Post-Concussion Syndrome Treatment

If you are reading this then you are either dealing with ongoing concussion symptoms, have a loved one struggling, or are wondering if this may explain why you feel the way you do.

So, what exactly is post-concussion syndrome? Post-concussion syndrome is a term used to describe when an individual continues to have ongoing symptoms beyond 3 months after a concussion occurred.

What are symptoms that someone often experiences with post-concussion syndrome, you don’t need all of these to meet criteria.

  • Headache
  • Brain Fog
  • Fatigue
  • Mood Changes
  • Depression
  • Blurry Vision
  • Dizziness
  • Light Sensitivity
  • Noise Sensitivity
  • Insomnia
  • Poor Concentration
  • Problems Finding Words
  • Migraines
  • Anxiety
  • Forgetfulness
  • Balance Issues

Yes, it is common to have many of these symptoms and not just one or two. No you aren’t crazy and it isn’t just a mental health issue

Post-Concussion Syndrome Myths

Have you been told:

  • Your symptoms will go away on their own
  • Your imaging is normal and nothing is wrong
  • You are depressed or anxious, not dealing with a concussion
  • Concussions don’t last that long
  • There is nothing you can do

If so, know that you are not alone. Each year millions of concussions occur in the United States and the reported numbers are far below what actually occurs due to individuals not seeking care or the diagnosis is missed. Research suggests that nearly 50% of those diagnosed in a hospital setting will continue to have symptoms a year later. This is much different than the initial thought of 5-10%.

It’s not simply the fact that you haven’t recovered, but it’s the lack of understanding from providers, family, friends, and co-workers that is really frustrating as it changes what gets the focus.

This leads to many thinking their concussion is no longer impacting them and they set on a quest to treat their symptoms. The problem is, treating a symptom is just that. It is a symptom, it doesn’t address the underlying reason for why the symptom is there to begin with.

We are going to first discuss some of the things that happen in the brain following a concussion. After that we will discuss different treatment options that one should consider.

What Does A Concussion Do To The Brain?

Research over the years has given us tremendous insight into what happens in the brain following a concussion. These changes can persist for months and years following the injury.

  • Inflammation – is a result of changes in immune cells in the brain. Initially following the injury the immune system should become activated to clean up the damaged tissue. This is an inflammatory process. As the damaged tissue gets cleaned up, then signals should be sent to quiet the inflammation and start the repair process. For some this never occurs and there are many reasons why this can happen.
  • Energy – this comes as no surprise as the majority of those battling post-concussion syndrome have chronic fatigue. Following the injury the mitochondria, which produce energy, are not as efficient as they should be. This would be like having your car not be as fuel efficient. It just simply doesn’t last as long as it should. This is why many individuals notice their symptoms get worse as the day goes on.
  • Blood Flow and Oxygen changes – injured parts of the brain aren’t as efficient with receiving blood flow and can have changes in the amount of oxygen especially when those parts are challenged.
  • Connections – the brain doesn’t connect and communicate as efficiently as it previously did. This is a result of everything noted above as well as damage to structures known as axons. Currently evaluating the connections in the brain provides tremendous insight as to why someone hasn’t recovered. Post-concussion syndrome evaluation should include eye movements, balance, cognition, mental health, labs, sleep, and lifestyle. It’s only when all of these are addressed that a complete picture is able to be made.

Treatments For Post-Concussion Syndrome

There are many treatments or therapies that can be performed and this isn’t meant to be an all inclusive list.

Vestibular Therapy

When someone hears the term vestibular system they often think of the inner ear crystals, but this ignores much of what the vestibular system actually does.

This system integrates information from the inner ears, central vestibular relay stations, cervical spine, and eye movements. When these work together appropriately you can function, but when they don’t you end up with a variety of symptoms.

  • Dizziness
  • Nausea
  • Anxiety
  • Neck Pain
  • Headaches
  • Poor Coordination

The vestibular system is routinely injured with concussions or whiplash injuries and is a major hindrance in recovery.

Vestibular therapy aims to strengthen the integration of body movements, cervical spine, and eye movements. Most places perform generic therapies which will work for some, but for more complicated cases they either won’t get better or can actually be made worse.

Oculomotor Therapy

Eyes are known as the window into the health of the brain. We are constantly taking in visual input throughout the day and many become visually dominant after the injury. Parts of this visual dominance can be seen when doing balance testing, specifically when the eyes are closed.

Common symptoms following concussion are blurry vision, poor concentration, brain fog, fatigue, and vision that changes throughout the day. These can all be caused by impairment of the oculomotor system, eye movements.

Eye movement function should be measured using computerized technology, video oculography, that records how well the brain controls movements as this allows for the highest level of objective testing possible

With the information gathered from the eye movement testing. Targeted oculomotor exercises can be performed to help the brain to reconnect and improve recovery. Even though these therapies may seem simple, they are very profound, demanding, and require multiple parts of the brain to perform. Think of it like finding something on the internet. It only takes typing a few words to get dozens of results, but we rarely think about all the complexity that is required to display those results. The same is true for eye movements.

Oculomotor therapy and vision therapy depending on the provider may be very similar or very different. For example, in our experience a neuro-optometrist when they perform vision therapy focuses on getting the eyes aligned. This is great, but they often don’t focus on getting the eyes stable, improving tracking, or speed of movement.

Nutritional Supplements

These may be used to support various aspects of a concussion. As noted above with a concussion there are changes to how the brain connects, produces or utilizes energy, and inflammation.

A variety of supplements may be considered to help support this.

  • Essential fatty acids (EPA and DHA)
  • Eleuthero
  • CBD
  • CoQ10
  • Acetyl-L Carnitine
  • Glutathione
  • Resveratrol

As much as we like utilizing supplements to help facilitate recovery from post-concussion syndrome, these do not replace therapies to strengthen the brain. When used on their own most people receive a fraction of the results they are truly capable of.

Transcranial Magnetic Stimulation Therapy

Transcranial Magnetic Stimulation Therapy (TMS) is a way to change the connections in the brain. It is most well known for its ability to help with depression and anxiety. Over the years more and more research has been performed for a variety of neurological based symptoms and conditions. This is a fantastic tool to have when dealing with depression, anxiety, insomnia, concentration, and brain fog.

Neurofeedback

This therapy is aimed at helping to restore the rhythm of the brain waves. When the rhythm is brought into balance many experience improvements. This is performed by wearing a cap that monitors your brain waves and you receive positive stimulation such as music, clear video screen as your brain waves are in an appropriate range.

This is a therapy that has become very popular. There are a variety of units out there and results are going to vary depending on the unit and provider utilizing it.

I personally find this works best in kids, but it can also work in adults as well but does require more time.

Hyperbaric Oxygen Therapy

Changes in blood flow and oxygen to the brain can persist following a concussion. As a result many are exploring hyperbaric oxygen therapy to help with post-concussion syndrome. There is some research suggesting its effectiveness at lower levels of pressure. As with anything, it doesn’t help everyone.

In our experience about 50-60% of individuals this significantly helps to aid in their recovery.

Just like neurofeedback, this therapy has become very popular. Very similar to supplements, this shouldn’t be used as a stand alone.

Finding the Right Post-Concussion Syndrome Treatment

As you may be able to tell, there are many therapies that one may consider for post-concussion recovery. In my experience there isn’t any single therapy that works best. I’ve been involved in concussion treatment for over a decade and haven’t found the magic bullet yet despite treating thousands of individuals. I’d avoid any clinic that claims for example neurofeedback fixes all concussions, that simply isn’t true. There is no magic supplement that does it all.

Each therapy has its place, but a thorough concussion examination that evaluates how your brain functions will provide insight into what therapy to use, when to use it, how to use it, and why it is being used.

When this is done we see the results that individuals aren’t achieving at other places and nearly 90% of our patients are getting improvement. This is a process that we have developed overtime and there is a reason we use it and continue to refine it. The world of concussion is continuing to change and we strive to be at the forefront of applying the research.

Idaho Brain and Body Institute For Post-Concussion Syndrome Treatment

Putting research into practice is delayed, especially true for traditional medicine. I’ve been treating concussions since 2012, while I was still early in my training. We were told that using vestibular, oculomotor, sensory input, and cognitive based therapies couldn’t work and were unnecessary. Despite that, we were using these therapies at that time and as a result helped individuals that weren’t getting help anywhere else.

Needless to say, there is hardly a clinic that would call themselves a concussion clinic that isn’t doing this to some level. The difference is the level of experience of the provider and the specificity of the treatment being offered. Specificity absolutely matters, even if it doesn’t seem that different.

If you’re ready to recover from post-concussion syndrome then contact us today to get started.

Idaho Brain & Body is here to help, request a discovery call today.