Rehabilitation from postconcussion syndrome: nonpharmacological treatment

Following mild traumatic brain injury (mTBI), one or more symptoms commonly occur that are known as the postconcussion syndrome (PCS). While PCS typically resolves within a few weeks of injury for most concussed patients, some patients have a more prolonged or otherwise adverse recovery course. There is relatively little systematic research on the treatment of PCS. This report offers strategies for nonpharmacological treatment of PCS during the acute, subacute, and chronic stages of recovery following mTBI. The treatment strategies are supported by clinical consensus and the limited evidence-based research wherever possible. Core treatment strategies emphasize (1) education about mTBI, PCS, and the natural recovery course, (2) reassurance of a good outcome, (3) reduction in activity level and refrain from hazardous behaviors during the acute phase, (4) gradual return to lifestyle activities as symptoms permit, (5) careful monitoring and early intervention for adverse emotional responses, (6) symptom-specific treatment when needed, and (7) ready access to providers during acute and subacute recovery periods.