Post-Concussion Syndrome: Understanding the Factors and Treatments
Post-concussion syndrome (PCS) is a complex and often debilitating condition that arises following a head or neck injury. It can persist for weeks, months, or even years after the initial trauma, manifesting a range of symptoms:
- headaches
- migraines
- brain fog
- dizziness & vertigo
- chronic fatigue
- inflammation
- full-body pain (e.g., fibromyalgia).
Despite its severe impact on quality of life, diagnosing a concussion typically involves symptomatic presentation rather than findings on diagnostic imaging like X-rays, CT scans, or MRIs. Such imaging is primarily used to rule out more serious conditions such as bleeding or fractures. One crucial but often overlooked factor in PCS is the role of the cervical spine or neck, which is frequently injured during a concussion event. Addressing neck health is essential for effective treatment and recovery from PCS.
The Nature of Concussions
Firstly, it’s important to understand the nature of concussions. A concussion does not necessarily involve a loss of consciousness. Concussions are graded on a scale from one to four:
- Grade 1: Feeling disoriented or seeing stars for less than a minute without loss of consciousness.
- Grade 2: Symptoms persist for more than a minute, still without loss of consciousness.
- Grade 3: Loss of consciousness for less than a minute.
- Grade 4: Loss of consciousness for more than a minute.
Proper neurological assessment following any head injury is crucial to identify and address the severity of the concussion.
Common Areas Affected by Concussions
Concussions commonly affect specific areas of the brain:
- Olfactory Nerves: Impacting the sense of smell.
- Vision Centers: Involving cranial nerves III, IV, and VI, affecting vision (i.e. blurry eyes).
- Facial and Vestibular Nerves: Affecting hearing, balance, and equilibrium.
These areas’ involvement explains why many concussion sufferers experience symptoms like blurry vision and loss of balance. Additionally, injuries often occur at the site of impact and the brainstem’s vestibular centers, due to the high bandwidth requirements and susceptibility to shear forces. The pituitary gland, which controls autonomic functions like heart rate, lung function, digestion, and hormone balances, is also frequently affected, contributing to symptoms of dysautonomia in PCS patients.
The Role of the Cervical Spine
It is nearly impossible to injure the head without also injuring the neck. Research indicates that while it takes around 40 Gs of force to cause a concussion, a mere 3 Gs can result in whiplash, which presents symptoms indistinguishable from those of a concussion. If head movements exacerbate symptoms, it’s likely a whiplash injury is also at play. Thus, rehabilitation must include addressing neck health.
Proper movement of the upper cervical spine is crucial for restoring autonomic nervous system function. The upper cervical spine significantly impacts brain circulation, influencing both arterial blood flow to the brain and venous blood clearance from the brain. Damage to the upper neck can disrupt this balance, causing blood to pool and promoting inflammation in the brain. Inflammation in the brain can lead to various pathologies, contributing to PCS symptoms.
Treatments for Post-Concussion Syndrome
Healing from a concussion requires a multi-faceted approach that reduces inflammation and addresses both direct and indirect factors affecting brain and body function. Here are key treatments:
- Upper Cervical Specific Chiropractic Care
- This specialized chiropractic approach does not involve popping, twisting, or cracking the neck. It focuses on precise adjustments to restore stability in the upper cervical spine, promoting normal nerve function, brain circulation, and reducing inflammation. Advanced diagnostic imaging helps tailor safe and effective adjustments.
- Cranial Sacral Therapy
- Techniques like spinal flow therapy facilitate autonomic balance, focusing on the head, upper neck, and sacrum. This therapy supports normal fluid circulation around the central nervous system, aiding in overall recovery.
- Vestibular Physical Therapy
- Specialized physical therapists prescribe exercises to retrain the brain following injury. These exercises help improve balance, coordination, and neural pathway function, progressively restoring brain functionality.
- Naturopathic Medicine
- Post-concussion leaky gut syndrome necessitates a carefully managed diet to reduce inflammation. Working with a nutritionist or naturopath can help clean up the diet, preventing the introduction of substances that exacerbate inflammation and impair brain healing.
- Neuro-Optometry
- Vision plays a significant role in sensory input. Post-concussion, it may be necessary to wear prescribed glasses that reduce sensory overload. Avoiding blue light, especially before bed, and managing exposure to computer screens and artificial lighting can mitigate symptoms.
Conclusion
Healing from post-concussion syndrome is a challenging and time-consuming process that requires a comprehensive, multi-disciplinary approach. It is essential to assemble a team of specialists to address the various facets of recovery. This integrated strategy not only promotes physical healing but also supports overall well-being, enabling individuals to regain their quality of life and functionality. Despite the difficulties, with the right treatment and commitment, recovery from PCS is achievable.