Demystifying post-concussion syndrome
Persistent post-concussion symptoms – Where do they come from?
By Sarah El Queisi, physiotherapist
What is post-concussion syndrome?
Most people who are unlucky enough to have a concussion will improve quickly, usually within 2-4 weeks. For about 20% of people who sustain concussions, recovery can be much longer.
WHY IS IT TAKING SO LONG TO GET BETTER?
Questions we hear regularly in the clinic are “Why is it taking so long to get better?” and “where are these symptoms coming from?”.
While we can’t always explain why some people take longer to improve than others, we do know that there are some predictors of prolonged recovery.
Research shows us that being female, having a history of concussion with prolonged recovery and history of migraines are all factors that can lead to longer recovery times. Other research has shown us the presence of dizziness soon after the injury is also a predictor of prolonged recovery.
The The 5P Tool is a handy way to help us predict the risk of prolonged recovery in a pediatric population.
Where do persistent symptoms come from?
After a concussion, patients will often complain of headaches, neck pain, dizziness and visual problems. Research from Dr. Michael Ellis’s group shows that persistent symptoms following concussion can be attributed to 3 different causes:
- Vestibulo-ocular dysfunction
- Exercise intolerance/autonomic dysfunction
- Cervical spine dysfunction
What now?
The good news is that all of these problems can be treated with help from a qualified and knowledgeable physiotherapist.
- A combination of vestibular rehabilitation exercises can address dizziness and visual complaints
- Aerobic exercise at an appropriate time and intensity can help treat exercise intolerance
- A combination of exercises and manual therapy can address neck pain and headaches coming from a whiplash injury
A detailed assessment from a trained physiotherapist can help figure out where persistent symptoms are coming from, and how to best get them under control. With appropriate treatment and good rehab plan, persistent symptoms can be improved.