Can Gentle Spinal Traction Help Car Accident Headaches Without Making Concussion Worse?

Written by Dr. Ron Losiewicz, D.C.
Chiropractic Physician, Injury Recovery Center | Denver Car Crash Doctor | Concussion Diagnostic & Treatment Specialist

When Your Headaches Won’t Go Away After a Car Accident: Concussion or Your Neck?

You leave the ER after a car accident with instructions to “rest and follow up if symptoms worsen.” Two weeks later, the headaches are still there—dull, relentless, sometimes sharp at the base of your skull. You’re exhausted. Light bothers you. Your neck feels stiff. And no one has given you a clear answer: Is this from the concussion, or is it from whiplash?

The answer is often both, and that’s where treatment gets complicated.

Cervicogenic headaches (headaches originating from neck structures) and post-concussion headaches can look nearly identical. Both cause pain that radiates from the back of the head. Both can trigger light sensitivity and fatigue. But they require different care strategies. Use the wrong treatment for the wrong cause, and you can make things worse.

This is especially true with intersegmental traction (often called “roller table therapy”)—a gentle, rhythmic spinal therapy that can be incredibly helpful for neck-related headaches. But if your headache is primarily driven by concussion symptoms, traction introduced too early can increase intracranial pressure sensitivity, worsen nausea, and delay your recovery.

That’s why assessment—not assumption—must come first.

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What Is Intersegmental Traction (and Why It Matters for Car Accident Headaches)?

Intersegmental traction is a form of passive spinal mobilization. You lie face-up on a table while a set of rollers slowly move beneath your spine, gently stretching and mobilizing each vertebral segment. The motion is rhythmic, non-forceful, and designed to encourage blood flow, reduce muscle guarding, and restore normal joint motion in the cervical and thoracic spine.

It is not the same as spinal decompression machines (which use harnesses and tension to create axial distraction). It’s also not manual traction, where a clinician applies sustained pulling force to the neck.

Intersegmental traction is gentler. That’s why many patients find it soothing—almost meditative—especially when neck muscles are locked up after whiplash.

When traction works for car accident headaches:

When your headache is cervicogenic (driven by joint restrictions, muscle spasm, or irritated cervical nerves), intersegmental traction can help by:

• Restoring normal segmental motion in the upper cervical spine (C1–C3, where many headache-triggering nerves live)
• Reducing protective muscle guarding that keeps your neck “locked”
• Improving local circulation and nutrient exchange in injured soft tissue
• Creating a calming parasympathetic response (your nervous system shifts out of “threat mode”)

But—and this is critical—traction is not appropriate for all headaches, especially in the early days after a concussion.

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When Traction Can Help—and When It’s Not Safe After Concussion

Let’s be direct: traction is not a first-line treatment for concussion headaches. If your symptoms are primarily neurological (brain-based), adding mechanical stress to the neck too soon can backfire.

Here’s a practical framework we use in our office to decide when traction is safe.

Green Light: Traction May Help

You may be a candidate for intersegmental traction if:

• Your headache is positional (worse when you turn your head or look up)
• Your neck is stiff or tender at the base of the skull or upper trapezius
• You’ve been cleared by a neurologist, or your concussion symptoms have significantly improved
• VITAL CNS testing shows stable or improving cognitive function (more on this below)
• You tolerate gentle manual therapy (light soft tissue work, range-of-motion exercises) without symptom flares

In these cases, traction may reduce the mechanical load on your cervical spine and give your neck the movement it needs to heal.

Yellow Light: Proceed with Extreme Caution

Traction might be tolerated, but only under close monitoring, if:

• You have mild concussion symptoms that are stable (no worsening in the past week)
• Your headache has both neck and brain-based features (e.g., pressure at the base of the skull and sensitivity to screens)
• You’re able to perform light activity (walking, light stretching) without triggering severe fatigue or nausea
• VITAL CNS scores show only mild deficits, and you’re trending toward improvement

In yellow-light cases, we start with extremely short traction sessions (2–3 minutes), watch for delayed symptom flares (headaches that spike 6–12 hours later), and adjust accordingly. If symptoms worsen, we stop.

Red Light: Do Not Use Traction

Traction is contraindicated (unsafe) if:

• You’re in the acute phase of concussion (first 7–14 days post-injury, especially if symptoms are moderate to severe)
• You have worsening or unstable symptoms (increasing headache intensity, new visual disturbances, worsening brain fog)
• You experience nausea, vomiting, or dizziness triggered by positional changes
• VITAL CNS testing shows significant cognitive deficits, or your scores have declined since baseline
• Your neurologist has advised against manual therapy or mechanical interventions
• You have suspected cervical instability, fracture, or ligamentous injury (ruled out via imaging)

In red-light scenarios, the priority is rest, neurological monitoring, and coordination with a concussion specialist or neurologist. Traction—no matter how gentle—adds a variable your brain does not need.

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How VITAL CNS Testing Guides the Decision

One of the reasons we’re able to make nuanced traction decisions at Injury Recovery Center is because we use VITAL CNS neurocognitive testing—the same assessment system used by neurologists and concussion clinics.

VITAL CNS is a computerized test that measures:

• Reaction time (how quickly your brain processes information)
• Memory (immediate and delayed recall)
• Processing speed (cognitive efficiency under timed conditions)
• Impulse control (ability to inhibit incorrect responses)

The test takes approximately 25–30 minutes and generates objective data

—scores that can be tracked over time.

Why this matters for traction decisions:

If your VITAL CNS scores show significant impairment, it tells us your brain is still working hard to recover. Adding mechanical input to the neck (even gentle traction) can overwhelm an already-taxed nervous system.

If your scores are stable or improving, and your headache is positional and neck-driven, that’s a signal that traction may be safe—assuming other clinical signs align.

Real-world example (anonymized):

A 34-year-old woman came to our office three weeks after a rear-end collision. She had been diagnosed with a mild concussion in the ER. Her main complaint was a constant headache at the base of her skull that worsened when she looked down at her phone.

Her initial VITAL CNS test showed moderate deficits in reaction time and memory. We held off on traction and focused on gentle manual therapy, postural education, and rest. Two weeks later, we retested: her scores had improved significantly, and her headache was now clearly worse with neck movement (not cognitive tasks).

We introduced intersegmental traction—3 minutes, twice per week—and monitored her response. She tolerated it well. By week six, her headache frequency had dropped from daily to 2–3 times per week, and she was able to return to work part-time.

Key takeaway: The VITAL CNS data gave us confidence to move forward—and the discipline to wait when her brain needed more time.

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What to Expect: A Step-by-Step Approach to Safe Recovery

If you’re working with a provider who specializes in post-concussion and car accident care, here’s what a safe, coordinated approach typically looks like.

Step 1: Initial Assessment (Week 1–2)

Your first visit should include:

• A detailed history of the accident and symptom timeline
• Orthopedic and neurological examination (to rule out fractures, ligament instability, or red-flag concussion symptoms)
• VITAL CNS baseline testing (if concussion is suspected)
• Discussion of current symptoms: Are they worsening, stable, or improving?
• Coordination with your neurologist or primary care provider (if you’ve already seen one)

At this stage, we typically do not use traction. The priority is understanding your injury pattern and giving your brain time to stabilize.

Step 2: Education and Symptom Monitoring (Week 2–4)

You’ll be asked to track your symptoms daily:

• Headache intensity (0–10 scale)
• Triggers (movement, light, screens, stress)
• Duration and timing (morning vs. evening, constant vs. intermittent)
• Associated symptoms (nausea, dizziness, brain fog, neck stiffness)

This data helps us distinguish cervicogenic patterns (headaches triggered by neck movement) from concussion patterns (headaches triggered by cognitive load or sensory input).

During this phase, treatment may include:

• Light soft tissue therapy (gentle massage, myofascial release)
• Postural and ergonomic guidance
• Gradual reintroduction of light activity
• Referral to physical therapy, neurology, or pain management if needed

Step 3: Retesting and Treatment Progression (Week 4–6)

If your symptoms are improving and VITAL CNS scores are stable or better, we may introduce:

• Brief intersegmental traction sessions (2–5 minutes)
• Gentle manual chiropractic adjustments (slow, trust-based, patient-controlled)
• Therapeutic exercises to restore neck mobility and strength

We watch for delayed symptom flares. If traction causes a headache spike or increased fatigue the next day, we pull back.

Step 4: Coordination and Referral (Ongoing)

Throughout your care, we stay in contact with:

• Your neurologist (especially if concussion symptoms persist beyond 4–6 weeks)
• Your primary care provider (to ensure all aspects of your health are monitored)
• Physical therapists (for vestibular rehabilitation or strength training)
• Mental health professionals (if anxiety, PTSD, or depression emerge post-accident)
• Your personal injury attorney (to document care and coordinate timelines)

You are never left to navigate this alone.

What To Do Next

If you’re living with headaches after a car accident and you’re unsure whether they’re coming from your neck, your brain, or both, the first step is an honest, thorough assessment.

At Injury Recovery Center, we specialize exclusively in car accident injuries. Dr. Ron Losiewicz takes the time to understand your injury, track your symptoms, and use tools like VITAL CNS neurocognitive testing to make informed, safe treatment decisions. We don’t rush. We don’t guess. And we don’t use traction—or any therapy—until we’re confident it’s right for you.

We also coordinate with neurologists, primary care providers, physical therapists, and your attorney to ensure your recovery is complete and your case is documented.

Call us today and speak with Dr. Ron directly.
We have three locations across the Denver metro area:

• Lakewood: 2290 Kipling St Unit 6,
  Lakewood, CO 80215
• Englewood: 730 W Hampden Ave Ste. 250,
  Englewood, CO 80110
• Aurora: 14261 E 4th Ave Building 6, Ste. 6-126, Aurora, CO 80011

You’re not a case number. You’re a person. And your recovery deserves clarity, patience, and expertise.

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