Headache after whiplash injury is common. After neck pain it is the second commonest symptom that these patients experience. The cervical spine originating head pain can often outweigh the neck pain in terms of severity – particularly in the early weeks after injury.
Nearly two thirds of cervical spine injury patients experience headache. About half of those who develop it after whiplash injury feel the pain in the back of their head, a further third get symptoms all over the head and a smaller number feel the whiplash related discomfort at their forehead or behind their eyes.
Headache after whiplash injury often shows itself for the first time on the morning after the accident. The pain sweeps up from the neck and over the back of the head. Most sufferers find that heat on the back of the neck will ease the headache. Cold makes it worse.
Neck movements often aggravate the problem – particularly if the neck is moved towards extension: looking up to the ceiling is often very painful.
Patients with whiplash related head pains often also get shoulder pain and touching the big trapezius muscles over the back of the neck and shoulders often provokes pain or spread of symptoms upwards. There are often tender spots or trigger points in these muscles.
Women get pains in the head after whiplash injury more often than men – the reason for this is unclear but might relate to the smaller structures of the female neck anatomy.
So what causes whiplash injury headache? Many research studies have looked to explain why this problem happens. It seems most likely that the situation arises from a mixture of inflammation in the neck muscles and irritation of the nerves that go from the neck, up and over the head.
Research has shown that whiplash injury headache can persist for a year or more in some patients – but for most the head pain improves within a month or two of the accident.
How should it be treated? Well, the research is not good quality so there is no definitive answer to this. In my experience the symptoms are often quickly improved by hands on physical therapy or by acupuncture. Anti-inflammatory tablets help some patients and – for a minority of these patients – injections deep into the spinal tissues can transform the situation.