Prevalence of Cervicalgia Following Mild Traumatic Brain Injury Among Active-Duty Service Members: Implications for Concussion Assessment

OBJECTIVES: To (i) determine the prevalence of cervicalgia within 90 days of a mild traumatic brain injury (mTBI) among active-duty service members, and (ii) describe associated demographic and clinical characteristics relevant to physical therapy management. DESIGN: Retrospective cohort study. METHODS: De-identified personnel and medical encounter data from the Military Assessment and Readiness System (2016–2024) were analyzed. Service members were identified using ICD-10 codes for initial encounter mTBI. Cervicalgia (M54.2) was classified as pre-existing (≤ 90 days pre-mTBI) or incident (≤ 90 days post-mTBI). Prevalence and clinical characteristics were compared by cervicalgia. RESULTS: Among 71,176 service members diagnosed with mTBI, 18.4% had cervicalgia within 90 days of injury (7.3% pre-existing; 11.1% incident). Cervicalgia clustered temporally around mTBI (mean 29 days pre-injury; 24 days post-injury). Compared with those without cervicalgia, affected service members had a higher prevalence of post-traumatic headache (16.1% vs 6.2%) and post-concussion syndrome (18.8% vs 11.0%), longer time in service, and greater deployment exposure. CONCLUSION: Nearly 1 in 5 service members diagnosed with mTBI had cervicalgia documented in close temporal proximity to injury. Cervicalgia was associated with greater post-concussive symptom burden.