Concussion Headaches That Won't Go Away: Burlington Guide

It's been weeks, maybe months, since your concussion. The dizziness has settled. You're sleeping better. But the headache? Still there — some days a dull ache behind your eyes, some days a pounding throb that sends you back to a dark room.

If you've typed "why won't my concussion headache go away" into Google, you're not alone, and you're not imagining it. Headache is the single most common and most stubborn symptom after a concussion, affecting anywhere from 30-90% of people after a traumatic brain injury, with about 1 in 5 still dealing with it a year later.

The good news: not all post-concussion headaches are the same, and knowing which type you have changes what actually helps.

Why do concussion headaches stick around?

Doctors call a headache that starts within 7 days of a head injury a post-traumatic headache. If it clears up within three months, it's considered acute. Past that point, it's called persistent post-traumatic headache — and it behaves differently depending on its underlying type.

A few things make someone more likely to end up with a lingering headache: a prior history of migraines or headaches, being female, being younger, a more significant initial injury, and co-occurring anxiety or low mood. None of these mean you're destined for chronic pain — they just help explain why two people with a similar bump to the head can have very different recoveries.

What type of concussion headache do you have?

Most post-traumatic headaches fall into one of three patterns, and many people experience more than one at the same time.

Migraine-type

Throbbing or pulsatile pain, often on one side, that can be severe enough to put you out of commission. It typically lasts anywhere from 4 to 72 hours and may come with light sensitivity, nausea, or sound sensitivity — essentially a migraine, triggered by the head injury.

Tension-type

A dull, aching, band-like pressure, usually mild to moderate. It tends to be shorter-lived than a migraine, though it ranges widely — from 30 minutes to several days. It's often described as a tight cap around the head rather than a pulsing pain.

Cervicogenic (neck-driven)

This one starts in the neck and refers pain up into the head or face. On exam, it often comes with reduced neck range of motion, tender or tight muscles at the base of the skull, and pain that reproduces when the upper neck is moved or pressed. It's frequently mistaken for a tension headache because the two can feel similar.

In younger people especially, a mix of migraine-like and tension-type headache is the most common combination around four months post-injury, found in roughly 40% of cases. Pure migraine-like headache is the next most common at around 36%.

Why does treating the neck help a headache that started with a head injury?

This is the part that surprises most people. The nerve that carries pain signals from the face and head (the trigeminal nerve) and the nerves from the top of the neck physically converge in the same spot in the brainstem — a meeting point known as the trigeminal-cervical convergence.

In practice, this means irritation in the upper neck can produce pain that feels exactly like it's coming from the head, and it can also aggravate migraine-type symptoms. Treating the neck doesn't just address a separate "neck headache" — it can calm the whole trigeminal-cervical system, including the migraine-like pain.

This is well supported in the research: in one case series, people with persistent concussion symptoms who received manual therapy to the neck alongside vestibular (balance and eye movement) rehab improved more than those who only did postural education, gentle range-of-motion work, and graded return to activity. In another small study, early neck-focused physiotherapy and simple deep neck strengthening brought headache ratings down to near zero in an average of just three visits.

For more on how the neck and brain interact after a crash specifically, our article on concussion after a car accident covers why this connection gets missed so often in emergency and walk-in settings.

What actually helps a lingering concussion headache?

Treatment works best when it's matched to the headache type rather than applied as a one-size-fits-all approach.

• Cervicogenic headache: manual therapy to the upper neck, deep neck flexor strengthening, and addressing posture and movement patterns that keep the neck irritated.
• Migraine-like headache: consistent sleep and meal timing, hydration, regular low-intensity cardiovascular exercise (started gradually), and stress-management strategies; medication decisions are best made with your physician.
• Tension-type headache: often responds to a combination of neck-focused manual therapy, graded activity, and relaxation-based strategies.
• All types: a vestibular and visual assessment is worthwhile, since dizziness and visual strain often travel with post-concussion headache and can feed into it.

Non-drug strategies — exercise programs tailored to your tolerance, cognitive behavioural approaches for pain, and relaxation or mindfulness-based techniques — have research support for improving long-term outcomes after concussion. Some people also find acupuncture a useful piece of the puzzle; you can read more in our post on acupuncture for headaches and migraines.

If dizziness is part of your picture too, our article on dizziness after a concussion walks through how that symptom is assessed and treated alongside headache.

What to expect from an assessment in Burlington

A thorough concussion headache assessment should look at more than just the head. At OMNI Health and Rehab, our concussion team examines the cervical spine, the vestibular system, and your overall symptom pattern to figure out which headache type (or combination) you're dealing with — because migraine-like, tension-type, and cervicogenic headaches each call for a different plan.

If you're still sorting out what a typical treatment plan looks like week to week, our guide on what concussion physiotherapy looks like, visit by visit is a good next read. And if your headache started after a car accident, our motor vehicle accident rehab program works directly within Ontario's auto insurance system to fund this kind of care.

This article is for educational purposes and doesn't replace an assessment by a qualified health professional.

If a concussion headache has outstayed its welcome, an assessment at our Burlington clinic can help sort out which type (or types) you're dealing with and build a plan around it. We direct bill to most extended health plans, so cost doesn't have to be a barrier to getting started. Book a concussion assessment when you're ready.