Etiology — what causes it
The same mechanism that produces concussion (acceleration–deceleration, direct head/neck impact) frequently injures the cervical spine. Cervical contribution to post-concussion symptoms is well-documented but often missed.
Epidemiology — who gets it
Cervical findings are present in a high proportion of persistent post-concussive presentations — exact prevalence varies by definition but cervical contribution is the rule rather than the exception in persistent symptoms.
Clinical signs
Restricted upper cervical range, positive flexion-rotation test, deep neck flexor endurance deficit, segmental tenderness, and reproduction of headache or dizziness with cervical assessment.
Symptoms
Headache that is cervicogenic in character (often unilateral, occipital-to-frontal), neck pain, dizziness reproduced or aggravated by neck movement.
Best evidence for chiropractic treatment
Schneider et al. (BJSM 2014) demonstrated that combined cervicovestibular rehabilitation produced earlier medical clearance for return to sport in adolescents with persistent post-concussion symptoms compared to a postural and stretching control. Specific cervical manual therapy, deep neck flexor training, and vestibular rehab are the cornerstones.
When to seek emergency care
Some symptoms need urgent medical attention — not a chiropractic visit. Call 911 or go to the nearest emergency department for: progressive limb weakness, loss of bowel or bladder control, saddle anesthesia (numbness in the groin/inner thighs), severe unrelenting pain unrelieved by position, signs of fracture after significant trauma, chest pain, stroke-like symptoms (face drooping, arm weakness, speech changes), or any rapidly worsening or unusual symptom.
Bottom line
Cervical contribution to persistent post-concussion symptoms is common and treatable. Targeted cervicovestibular rehab outperforms standard care.