Management of Prolonged Symptoms

What are prolonged symptoms?

Most patients recover from a concussion within the first few weeks after the injury, but 15-20% of patients will experience symptoms beyond one month. These are called prolonged symptoms.

What can I do to manage prolonged symptoms?

Talk to your primary healthcare provider if you have prolonged symptoms after a concussion. You will need to have a physical exam and maybe an exertion test. An exertion test is used to to find out how different levels of physical activity affect your symptoms. Other tests may also be needed and can be done by concussion specialists.

Symptoms of concussion are sometimes linked to other conditions, such as depression, headache, poor concentration, sleep problems, dizziness, and fatigue. For this reason, when deciding on the best way to help you with your prolonged symptoms, your primary care provider should consider many different things, including any emotional distress, fatigue, or pain you may be feeling.

The aim of treatment is to improve your activities in your daily life. Depending on the symptoms you are having, you may need to see your primary healthcare provider every few weeks to see if your symptoms are improving, the same, or getting worse.

Having support from your family and friends during this time will be important as you adjust to life after your injury. You may want to consider having a friend or family member with you at your appointments to help you talk with your healthcare provider, and to remember their instructions.

How can I return to daily activities?

Your healthcare providers should help you make a plan to return to your daily activities. It is recommended to add regular, mild exercise as you return to your usual activities and life roles. It is important to add these activities gradually over time, so they do not bring on new symptoms or make your symptoms worse.

Everyone has an individual threshold for when the onset of symptoms may begin. The goal is to gradually increase your activity tolerance without increasing your symptoms or crossing your symptom threshold. It is normal to be uncomfortable because of your symptoms as you increase your activity. You want to avoid making symptoms a lot worse. This means you want to avoid large increases in symptom severity, especially to the point of severe discomfort. If you notice your symptoms are getting worse while you are doing an activity, you should stop doing the activity and talk to your healthcare provider about it.

It is a good idea to keep a journal or log of symptoms that come up as you gradually return to your activities or exercise.

What strategies can I use to monitor symptoms and progress?

Planning and pacing your activities is important. There are many strategies that can help you manage and track your symptoms and progress:

• Start with shorter periods of structured exercise/activity, with rest in between.
• Switch between different types of activities (e.g., switching from reading to walking).
• Plan and schedule your days in advance. Schedule rest breaks to avoid making symptoms worse .
• Use an agenda or calendar to help you remember appointments, tasks, and commitments.
• Track your activities to find connections between activities and symptom onset, or patterns of setback.
• Use a timer to help you stop doing an activity before your symptoms start or get worse.