while missing the other entirely — and recovery remains incomplete.

Your neck doesn't have to hold your recovery back

Cervical spine dysfunction after concussion is common, underdiagnosed, and highly responsive to treatment. If your concussion symptoms have been slow to resolve — particularly headaches and dizziness — a targeted neck assessment may reveal why.