Headaches Following Concussion

Why they happen, why they persist, and how they fit into recovery

Headaches are one of the most common and persistent symptoms after concussion. For some people they settle quickly; for others they become frequent, unpredictable, or tightly linked to thinking, screens, or stress. This can be frustrating and worrying—especially when scans are normal and explanations feel vague.

This page explains why headaches occur after concussion, the different patterns we commonly see, and how headaches often interact with cognitive load, mood, and recovery.

 

An important starting point

 

Post-concussion headaches are rarely caused by a single problem. In most cases, they reflect an interaction between:

  • brain energy disruption

  • sensory sensitivity

  • neck or musculoskeletal factors

  • cognitive load and fatigue

  • emotional and stress responses

 

Understanding which factors are relevant for you is often more helpful than simply labelling the headache type.

 

Common headache patterns after concussion

 

People describe post-concussion headaches in different ways. Common patterns include:

  • pressure or tightness across the head

  • headache that builds with thinking or screen use

  • headaches that worsen later in the day

  • headaches triggered by light, noise, or busy environments

  • headaches linked to neck pain or posture

  • headaches that flare after cognitive or emotional stress

 

The pattern often provides more useful information than the intensity alone.

 

Why headaches are so common after concussion

 

1. Brain energy and sensory regulation changes

 

After concussion, the brain can become less efficient at regulating sensory input and energy use. This can lead to:

  • increased sensitivity to light, sound, or visual motion

  • headaches triggered by screens or busy environments

  • headache onset after sustained mental effort

 

This does not imply ongoing damage, but rather reduced tolerance during recovery.

 

2. Cognitive load and mental fatigue

 

Headaches often track cognitive effort, not just physical activity.

You may notice:

  • headaches appear after meetings, reading, or problem-solving

  • pain increases as mental fatigue builds

  • headaches improve with rest but recur when load returns

 

This link between thinking and headache is a key reason headaches can feel unpredictable.

 

3. Neck and musculoskeletal factors

 

Concussion commonly occurs with forces that affect the neck and upper spine.

Neck-related factors can:

  • contribute directly to headaches

  • amplify headaches triggered by cognitive or visual load

  • worsen with poor posture or prolonged screen use

 

Addressing cervical factors is often essential for headache improvement.

 

4. Visual and vestibular contributors

 

Difficulties with eye movement, visual tracking, or balance can also trigger headaches, particularly with:

  • screens

  • reading

  • driving

  • supermarkets or busy spaces

 

In these cases, headache is often a signal of overload, not just pain.

 

5. Stress, tension, and emotional load

 

Emotional stress and uncertainty after concussion can increase muscle tension and nervous system arousal.

This can:

  • lower headache thresholds

  • prolong headache recovery

  • make pain feel harder to control

 

Importantly, this does not mean headaches are “just stress”—it means stress can be a multiplier.

 

Why headaches often worsen with thinking

 

Many people are confused by headaches that:

  • are mild at rest

  • escalate with mental activity

  • peak after effort rather than during

 

This pattern reflects how cognitive load increases metabolic demand in the brain. When tolerance is reduced, headache can act as an early warning sign that the system is overloaded.

 

Fluctuation is common—and misleading

 

Post-concussion headaches often:

  • vary day to day

  • improve, then flare again

  • worsen on “busy” or high-demand days

 

This fluctuation can create fear that recovery is going backwards. In reality, it often reflects variable load, not deterioration.

 

The risk of over-avoidance

 

Because headaches are unpleasant, people understandably begin to avoid triggers such as:

  • screens

  • work tasks

  • thinking for long periods

 

While short-term reduction can help, long-term avoidance can:

  • lower tolerance further

  • increase sensitivity

  • slow reintegration

 

Recovery usually requires graded exposure, not complete avoidance.

 

When headaches become a barrier to recovery

 

Headaches may begin to slow recovery when they:

  • dictate daily activity levels

  • prevent return to work or study

  • drive fear of cognitive effort

  • interact with fatigue and mood changes

 

At this point, headaches are no longer just a symptom—they are shaping behaviour and recovery patterns.

 

How headaches typically improve after concussion

 

Headache improvement often involves:

  • understanding personal triggers and patterns

  • pacing cognitive and sensory load

  • addressing neck, visual, or vestibular contributors

  • reducing boom–bust cycles

  • improving sleep and recovery quality

  • reducing fear and uncertainty around symptoms

 

Medication may play a role for some people, but is rarely the whole solution.

 

The role of assessment

 

Assessment can help to:

  • identify links between headaches and cognitive load

  • distinguish headache-driven fatigue from primary cognitive issues

  • clarify which systems are contributing (cognitive, cervical, visual, emotional)

  • guide appropriate referrals (e.g. physio, vision, medical care)

 

Understanding why headaches occur often reduces their impact, even before they fully resolve.

 

Our approach

 

We approach post-concussion headaches by:

  • understanding how headaches interact with thinking, fatigue, and emotion

  • avoiding one-size-fits-all explanations

  • coordinating with physiotherapists, medical providers, and vision specialists as needed

  • supporting graded return to cognitive and daily activities

  • integrating headache management into overall recovery planning

 

The aim is not simply to suppress headaches—but to help the brain and nervous system regain tolerance and stability.

 

If headaches are persisting after concussion and are interfering with your thinking, work, or confidence, we’re happy to help you understand what may be driving them and what the next steps might be.