By Benjamin McCay, DC, CCSP

Published July 10, 2026

 

A concussion is one of the most common injuries sustained during a motor vehicle accident. Although many people associate a concussion with a direct blow to the head, it can also occur from the rapid acceleration and deceleration forces experienced during a collision—even if the head never strikes the steering wheel, dashboard, window, or headrest.

During a crash, the brain can move rapidly within the skull, temporarily disrupting normal brain function. This type of injury is known as a mild traumatic brain injury (mTBI). Despite the term mild, the symptoms can significantly affect daily activities, work, school, and quality of life.

One of the challenges with concussions is that symptoms are often delayed. A person may initially feel relatively normal immediately after a collision because adrenaline and other stress hormones temporarily mask symptoms. Hours later—or even several days after the accident—they may develop headaches, dizziness, brain fog, memory problems, or difficulty concentrating.

Because a concussion is a brain injury, anyone with symptoms suggestive of a concussion should receive appropriate medical evaluation. Early recognition helps identify patients who require emergency care while also providing guidance for a safe recovery.

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What Is a Concussion?

A concussion is a mild traumatic brain injury (mTBI) caused by forces that temporarily disrupt normal brain function.

Unlike a skull fracture or bleeding within the brain, a concussion is primarily considered a functional injury rather than a structural injury. Brain cells continue to appear normal on most imaging studies, but their ability to communicate with one another becomes temporarily impaired. This is why many people experience symptoms despite having a normal CT scan or MRI.

Most concussions improve over time with appropriate medical management, although recovery varies from person to person. While many individuals recover within several weeks, others may experience symptoms for months.

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Can You Get a Concussion Without Hitting Your Head?

Yes.

Many people are surprised to learn that direct head impact is not required for a concussion to occur.

During a rear-end collision, for example, the head is rapidly thrown backward and then forward in a matter of milliseconds. These acceleration and deceleration forces can cause the brain to move within the skull, temporarily disrupting normal brain function even when the head never contacts another object.

Concussions may occur during:

• Rear-end collisions
• Front-end collisions
• Side-impact (T-bone) collisions
• Rollover accidents

The absence of visible vehicle damage or direct head impact does not rule out a concussion. Healthcare providers determine whether a concussion is likely based on the patient's history, symptoms, and clinical examination—not simply by whether the head struck something during the crash.

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Why Concussions Can Be Difficult to Recognize

Unlike a broken bone or a deep cut, a concussion often has no outward signs of injury.

Many patients:

• Never lose consciousness
• Remember the accident clearly
• Walk away from the scene feeling "fine"
• Do not seek medical attention until symptoms appear later

In fact, loss of consciousness occurs in only a minority of concussions. Many patients experience more subtle symptoms that gradually become noticeable over the next several hours or days.

For this reason, anyone who develops persistent headaches, dizziness, confusion, memory difficulties, or other neurological symptoms following a motor vehicle accident should be medically evaluated.

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Common Concussion Symptoms

Concussion symptoms vary considerably from person to person. The Centers for Disease Control and Prevention (CDC) groups symptoms into four broad categories: physical, cognitive, emotional, and sleep-related. Patients may experience symptoms from one or several of these categories.

Physical Symptoms

Physical symptoms commonly include:

• Headache
• Neck pain
• Dizziness
• Balance problems
• Nausea or vomiting
• Blurred or double vision
• Sensitivity to light
• Sensitivity to noise
• Ringing in the ears (tinnitus)
• Fatigue
• Feeling slowed down

Cognitive Symptoms

Cognitive symptoms affect how the brain processes information and may include:

• Difficulty concentrating
• Memory problems
• Feeling mentally "foggy"
• Slowed thinking
• Difficulty finding words
• Confusion
• Difficulty learning new information
• Reduced attention span

Many patients describe these symptoms simply as brain fog.

Emotional Symptoms

Changes in mood are also common after a concussion.

Symptoms may include:

• Irritability
• Anxiety
• Depression
• Mood swings
• Increased emotional sensitivity
• Nervousness

Family members are often the first to notice these changes.

Sleep-Related Symptoms

Concussions frequently disrupt normal sleep patterns.

Patients may experience:

• Sleeping more than usual
• Sleeping less than usual
• Difficulty falling asleep
• Difficulty staying asleep
• Excessive daytime sleepiness
• Feeling tired despite a full night's sleep

Because sleep plays an important role in recovery, persistent sleep disturbances should be discussed with your healthcare provider.

Delayed Concussion Symptoms

One of the most challenging aspects of a concussion is that symptoms are not always immediately apparent.

Following a motor vehicle collision, the body's natural stress response releases hormones such as adrenaline and cortisol. These chemicals help prepare the body to respond to an emergency and may temporarily reduce pain perception or mask neurological symptoms.

As these stress hormones decline over the next several hours or days, symptoms may gradually become more noticeable.

Patients commonly report:

• Persistent or worsening headaches
• Brain fog
• Difficulty concentrating
• Memory problems
• Dizziness
• Fatigue
• Neck pain
• Nausea
• Increased sensitivity to light or noise

For some individuals, symptoms begin immediately. Others may not notice problems until the following day or several days after the collision.

Because concussion symptoms may develop gradually, it is important to monitor yourself closely after any significant motor vehicle accident—even if you initially feel well.

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When Should You Go to the Emergency Room?

Although most concussions are not life-threatening, some symptoms may indicate a more serious brain injury requiring immediate medical attention.

Seek emergency medical care immediately if you experience:

• Loss of consciousness
• Repeated vomiting
• Severe or worsening headache
• Increasing confusion or unusual behavior
• Difficulty speaking or understanding speech
• Weakness or numbness in an arm or leg
• Difficulty walking or maintaining balance
• Unequal pupil size
• Seizures
• Significant vision changes
• Increasing drowsiness or inability to awaken
• Clear fluid draining from the nose or ears

These symptoms may indicate bleeding within the brain, increased pressure inside the skull, or another serious neurological injury that requires urgent evaluation.

If you are uncertain whether your symptoms represent an emergency, it is safest to seek immediate medical attention.

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How Is a Concussion Evaluated?

A concussion is diagnosed by an appropriate medical provider using the patient's history, symptoms, and physical examination.

The evaluation typically includes questions about:

• How the injury occurred
• Whether there was loss of consciousness
• Memory before and after the accident
• Current symptoms
• Previous concussions
• Medications and medical history

The neurological examination may include assessment of:

• Orientation and memory
• Attention and concentration
• Balance
• Coordination
• Eye movements
• Cranial nerve function
• Reflexes
• Strength and sensation

Healthcare providers may also use standardized concussion assessment tools to help document symptoms and monitor recovery over time.

Because concussion symptoms frequently overlap with injuries involving the cervical spine, a thorough examination often includes evaluation of the neck as well.

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Why Whiplash and Concussion Are Both Evaluated

Many symptoms that develop after a car accident can originate from either the brain, the cervical spine, or both.

For example, the following symptoms may occur with a concussion, whiplash, or a combination of both:

• Headaches
• Dizziness
• Neck pain
• Difficulty concentrating
• Balance problems
• Visual discomfort

Distinguishing between these injuries is important because treatment recommendations may differ. A comprehensive evaluation helps determine whether symptoms are most consistent with a concussion, a musculoskeletal injury such as whiplash, or both.

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Will a CT Scan Show a Concussion?

Usually not.

A CT (computed tomography) scan is excellent for identifying serious injuries such as:

• Bleeding within the brain
• Skull fractures
• Significant swelling
• Other life-threatening traumatic injuries

However, most uncomplicated concussions appear normal on a CT scan because the injury affects how brain cells function rather than causing obvious structural damage.

For this reason, a normal CT scan does not rule out a concussion.

CT scans are generally performed when a healthcare provider suspects a more serious injury or when certain high-risk symptoms are present.

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Will an MRI Show a Concussion?

Not necessarily.

Like CT scans, MRI (magnetic resonance imaging) is designed to evaluate structural abnormalities within the brain.

Most patients with a concussion have a normal MRI because conventional MRI cannot detect the temporary functional changes that occur following a mild traumatic brain injury.

An MRI may be recommended when:

• Symptoms persist longer than expected
• Symptoms worsen over time
• Another neurological condition is suspected
• Additional evaluation is needed after the initial injury

A normal MRI does not mean that a patient's symptoms are not real or that a concussion did not occur.

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Can Imaging Rule Out a Serious Brain Injury?

Yes—and that is one of its most important purposes.

Although CT scans and MRI often appear normal after a concussion, they are extremely valuable for identifying conditions that require immediate treatment, including:

• Brain hemorrhage
• Skull fractures
• Significant brain swelling
• Other traumatic injuries

This is why patients with severe symptoms or concerning neurological findings are often referred for emergency imaging, even though the concussion itself may not be visible on the scan.

Whiplash vs. Concussion: What's the Difference?

Whiplash and concussion are different injuries, but they frequently occur together during a motor vehicle accident.

A concussion is a mild traumatic brain injury caused by rapid movement of the brain within the skull.

Whiplash is a musculoskeletal injury involving the muscles, ligaments, joints, fascia, discs, and other soft tissues of the cervical spine. During a collision, the head and neck are rapidly accelerated and decelerated, placing significant stress on these structures.

Because the same forces that can cause a concussion also commonly cause whiplash, many patients experience both injuries simultaneously.

Concussion	Whiplash
Brain injury	Neck injury
Primarily affects brain function	Primarily affects muscles, ligaments, joints, and other cervical tissues
May cause cognitive and neurological symptoms	Primarily causes musculoskeletal symptoms
Requires appropriate medical evaluation	May benefit from conservative musculoskeletal treatment after appropriate evaluation

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Can Whiplash Cause Symptoms That Feel Like a Concussion?

Yes.

One of the reasons concussion can be difficult to recognize after a car accident is that injuries involving the cervical spine can produce many of the same symptoms.

Research has shown that neck injuries may contribute to symptoms including:

• Headaches
• Dizziness
• Neck pain
• Visual discomfort
• Difficulty concentrating because of pain
• Balance disturbances
• Fatigue

These symptoms may result from:

• A concussion
• A cervical spine injury
• Or a combination of both

For example, an injured cervical joint or muscle may produce a cervicogenic headache, while irritation of structures in the upper cervical spine may contribute to dizziness or balance problems.

Because of this overlap, symptoms should not automatically be attributed to only the brain or only the neck. A comprehensive evaluation helps determine which structures are contributing to a patient's symptoms.

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Why Neck Pain Should Never Be Ignored

Neck pain is one of the most common complaints after a motor vehicle accident and frequently accompanies concussion.

Common symptoms of whiplash include:

• Neck pain
• Muscle tightness
• Reduced range of motion
• Shoulder pain
• Upper back pain
• Headaches
• Muscle spasms

Fortunately, many of these musculoskeletal injuries respond well to conservative treatment.

Addressing neck dysfunction may also improve symptoms such as cervicogenic headaches, muscle tension, and restricted movement that commonly develop following a collision.

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How Long Does It Take to Recover From a Concussion?

Recovery varies considerably from person to person.

Many people recover within several weeks, while others require months before symptoms completely resolve.

Recovery depends on many factors, including:

• Severity of the injury
• Previous concussions
• Age
• Overall health
• Associated injuries
• Whether whiplash or other musculoskeletal injuries are also present

Although most patients improve over time, recovery is not always linear. Some days may be better than others, particularly during the early stages of healing.

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What Does Recovery Typically Involve?

Current medical guidelines generally recommend relative rest during the first 24 to 48 hours after a concussion rather than prolonged bed rest.

As symptoms improve, patients are usually encouraged to gradually resume normal daily activities under the guidance of their healthcare provider.

Recovery often includes:

• Gradual return to work or school
• Progressive increase in physical activity as tolerated
• Symptom monitoring
• Follow-up with the appropriate healthcare provider
• Management of associated injuries, such as whiplash

Returning too quickly to strenuous physical or cognitive activity may worsen symptoms or delay recovery.

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What Is Post-Concussion Syndrome?

Most people recover from a concussion within several weeks.

However, some continue to experience symptoms for months after the initial injury. This is commonly referred to as post-concussion syndrome (PCS).

Persistent symptoms may include:

• Headaches
• Brain fog
• Difficulty concentrating
• Memory problems
• Dizziness
• Fatigue
• Sleep disturbances
• Anxiety or depression

Persistent symptoms should be evaluated by the appropriate healthcare provider, who may recommend additional testing or referral to specialists such as neurology, neuropsychology, vestibular rehabilitation, or other healthcare professionals depending on the patient's symptoms.

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Why Follow-Up Care Is Important

Concussion symptoms often improve gradually, making follow-up appointments an important part of recovery.

Regular follow-up allows healthcare providers to:

• Monitor symptom progression
• Identify persistent or worsening symptoms
• Guide a gradual return to normal activities
• Determine whether additional testing or specialist referral is appropriate

Patients should also continue to report any new or worsening neurological symptoms, especially if they develop after the initial evaluation.

Although most people recover fully, ongoing symptoms deserve careful attention rather than being dismissed as "normal" after a car accident.

Can Chiropractic Care Help After a Concussion?

A concussion is a brain injury and should be evaluated and managed by an appropriate medical provider.

In Washington State, chiropractors diagnose and treat musculoskeletal conditions within their scope of practice. While chiropractic care does not treat the brain injury itself, many patients who sustain a concussion during a motor vehicle accident also suffer injuries involving the neck, muscles, ligaments, joints, fascia, and other soft tissues.

These associated injuries may contribute to symptoms such as:

• Neck pain
• Whiplash
• Muscle tension
• Cervicogenic headaches
• Reduced cervical mobility
• Joint stiffness

After appropriate medical evaluation has been completed and serious neurological injury has been excluded, conservative treatment of these musculoskeletal injuries may help improve comfort, restore movement, and support overall recovery.

Treatment plans are individualized based on each patient's injuries and may include chiropractic care, soft tissue therapy, massage therapy, rehabilitative exercises, or referral to other healthcare providers when appropriate.

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When Should You See a Chiropractor After a Car Accident?

Even relatively low-speed collisions can produce injuries that are not immediately obvious.

If you develop any of the following after a motor vehicle accident, you should be evaluated by a healthcare provider:

• Neck pain
• Back pain
• Headaches
• Muscle stiffness
• Reduced range of motion
• Pain that worsens over the next several days

If you also experience symptoms that may be consistent with a concussion—such as dizziness, brain fog, memory problems, confusion, or balance difficulties—you should first receive appropriate medical evaluation.

Once serious neurological injury has been evaluated, chiropractic care may help address the associated musculoskeletal injuries that commonly accompany motor vehicle accidents.

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Concussion, Whiplash, and Neck Pain After a Car Accident in Everett & Lynnwood

At Advanced Chiropractic & Massage, we regularly evaluate patients following motor vehicle accidents who are experiencing neck pain, headaches, stiffness, reduced mobility, and other musculoskeletal complaints.

Because concussion symptoms and whiplash symptoms often overlap, we carefully assess the cervical spine while remaining alert for signs and symptoms that may indicate a concussion or other neurological injury.

When a patient's history or examination raises concern for a concussion, we recommend prompt medical evaluation by the appropriate healthcare provider.

After serious neurological injury has been appropriately evaluated, we focus on treating the musculoskeletal injuries commonly associated with motor vehicle accidents, including whiplash, cervical sprain and strain injuries, joint dysfunction, muscle tension, and cervicogenic headaches.

If you've been injured in a car accident in Everett, Lynnwood, or the surrounding communities, early evaluation can help identify injuries, guide appropriate referrals when needed, and begin treatment for the musculoskeletal conditions that commonly develop after a collision.

 

 

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Frequently Asked Questions

Can you have a concussion without hitting your head?

Yes. A concussion may occur from the rapid acceleration and deceleration forces of a motor vehicle collision, even if your head never strikes the steering wheel, dashboard, window, or another object.

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How long after a car accident can concussion symptoms appear?

Symptoms may begin immediately, several hours later, or even a few days after the collision. Delayed symptoms are common, which is why it is important to monitor yourself closely after an accident.

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Does everyone lose consciousness after a concussion?

No.

Most people with a concussion do not lose consciousness. Many remain awake throughout the accident and are able to walk away from the scene before symptoms gradually develop.

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Will a concussion show up on a CT scan or MRI?

Usually not.

Most uncomplicated concussions do not produce abnormalities visible on conventional CT scans or MRI because they affect brain function rather than causing structural damage. These imaging studies are primarily used to identify more serious injuries such as bleeding or skull fractures.

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Can whiplash and a concussion happen together?

Yes.

The same forces that cause a concussion commonly injure the cervical spine. As a result, many patients experience both a concussion and whiplash following a motor vehicle accident.

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Can neck injuries cause symptoms similar to a concussion?

Yes.

Whiplash injuries may contribute to headaches, dizziness, neck pain, fatigue, balance problems, and difficulty concentrating. Because these symptoms overlap with concussion, a thorough evaluation is important to determine the source of a patient's symptoms.

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Should I drive if I think I have a concussion?

If you are experiencing dizziness, slowed thinking, blurred vision, impaired concentration, or other symptoms that may indicate a concussion, avoid driving until you have been evaluated and cleared by an appropriate medical provider.

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When should I seek emergency medical care?

Seek immediate emergency care if you experience:

• Loss of consciousness
• Repeated vomiting
• Severe or worsening headache
• Increasing confusion
• Weakness or numbness
• Difficulty speaking
• Seizures
• Unequal pupils
• Significant vision changes
• Difficulty walking
• Increasing drowsiness or inability to awaken

These symptoms may indicate a more serious brain injury requiring urgent medical evaluation.