A headache after a car accident is most often caused by neck strain or whiplash, a concussion, or tight, injured muscles in the neck and shoulders, and it can start right away or several days after the crash. Most crash-related headaches are not dangerous, but some are warning signs of a brain injury that needs emergency care. If you were in a crash in Jacksonville and your head hurts, get checked, and go to the ER right away for a sudden severe headache, a headache that keeps getting worse, repeated vomiting or confusion.
This guide covers the common types of car accident headache, why they can start late, ER warning signs and Florida’s 14-day PIP rule.
Key facts
- Post-traumatic headache is a headache that begins after an injury to the head or neck, including a car crash.
- Spinal manipulation and exercise have modest evidence for cervicogenic and tension-type headaches; evidence for migraine is weak.
- Florida PIP pays medical benefits only if you receive initial care within 14 days of the crash (F.S. 627.736).
- Only an MD, DO, PA, APRN or dentist can make the Emergency Medical Condition determination that opens the full PIP medical benefit; without it, medical benefits are limited to $2,500.
- In 2024, Duval County recorded 23,013 crashes and 15,480 injuries (FLHSMV, Traffic Crash Facts 2024).
Why Your Head Hurts After a Crash
In a collision, the seat belt holds your body while your head keeps moving. The neck bends back and forth quickly, and the brain can shift inside the skull. Either force can cause a headache, and many people have both.
Common Types of Car Accident Headache
Cervicogenic headache (from the neck)
This headache starts in the joints, discs, muscles or nerves of the upper neck and is felt in the head. It often sits at the base of the skull, wraps toward the temple or eye on one side, and gets worse when you turn your head or hold one posture for a long time. It is common after whiplash, and our guide to how long whiplash lasts explains typical recovery stages for the neck.
Tension-type and muscle strain headache
Strained, guarded muscles in the neck, shoulders and scalp can cause a dull, band-like pressure around the head. This type often builds through the day and can come with neck stiffness and tender spots in the upper back. When tight muscles and trigger points are part of the problem, physical therapy may include dry needling for trigger points.
Post-traumatic headache
This is the term doctors use for a new headache that starts after an injury to the head or neck. It can look like a tension headache, a migraine or a mix of both. It is one of the most common symptoms after a concussion.
Migraines after a car accident
Some people develop throbbing, one-sided headaches with nausea and sensitivity to light or sound after a crash. Others who already had migraines notice attacks becoming more frequent. These migraine-like headaches deserve a medical evaluation, because they can be part of a concussion and because treatment is different from a simple muscle headache.
Occipital nerve irritation
The occipital nerves run from the upper neck over the back of the head. When they are irritated, pain can feel sharp, shooting or electric, starting at the base of the skull and running up the scalp. The area may be tender to touch.
Why a Headache Can Start Days Later
Adrenaline can mask pain for hours, and inflammation in the neck often builds over the first day or two, so a headache after a car crash may first show up the next morning. Concussion headaches may only become obvious when you go back to work or screens. A late start does not mean the headache is unrelated to the crash. A short daily note of when it happens and what changes it helps your provider see the pattern.
Warning Signs: Go to the ER or Call 911
Some headaches after a crash can be a sign of bleeding or swelling in the brain. Get emergency care right away for:
- A sudden, severe headache, the worst you have ever had
- A headache that keeps getting worse and does not go away
- Repeated vomiting
- Increasing confusion, unusual drowsiness or being hard to wake
- A seizure
- Slurred speech, weakness, numbness or trouble walking
- Vision loss, double vision or one pupil larger than the other
- Any loss of consciousness
- A headache with fever and a stiff neck
If you take a blood thinner, or you are an older adult, get checked promptly after any blow to the head, even if the headache seems mild.
Headaches After a Jacksonville Crash and the 14-Day PIP Rule
Jacksonville drivers spend a lot of time on I-95, I-295, J. Turner Butler Blvd (JTB), SR 9A and Beach Blvd, where rear-end and merging collisions are common. Duval County recorded 23,013 crashes and 15,480 injuries in 2024, according to the Florida Department of Highway Safety and Motor Vehicles.
Florida’s no-fault law adds a practical deadline. Under F.S. 627.736, PIP pays medical benefits only if you receive initial care within 14 days of the crash. An ER or urgent care visit counts as initial care. The full PIP medical benefit also depends on an Emergency Medical Condition determination by an MD, DO, PA, APRN or dentist; a chiropractor cannot make that determination. If your headache is still there a week after the crash and you have not been seen, it is worth getting an evaluation before the 14 days are up. For more on the deadline, read how Florida’s 14-day PIP rule works. For questions about your claim, talk to an attorney.
Our guide to the PIP 14-day rule after a Jacksonville crash walks through what counts as initial care and what to bring to your first visit.
How a Headache After a Crash Is Evaluated
The evaluation starts with how the crash happened and when the headache began. The exam checks neck movement and tender points, a neurological screen (reflexes, strength, sensation, coordination and eye movements) and concussion screening questions, and looks for the red flags above.
Imaging is not needed for every headache. When warning signs suggest bleeding or a fracture, a CT scan is the usual first test, and an MRI may be ordered later if symptoms do not improve. We refer patients out for CT and MRI; we do not do them in our office. Our guide to how doctors diagnose a traumatic brain injury explains each step, from the neurological exam to imaging. A normal scan does not rule out a concussion or a neck-related headache, which is why the exam matters.
Treatment Options
Treatment is matched to the type of headache and what is driving it:
- Medical management. Our medical providers evaluate the headache, rule out warning signs, guide medication use and monitor progress.
- Neck-focused care. For cervicogenic and tension-type headaches, our chiropractic and physical therapy teams use manual therapy, spinal manipulation where appropriate, and exercises for neck strength and posture. These approaches have modest evidence for these headache types.
- Concussion care. When the headache is part of a concussion, our concussion and vestibular rehabilitation specialists add graded activity, balance work and eye-movement exercises.
- Pain management. For stubborn headaches tied to the occipital nerves or neck joints, our pain management team can discuss options such as nerve blocks.
Our headache and migraine care page explains these options in more detail. To be honest, many crash-related headaches improve over weeks, but timelines vary and no one can promise when one will stop. If your symptoms point to something outside what we treat, we will refer you to a neurologist or other specialist.
Paying for Headache Care After a Crash
After a car accident in Florida, your own Personal Injury Protection (PIP) coverage is usually the first place your medical bills go, as long as your first care is within 14 days of the crash. If you have a personal injury attorney, we can treat under a Letter of Protection where that is the arrangement; your attorney can call our office to set it up. We also accept a limited number of private health plans. Our front desk verifies coverage before your first visit and explains what is and is not covered for your case.
Frequently Asked Questions
Is it normal to have a headache after a car accident?
Headaches are one of the most common symptoms after a crash, often from neck strain, whiplash or a concussion. Common does not mean it should be ignored. A headache that lingers, keeps coming back or comes with other symptoms deserves a medical evaluation.
How long after a car accident can a headache start?
Some headaches start right away. Others begin the next morning or several days later, once adrenaline wears off and inflammation in the neck builds. A headache that starts days after the crash can still be related to it, so mention the crash to whoever examines you.
Can a car accident cause migraines?
A crash can trigger headaches with migraine-like features, such as throbbing pain, nausea and sensitivity to light or sound, and it can make an existing migraine pattern worse. These are often classified as post-traumatic headaches. A medical provider can sort out which type you have and what is likely driving it.
When is a headache after a crash an emergency?
Go to the ER or call 911 for a sudden, severe headache (the worst of your life), a headache that keeps getting worse, repeated vomiting, confusion, unusual drowsiness, a seizure, slurred speech, weakness or numbness, vision loss or one pupil larger than the other. People who take blood thinners should be checked promptly after any head injury.
Can neck pain cause headaches after a car accident?
Yes. A cervicogenic headache starts in the joints, muscles or nerves of the neck and is felt in the head, often at the base of the skull, behind the eyes or on one side. Whiplash is a common cause. Treating the neck is usually part of treating this kind of headache.
Does Florida PIP cover headache treatment after a crash?
PIP can pay for medically necessary care after a crash if you receive initial care within 14 days. PIP pays 80% of reasonable charges, and the full medical benefit requires an Emergency Medical Condition determination by an MD, DO, PA, APRN or dentist; without it, medical benefits are limited to $2,500. For questions about your specific claim, talk to an attorney.
Getting Care at Our Jacksonville Clinics
If you have a headache after a car accident, our team can evaluate you, check for warning signs, treat the neck and head together under one roof, and handle the records your PIP claim needs. You can be seen at our Southside clinic at 10550 Deerwood Park Blvd, Suite 609 (32256), near JTB and I-295, or at our North Jacksonville clinic at 13453 N Main St, Suite 302 (32218), north of I-295. Both clinics offer the same services and the same hours, Monday through Friday, 9 AM to 6 PM. Call (904) 513-3954 or request an appointment.
