PCS Treatments

For the vast majority of concussions, simply resting and gradually returning to activity under the guidance of a medical professional clears up concussion symptoms in a matter of days or weeks. This is the current standard of care, and has helped countless concussion victims through a full recovery. Sometimes, however, rest on its own isn’t enough, and so doctors may suggest trying active treatments to target symptoms that are not resolving on their own.

When should I consider trying active treatments?

The decision to augment traditional concussion recovery with active treatments is an important conversation with your doctor. Unfortunately, there are currently no empirical guidelines on when is most appropriate to begin active treatments, underscoring the importance of working with an experienced doctor who has helped patients navigate the process before. As a rule of thumb, most medical professionals suggest waiting at least several weeks after injury before beginning additional treatments, fearing that beginning active treatments too soon may actually hamper recovery by over-exerting vulnerable brain cells.

Lily Winton PCS

What treatments are available for Post-Concussion Syndrome (PCS)?

There are many treatments available to help concussion patients recover.  Below, we provide a list of treatments that are supported by peer-reviewed scientific publications. Every concussion is different, however, so what works for others may not work for everyone. Often patients will try many different treatments unsuccessfully before finding the right one. Patience is key. It may be slow going, but remember that almost all concussions recover eventually!

Vision Therapy (also known as oculomotor training)
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Who could this work for?

Common vision problems and symptoms following a concussion can include sensitivity to motion, difficulty with eye movements, eye pain and headaches, dizziness and balance problems, sensitivity to light, blurry vision, double vision, and peripheral vision problems. Patients suffering from these symptoms may benefit from vision therapy.

What is it?

Vision therapy includes a large range of techniques designed to help train specific aspects of the visual system, helping it return to normal after a concussion. A variety of different tools and exercises that help improve the accuracy of our eyes can be utilized in vision therapy.

Why it might work

The vision system is the largest in the brain – more brain areas are involved in processing visual information than any other system in the brain. This makes it particularly vulnerable to concussion – there are a lot of parts that can break down during a concussion.

Vision therapies can help in two ways. In some cases, the exercises may help repair damaged connections, returning them to normal. In cases of more severe damage, the exercises can help the brain develop techniques to compensate for longer lasting deficits.

Neuro-Optometric Rehabilitation
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Who could this work for?

Neuro-Optometric Rehabilitation is a specialized, individualized treatment regimen for those who have visual deficits as a direct result of traumatic brain injuries, physical disabilities, and other neurological insults.

What is it?

Neuro-Optometric Rehabilitation therapy utilizes therapeutic prisms, lenses, filters and occlusion to help stimulate parts of the brain which are not functioning to their highest potential, due to interruptions caused by the brain injury. The rehabilitation plan and graded return can be tailored to the specific individual’s needs when it comes to returning to school, work, athletics, or other visually demanding tasks.

Neuro-Optometric Rehabilitation is not to be confused with vision therapy, which is a separate therapy (see above) needed by some brain injury survivors.

Why it might work

A neuro-optometric rehabilitation treatment plan can be designed on an individualized basis to improve specific acquired vision symptoms based on standardized diagnostic criteria.

Learn more: We collaborated with the Neuro-Optometric Rehabilitation Association (NORA) to create an educational resource on common vision problems and symptoms following a concussion. Click here to view or print.

 

Vestibular Therapy (also known as balance therapy)
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Who could this work for?

Vestibular therapy can be particularly helpful for patients who are suffering from persistent dizziness, vertigo, or balance problems after a concussion.

What is it?

Vestibular therapies encompass a wide range of techniques, including habituation exercises, gaze stability training, and balance training. Depending on what types of activities tend to make balance symptoms worse, doctors can develop training plans to alleviate symptoms.

Why it might work

Our sense of balance relies on input from many different systems in our brain, including the visual system, our sense of proprioception (which tells us where our body parts are in space), and our vestibular system (that tells us how our body is oriented and moving in space).

In some cases, doctors can isolate what systems are causing problems, opening the door for targeted treatments that can improve overall outcomes.

Physical Therapy
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Lily Winton PCS

Who could this work for?

Physical therapy can be helpful for patients with certain types of headaches, and for patients who may have suffered orthopedic injuries at the same time as their concussion.

What is it?

Physical therapy is a wide discipline of medicine that treats ailments through physical means, as opposed to surgical or pharmacological treatments. This includes techniques such as massage, exercise therapy, and heat treatments.

Why it might work

Often times, the violent collisions that cause concussions also cause other injuries, especially when whiplash is involved.

Sometimes, those other injuries can interact with the concussion, making the symptoms worse. Physical therapy can help concussions by relieving injuries that may be making the concussion symptoms worse.

Exertional Therapy
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Who could this work for?

Exertional therapy can be helpful for patients who are experiencing a slower recovery than may otherwise be expected.

What is it?

Exertional therapy involves a concussion patient performing light aerobic activity in a controlled and monitored environment. This could be on a treadmill, in a pool, or other setting with no risk of inadvertent head impact.

Doctors will design a custom plan for each patient that helps them raise their heart to a specified level. It is extremely important that this be done under the close supervision of a medical professional, as over-exertion can hamper recovery.

Why it might work

Exercise has a very well documented effect on health – simply put it is good for our bodies. By having patients lightly exert themselves in a controlled environment, doctors seek to take advantage of these benefits.

Cognitive Behavioral Therapy (CBT)
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Who could this work for?

Cognitive Behavioral Therapy (CBT) can be very effective for concussion patients who are suffering from mood changes after a concussion, most commonly depression or anxiety. This is especially helpful for patients with longer term symptoms, such as patients suffering from post-concussion Syndrome.

What is it?

CBT is a psychological therapy frequently used to treat problems with mood, including depression and anxiety. CBT helps patients develop the ability to identify negative thought patterns that contribute to a patients individual difficulties, and teaches concrete skills that patients can use to help manage them.

Why it might work

CBT is a highly effective treatment for many mood and anxiety disorders, often providing clinically meaningful relief within weeks or months. In the setting of concussion, preliminary evidence suggests that CBT may be able to similarly help patients develop coping strategies to help manage their symptoms.

We'll review experimental therapies soon. Are there experimental therapies that have worked for you? Let us know at info@concussionfoundation.org.

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Concussion Legacy Foundation
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(T) 857.244.0810
info@concussionfoundation.org

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