Post-concussion syndrome (PCS) can cause bothersome symptoms that affect vision, balance, sleep, and more. Dealing with PCS can be quite frustrating as issues can linger after the initial injury and without a clear timeline for recovery.

Fortunately, PCS is a treatable condition. However, it requires a multi-disciplinary approach for management, as there is not a “one-size-fits all” solution. In other words, a care team made up of several specialists can help provide a comprehensive treatment plan. 

This article will go over the main treatment approaches for the most common PCS symptom categories, things to avoid, realistic recovery timelines, and when to seek specialist care. 

What Is Post-Concussion Syndrome?

PCS is when concussion symptoms persist longer than the expected recovery window (usually longer than 4 weeks, sometimes months). About 15% of people who have a concussion are affected by PCS, which can cause symptoms that affect vision, balance, sleep, cognition, and more. This percentage may be underestimated as the condition is sometimes underdiagnosed. 

PCS occurs as the brain recovers from injuries sustained from the initial concussion, which can vary depending on the individual. It does not happen because something was “done wrong”. Due to these processes, people who have had multiple traumatic brain injuries have a higher risk of developing PCS. 

Find out more about what a concussion does to the brain.

Post-Concussion Syndrome Treatment by Symptom

The First Step for Any Concussion: Rest — But Not Complete Rest

After the initial injury, concussion experts recommend rest for 24 to 48 hours. Prolonged rest may impair recovery and is no longer recommended.

When it comes to returning to activity, specialists recommend a gradual step-by-step approach. With this method, activity is slowly increased as your cognitive and physical ability allows. You would need to be symptom-free before advancing to the next step.

For example, in sports this step-by step process could look like:

• rest
• light aerobic activity (walking or jogging)
• sport-specific exercise (throwing a football or dribbling a soccer ball)
• non-contact drills (such as practice with no tackling)
• full activity (normal practice)

This gradual approach also applies to work, school, and other activities. The exact recovery timeline may vary depending on the individual’s symptoms and must always be done with the guidance of a clinician. 

Concussion-related Headache Treatment

Headaches are by far the most common and noticeable symptom associated with PCS. Often these post-concussion headaches present similarly to other types of headaches such as tension-type headaches or migraines. 

If the headaches are migraine-related or have a similar presentation, a neurologist may prescribe medications to treat acute episodes and/or prevent future ones. Some of these medications include triptans or beta blockers. Over-the-counter painkillers may provide short-term relief of symptoms. However, there is a risk of rebound headaches if these medications are used too frequently. 

There are also a variety of non-medication approaches such as biofeedback, trigger identification and avoidance, and improving sleep hygiene. 

Concussion-related Sleep Disruption Treatment

Both insomnia and hypersomnia (sleeping too much) are common PCS symptoms that can disrupt daily life and make recovery more difficult. Good sleep hygiene is usually the first-line management approach. For example, a consistent sleep schedule, limiting screen time before bed, and avoiding daytime naps can help improve quality of sleep.

In certain cases, a clinician may choose to prescribe short-term medication to help with sleep. This should always be initiated and managed by a professional.

Concussion-related Cognitive Symptoms Treatment (Brain Fog, Memory, and Concentration)

Cognitive issues like brain fog, problems with memory and reduced concentration can be very disruptive to work, school, and daily life. Cognitive rehabilitation therapy (CRT) is one way to help treat these bothersome symptoms. Through sessions with a neuropsychologist, these symptoms can be managed using a variety of  strategies to retrain memory and attention.

Some other helpful cognitive pacing strategies to manage symptoms during recovery are taking structured breaks and using reminders such as to-do-lists, calendars, or alarms. 

Concussion-related Mood Changes, Anxiety, and Depression Treatment

Mood changes due to PCS can be distressing.  Sometimes people may suffer increased anxiety, depression, or other changes in behavior and emotion. It helps to note that these changes have a neurological component related to the injury and are not purely psychological. 

‍Cognitive behavioral therapy (CBT) is an evidence-based approach for these kinds of mood-related symptoms. Sometimes, a medical provider may prescribe medications such as antidepressants or anxiolytics to help manage symptoms. This could be done in combination with CBT, depending on what the specialist thinks would be most effective. 

As these mood-related symptoms are often underreported by those who suffer from PCS, it is important to reach out to a medical provider if you notice any of these changes.

Concussion-related Dizziness and Balance Problems Treatment

Disruptions to the vestibular system are common with PCS and can cause dizziness, vertigo, and trouble with balance. Fortunately, these symptoms are highly treatable with a specialist. Working with a physical therapist trained in vestibular rehabilitation therapy (VRT) is considered the gold-standard intervention for these concerns. 

During your program, your physical therapist will give you a variety of exercises to help improve your symptoms. Because the programs are tailored towards the specific cause of the vestibular dysfunction, it is important to only perform these exercises under the guidance of a trained professional.

Concussion-related Vision Problems Treatment

PCS can also cause issues with vision and how the eyes work together as a team. These issues often go underdiagnosed and can cause bothersome symptoms like eyestrain, blurry vision, headaches, double vision, and difficulty reading. 

More specifically, these problems include convergence insufficiency (difficulty turning your eyes inward when looking at things up close), light/glare sensitivity (also called photophobia), and oculomotor dysfunction (trouble making quick movements and/or following objects with your eyes). 

Specialty treatment options like neuro-optometric rehabilitation and vision therapy can help improve visual symptoms. Specialists will provide you with eye training exercises to improve how well your eyes work together. You can think of it as physical therapy for your eyes. In addition, they can prescribe special tinted lenses to help reduce discomfort from light sensitivity. 

What Not to Do When You Have Post-Concussion Syndrome

With PCS, symptoms should be managed with care and under the supervision of specialists. With this being said, there are some things that should not be done during the recovery process:

• return to contact sports (or other high impact physical activity): returning to these kinds of activities should only be done when cleared by a medical provider, as getting a second concussion during this period can significantly impair recovery and lead to poorer outcomes
• extended bed rest: although a limited period of rest is important following the initial injury, concussion experts note that extended rest can actually prolong the recovery process and make symptoms worse
• try to push through symptoms: returning too early to work, school, or sports while you are still experiencing symptoms can disrupt the recovery process. It is important to gradually return to your normal activities under the direction of a specialist
• rely on pain medications: using over-the-counter pain relievers too frequently can cause rebound headaches, which can make overall symptoms worse
• drink alcohol: alcohol can prolong the recovery process by making cognitive symptoms worse and disrupting your sleep
• self-diagnose and manage your condition: Because PCS symptoms are complex and vary among individuals, each person experiences the condition differently. As a result, it is important to seek care from specialists and get treated under their direction. 

How Long Does Post-Concussion Syndrome Last?

Because every person is different, exact recovery timelines may vary. However, most people with PCS experience a full recovery within 3 months. A smaller percentage may have prolonged symptoms that linger for up to 6 to 12 months or longer. Seeking care from a specialist, getting appropriate treatment, and following the protocol for a gradual return to activity all improve recovery outcomes. 

PCS that is persistent (meaning that symptoms last longer than 3-6 months) usually requires a more in-depth approach to recovery. A multidisciplinary team can help manage and treat the various categories of symptoms. 

Fortunately, PCS usually has a good prognosis and most people recover. Only a small percentage experience prolonged symptoms that require more complex management. 

How to Speed Up Post-Concussion Syndrome Recovery

Although nothing guarantees that you will recover faster, there are some things that you can do to put yourself on the best path for recovery:

• seeking specialist care early: consulting with a neurologist or other concussion specialist as soon as possible can help identify issues early so that they can be appropriately managed. You do not need to wait until symptoms worsen before seeking care. 
• following return to activity guidelines: returning too soon can prolong the recovery process and make symptoms worse. It is important to gradually return to activities under the direction of a specialist.
• following good sleep hygiene: getting quality sleep is important in helping your body recover 
• managing mood symptoms early: anxiety, depression, and other changes in mood or behavior can be disruptive during the recovery process. As a result, seeking care for these symptoms early can improve overall outcomes. 
• avoiding re-injury: getting another concussion during the recovery period has been shown to prolong the recovery process and lead to poorer outcomes. This is one of the most important protective factors during this period of recovery. 

When to See a Specialist for Post-Concussion Syndrome

If PCS symptoms last longer than 1 month (or significantly affect daily life), then additional management with a multidisciplinary team, instead of through primary care alone, could be warranted. 

Here are some of the multidisciplinary specialists and their roles in managing PCS:

• neurologists: overall diagnosis and management of PCS, treatment of headaches and other neurological symptoms 
• neuropsychologists: identification and management of cognitive symptoms 
• vestibular physical therapists: management of vestibular symptoms such as dizziness or balance issues 
• neuro-optometrists: management of vision issues such as light sensitivity, double vision, or blurry vision 
• psychiatrists or psychologists: treatment of anxiety, depression, or other changes in mood or behavior

Early referral for treatment with a multidisciplinary approach can lead to improved recovery outcomes. Many concussion clinics and academic medical centers that specialize in treating PCS coordinate all of these multidisciplinary services within the same facility. 

If you are concerned about symptoms or are unsure where to begin, you can take the first step and speak with a Neura neurologist.

Frequently Asked Questions

What not to do when you have post-concussion syndrome?

You should avoid returning to your activities too soon, prolonged bed rest, pushing through your symptoms, and overusing over-the-counter pain relief medications. Getting a second concussion during the recovery process can lead to poor outcomes by prolonging symptoms and can lead to serious injury. As always, you should work with your medical provider to discuss the best plan of care for your symptoms. 

Is post-concussion syndrome the same as a traumatic brain injury (TBI)?

No, they are not the same thing, though they are related. PCS refers to the variety of symptoms that occur after a concussion (which is considered a “mild TBI”). TBIs is a broad term for complex conditions caused by moderate to severe brain injury. Putting it all together, PCS is the collection of symptoms that occur due to a mild TBI, where mild refers to the injury itself, rather than how bad the symptoms feel. 

Can children and teenagers get post-concussion syndrome?

Yes, both children and teenagers can get PCS as they are often involved in activities (like sports) that carry the risk of concussions. Research suggests that this age group can take longer to recover from concussions compared to adults. As a result, PCS is relatively more common with younger patients. Evaluation with a pediatric neurologist or other concussion specialist is essential in managing symptoms, formulating a return-to-activity plan for school, and optimizing the recovery process. 

Can post-concussion syndrome be treated without medication?

Yes, many symptoms are managed though approaches like vestibular rehabilitation therapy, vision therapy, cognitive behavioral therapy, or gradual return-to-activity protocols. In some cases, medical providers might decide that medications would be beneficial in addressing symptoms such as severe headaches, poor sleep, anxiety, or depression. Usually the most effective management plan for PCS is multimodal, meaning that it involves lifestyle modifications, rehabilitation therapy, and medications as needed.

What strategy is crucial for managing persistent post-concussion syndrome?

Evidence shows that persistent PCS is best managed with a multidisciplinary approach. A variety of specialists (such as neurologists, vision therapists, or psychologists) can address categories of symptoms and help individualize care. Seeking care as soon as possible, rather than waiting for symptoms to get worse, consistently leads to improved recovery outcomes. 

References:

Permenter CM, Fernández-de Thomas RJ, Sherman AL. Postconcussive Syndrome. [Updated 2023 Aug 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK534786/

Fischer MA, Jan A. Medication-Overuse Headache. [Updated 2023 Aug 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK538150/

Galeno E, Pullano E, Mourad F, Galeoto G, Frontani F. Effectiveness of Vestibular Rehabilitation after Concussion: A Systematic Review of Randomised Controlled Trial. Healthcare (Basel). 2022;11(1):90. Published 2022 Dec 28. doi:10.3390/healthcare11010090

Leddy JJ, Sandhu H, Sodhi V, Baker JG, Willer B. Rehabilitation of Concussion and Post-concussion Syndrome. Sports Health. 2012;4(2):147-154. doi:10.1177/1941738111433673