Post-Concussion Management

“Post-concussion management focuses on the evaluation and treatment of symptoms following a concussion, with the goal of restoring cognitive, physical, and neurological function. Care is individualized and may include symptom monitoring, activity modification, rehabilitation therapies, and targeted interventions to address persistent issues such as headaches, dizziness, and cognitive difficulties. As part of a comprehensive neurological care approach, post-concussion management may also involve diagnostic testing and coordination with other specialties when symptoms overlap with conditions affecting nerves, spine, or musculoskeletal function.”

-Dr. Anatoly Pisman, MD

What is Post-Concussion Management?

Post-concussion management is a structured approach to diagnosing, monitoring, and treating symptoms that persist after a concussion. While many individuals recover within a short period, some experience ongoing symptoms such as headaches, balance issues, memory problems, or sensitivity to light and sound.

Management focuses on identifying contributing factors and addressing them through a combination of medical evaluation, functional assessment, and rehabilitation strategies. In some cases, symptoms may overlap with conditions such as nerve pain & pinched nerves, requiring a broader neurological and musculoskeletal evaluation.

Common Post-Concussion Symptoms

Evaluation and Diagnostic Approach

A thorough evaluation is essential to determine the cause of ongoing symptoms. This may include a neurological exam, physical assessment, and review of medical history.

In some cases, diagnostic tools such as EMG / NCV testing may be used to assess nerve function when symptoms suggest possible nerve involvement. Evaluation helps differentiate concussion-related symptoms from other conditions like peripheral neuropathy or entrapment syndromes such as carpal tunnel syndrome.

Treatment Options for Post-Concussion Symptoms

Treatment is individualized and may involve multiple modalities depending on symptom patterns and severity.

Activity Modification and Rest

Gradual return to normal activities is guided by symptom tolerance. Overexertion can worsen symptoms, so pacing is important during recovery.

Rehabilitation Therapies

Rehabilitation may include physical therapy, vestibular therapy, and cognitive strategies to improve balance, coordination, and mental clarity.

Interventional Procedures

If symptoms overlap with musculoskeletal or spinal conditions, interventional treatments may be considered as part of a broader plan within PMR interventional procedures, including:

• Epidural steroid injections for nerve-related inflammation
• Facet joint injections for neck or back pain contributing to symptoms
• Trigger point injections for muscle tension and associated headaches

These treatments are typically considered when structural or inflammatory contributors are identified alongside concussion symptoms.

Regenerative and Supportive Therapies

In select cases, therapies such as PRP therapy may be used when soft tissue injury or chronic inflammation is contributing to ongoing discomfort.

Neurological Considerations

When to Seek Evaluation

Post-concussion management is recommended if symptoms persist beyond the expected recovery period or interfere with daily functioning. Early evaluation can help identify underlying issues and prevent symptoms from becoming chronic.

What to Expect at Your Visit

During your visit, your symptoms, injury history, and functional limitations will be reviewed in detail. A focused neurological and musculoskeletal exam will help determine whether symptoms are primarily concussion-related or influenced by other factors such as nerve irritation, spine involvement, or soft tissue dysfunction.

Based on findings, a personalized treatment plan may include rehabilitation, diagnostic testing, lifestyle modifications, and targeted interventions tailored to your condition and recovery goals.

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