Key takeaways.
- Most post-crash headaches fall into a few groups: neck-driven (cervicogenic), post-traumatic, and post-concussion. They overlap, but they are not the same.
- You do not need to have hit your head. A whipped neck alone can refer pain up into the head.
- Some symptoms are red flags that mean the emergency room. Call 911 or go to Lions Gate Hospital if a headache worsens steadily or comes with vomiting, confusion, or weakness.
- Physiotherapy for crash-related headaches is pre-approved under ICBC, the Insurance Corporation of British Columbia, in the first 12 weeks. No referral is needed.
The main types of headache people get after a crash.
A cervicogenic headache is a neck-driven headache. The sudden back-and-forth of a crash can strain the upper neck joints and muscles. Those structures refer pain up into the head, often felt at the base of the skull, behind one eye, or across one side. It can come with a stiff, sore neck and limited movement. This type usually moves with the neck, so turning or holding a posture can make it worse.
A post-traumatic headache is a headache that starts after the injury itself, whether or not the head was struck. It can feel like a tension headache, a band of pressure around the head, or it can feel more like a migraine, with throbbing and sensitivity to light or noise. It often sits alongside a neck problem rather than apart from it.
A post-concussion headache is part of a wider set of symptoms after a concussion, a mild brain injury. A concussion can happen from the force of the crash even without a direct knock to the head. Headache here may come with dizziness, brain fog, trouble concentrating, or feeling worse with screens and busy environments. If you think you may have a concussion, see our guide to concussion after a crash.
In real life these often overlap. The same person can have a sore neck driving one part of the headache and a concussion driving another. Sorting out what is contributing is the point of a proper assessment.
The red flags that mean the emergency room, not the clinic.
Most headaches after a crash are not dangerous, but some symptoms need urgent medical care. Based on HealthLinkBC's head injury guidance, call 911 or go to the emergency room if a headache:
- gets steadily worse instead of better, or is the worst headache of your life
- comes with repeated vomiting
- comes with confusion, unusual drowsiness, or being hard to wake
- comes with a seizure, slurred speech, or weakness or numbness in the face, arm, or leg
- comes with clear fluid leaking from the nose or ears
- comes with vision changes, or pupils that look uneven
The nearest emergency department is Lions Gate Hospital in North Vancouver. If someone is unconscious, having a seizure, or you are worried about a serious head injury, call 911. We are a physiotherapy clinic, not an emergency service, and we do not diagnose brain injuries. When in doubt, get checked first.
How physiotherapy approaches crash headaches.
Once anything urgent is ruled out, the first job is to work out where the headache is coming from. The assessment looks at the neck joints, the muscles, your movement, and how the headache behaves through the day. That tells us whether the neck is the main driver, whether a concussion is in the picture, or both.
When the neck is a driver, treatment often pairs hands-on manual therapy for the stiff or irritated joints with active rehab: graded exercise to restore movement and rebuild the deep neck muscles that support the head. We may also address posture, sleep, and how you load the neck through the day, because all of those feed the symptom.
Where a concussion is involved, the plan is more careful and paced. We work within what your symptoms tolerate and progress as they settle. A flare-up is treated as information to adjust the dose, not a setback. Your physiotherapist sets the pace based on how you respond, not a fixed schedule.
How ICBC covers treatment for crash headaches.
ICBC, the Insurance Corporation of British Columbia, runs the no-fault Enhanced Care system. Under it, physiotherapy for crash-related symptoms, including headaches tied to the neck, is pre-approved in the first 12 weeks after a reported crash. You do not need a doctor's referral to start. ICBC sets out the details on its treatment-access page.
To get started, bring your claim number and your Personal Health Number. We confirm the coverage with ICBC and bill them directly, so there is nothing to pay upfront for covered visits. For the full picture of what is pre-approved, see what ICBC actually covers in the first 12 weeks.
Common questions.
How long do headaches last after a car crash?+
It depends on the type and the cause. A headache driven by an irritated neck behaves differently from one tied to a concussion. In our clinic we often see headaches ease as the neck and the irritable early phase settle, but there is no single timeline. Your physiotherapist will set expectations after assessing you.
I have a headache but didn't hit my head, so why?+
You do not need a direct blow to the head to get a headache after a crash. Many post-crash headaches start in the neck. The sudden whip of the neck can irritate the upper joints and muscles, and that pain often refers up into the head. This is called a cervicogenic, or neck-driven, headache.
When is a headache after a crash an emergency?+
Call 911 or go to the emergency room if a headache gets steadily worse, comes with repeated vomiting, confusion, drowsiness you cannot shake off, slurred speech, weakness or numbness, a seizure, or clear fluid from the nose or ears. The nearest emergency department is Lions Gate Hospital in North Vancouver. When in doubt, get checked.
Does ICBC cover treatment for headaches after a crash?+
Yes. Under Enhanced Care, physiotherapy for crash-related symptoms, including headaches tied to the neck, is pre-approved in the first 12 weeks after a reported crash. You do not need a doctor's referral to start. Bring your claim number and Personal Health Number.
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