Chiropractors for Post-Concussion Syndrome

adjustments of chiropractors for Post Concussion Syndrome

Are you not able to perform your daily activities? And remain disturbed due to the persistence of symptoms like dizziness, vertigo, neck pain, and more, even after head trauma. And you came across the query that what is the role of  Chiropractors for Post-Concussion Syndrome treatment.

Chiropractors have a very obvious role in treating post-concussion syndrome. They do it by assessing the patient’s condition and devising an individualized treatment for every patient. Because every patient has a speed of recovery according to his genetic composition and how much he sticks to the advice of his doctor.

In this blog, we will cover all aspects of Post-concussion syndrome, how it is diagnosed, and the treatment options offered by chiropractors for post-concussion syndrome.

Post-Concussion Syndrome

Post-concussion syndrome is a complex disease in which the concussive symptoms deteriorate to a much worse stage due to improper treatment. Symptoms may be physical, cognitive, emotional, or behavioural. It is a very difficult task to diagnose a patient with PCS as its symptoms can vary from patient to patient.

 Almost 40-50 per cent of patients with head trauma can develop PCS. Considering the prevalence one must understand that it is a very less understood disease to doctors. But, specialities like chiropractic neurology have answers to some serious symptoms that are associated with spinal misalignments and inner ear problems.

The majority of symptoms of traumatic brain injury (TBI) may remain for 7-10 days, but they can be prolonged in many cases due to negligence either from a medical staff or patient. In order to make patients careful, we will discuss the severe types of symptoms and possible outcomes of PCS.

Pathophysiology 

To understand the basics, it is not possible to neglect the pathophysiology of the disease. In concussion, the damaged part of the brain goes into metabolic distress. Potassium ions collect outside the neuronal cells. 

As a result, it causes the influx of calcium into the cell and, ultimately, in mitochondria. Mitochondria is the lungs of a cell due to calcium binding to mitochondria. Electrolyte imbalance then causes the neurons to remain depolarised. Due to the persistent depolarization, cells go into an energy deficit.

The part that gets injured results in symptoms that are specifically related to that part.

Risk Factors

PCS has multiple of the identified type of risk factors that have a major impact on its progression:

1. Severe impact

The probability of developing PCS is directly proportional to the severity of the impact. And also depends on the surface area which is involved.

2. Double Impact 

Suppose the person gets hit on one side by the object and falls on the ground, directly hitting the head on the ground. This type of injury will be a double-impact injury.

3. Preexisting conditions

Preexisting neurological conditions have an added effect on concussion. It  can progress to develop PCS in the following conditions:

  •  ATTENTION DEFICIT HYPERACTIVITY DISORDER
  •  Anxiety and depression
  •  Migraine 
  •  Seizures 

Population Susceptible to Concussion

  • Athletes 50-60 %
  • Children 10-20%
  • Cyclists, motorcyclists, or others going on the road in their vehicles. 20-30% 

Signs and Symptoms

There are four baskets in which we can classify the signs and symptoms of PCS:

 

     Cognitive                   Sleep   Mood/Behavioural         Physical 
Memory  Initially, sleeping too much Irritability  Headache and dizziness
Attention  Later on, the difficulty falling asleep Anxiety  Neck pain 
Focus  Depression  Lightheadedness
Executive function Sensitivity to light
Sensitivity to sound

Causes of PCS

Following are the few causes of symptoms that combine to form a syndrome known as PCS:

Whiplash Injury

Whiplash injury often results from sudden, forceful back-and-forth movement of the neck, like in a car accident. This abrupt motion can cause a concussion, leading to Post-Concussion Syndrome (PCS). 

Hormonal Imbalance

As pituitary and hypothalamus are the main parts of the brain that produce hormones, but injury to these parts can cause decreased secretion of these hormones. This fall in levels of hormones can lead to PCS symptoms if prolonged.

Decoupling of Neurons and Vessels

The vascular supply of the brain is dependent on the activity of neurons. As activity increases, the blood supply of the brain is increased. This signalling is decoupled, and the blood supply of the brain is compromised.

Autonomic Dysfunction

Blood supply to the autonomic system, when it gets compromised, will lead to disturbance in the gut and heart because it balances between the sympathetic and parasympathetic signaling to the heart and gut.

How a Chiropractor Diagnoses Post-Concussion Syndrome?

Chiropractors can diagnose PCS through typical methods that a health care provider mostly uses. They are not different at it, starting from history, doing examination, and then prescribing investigations to be done. Let us go deep into them one by one.

History 

  • First, he listens to the complaints of patients.
  • Ask a few questions to assess the neurologic status.
  • Previous medical or psychiatric history
  • Previous surgical history of skull
  • Any correlating family history

Physical Examination

Following are the examinations that a chiropractor can perform:

  • Vitals
  • Confrontation test for abnormal eye movements
  • Rotatory chair test is a common test for vestibular evaluation
  • Gait assessment
  • Romberg test for vestibular and cerebellar assessment
  • Power of limbs
  • Light reflex for pupillary dilatation, if any.
  • Electronystagmography 
  • Videonystagmography

Investigations

  • CT scan for bleed or infarct in brain
  • MRI brain for acute brain changes and seizures
  • EEG if seizures
  • Serum electrolytes for depression and seizures
  • X-ray of skull and spine
  • All baselines 

Treatments offered by Chiropractors for Post-Concussion Syndrome

Following is the pattern that is usually followed:

Physical and cognitive rest

If there is no active bleeding or inflammation in the brain, then as a doctor, we need to counsel the patient, either inpatient or outpatient, to rest both physically and cognitively. Because rest is the first line of therapy to treat PCS, other treatments, such as medications and therapies, are offered if symptoms prolong for months.

Why rest is so important after a concussion?

We have discussed the pathophysiology above in detail, and our answer lies in it. When trauma to the brain happens, a metabolic deficit occurs in the brain. This metabolic deficit causes the weakening of neurons, and if, at this stage, we put an extra burden on them by thinking and working, then they will be exhausted to death. 

You must know that neurons are non-regenerating cells of the body. Once they die, their function will not reverse again. That’s why rest is so important after a concussion.

 

Targeted therapies

Chiropractors for Post-Concussion Syndrome

Therapies that treat some specific symptoms that occur due to damage to some specific part of the body are known as targeted therapies. Chiropractors for postconcussion syndrome are often used to target specific parts of the body, such as cognition, headache or neck pain, and ocular and vestibular therapies.

For neck pain and headache

Adjustment techniques are the most commonly known therapies that chiropractors use to alleviate neck pain and headaches. In this technique, chiropractors do a hands-on cervical, especially C1 adjustments.

 Cervical adjustments have a deep connection with these symptoms.

How do C1 misalignments cause headaches and neck pain?

1. Compromise of blood to the brain

The cervical spine is basically a tunnel through which many important structures, such as blood supply to the brain, pass. When there is stenosis of vertebral space due to misalignments, then the blood supply is compromised, so healing nutrients are not delivered to the brain. 

That is why the healing of the brain slows down.

2. Abnormal CSF flow

Compression due to misalignments of cervical vertebrae can obstruct the normal passage of CSF, so stasis of CSF in brain spaces can cause compression on brain parts, and prolonged compressions may also lead to infarction.

For Balancing Problems

There are two methods that chiropractors use for balancing issues:

1. Epley’s maneuver

BPPV can occur in most of the traumatic cases. Epleys manoeuvre is the key therapeutic procedure to correct the balance issues due to BPPV.

2. Vestibular Rehabilitation Therapy

VRT is basically an exercise-based correction of balance and dizziness.

Ocular exercises 

These exercises, as the name suggests, focus on the eyes and are designed to improve visual processes that might have been affected by a concussion. Following a concussion, patients frequently experience difficulties with eye tracking, eye coordination, and focus, and these exercises can help to address these issues.

Ocular exercises involve a series of controlled eye movements, such as shifting focus between different targets, following a moving object with the eyes, or rapidly changing focus between near and far objects. These exercises aim to strengthen the eye muscles and enhance neuro-visual processing, thereby improving overall visual performance. 

Physiotherapy 

In paralytic patients, the main aim of treatment is only to improve the quality, but the root cause is not addressed. So chiropractors can apply physiotherapy to muscles that are affected. This is also an effective supportive treatment.

Cognitive Therapy

Cognitive therapies are another crucial component of a chiropractor’s approach to managing Post-Concussion Syndrome. This form of treatment targets cognitive dysfunction, a common issue in PCS patients, which can manifest as difficulties with memory, attention, and executive functions.

Chiropractors often utilize brain training exercises as a part of cognitive therapies. These exercises, often computer-based, challenge the brain to improve its cognitive capabilities. For instance, memory games can assist in improving short-term memory. Puzzles and problem-solving tasks can enhance executive function.

Other techniques are:

  • Soft Tissue Therapy
  • Deep Massage

Follow Up

Follow-ups are very much required in chiropractic type of treatment.

Benefits of Chiropractors for Post-Concussion Syndrome

Chiropractors offer multiple benefits over primitive medications:

  • Improves movement of limbs that have lost strength
  • Provides relief from pain
  • Makes eye movements more normal
  • Assists in coordinating movements of the body
  • Alleviates headaches and feelings of dizziness
  • Boosts posture improvement
  • Enhances overall quality of life
  • Reduces reliance on long-term medications for pain
  • Offers tailored treatments

Case Study

Patient Profile

Name= J.Laughlin

Age=35 years

Occupation=Software engineer

C/O=Headache, dizziness, and difficulty in focusing /3 weeks

H/O=RTA 

Despite no immediate signs of trauma, a visit to his general practitioner confirmed John’s fears – he was diagnosed with Post-Concussion Syndrome (PCS). Over-the-counter medications did little to ease his symptoms, and his work performance started to suffer. Desperate for a solution, John decided to try chiropractic care for his PCS.

His first visit to the chiropractor involved an in-depth discussion about his symptoms, a thorough physical examination, and a review of his medical history. Based on John’s symptoms and the nature of his injury, the chiropractor suggested a comprehensive treatment plan involving spinal adjustments, ocular exercises, and cognitive therapies.

Within a few weeks of regular chiropractic sessions, John began to notice a significant difference. The chiropractic adjustments alleviated his headaches, and the ocular exercises improved his focus. 

Alongside these physical improvements, the cognitive therapies, including memory games and problem-solving tasks, helped John confront cognitive difficulties stemming from his PCS. Over time, with consistent chiropractic care, John’s PCS symptoms noticeably lessened, and his work performance improved. Today, John continues his chiropractic treatments, feeling healthier and stronger than ever before. 

This case demonstrates the potential of Chiropractors for Post-Concussion Syndrome and underscores its role in enhancing overall wellness.

FAQS

1. What is the best treatment for post-concussion?

Rehab and medication are the two best treatments for PCS. Chiropractors for Post-Concussion Syndrome are experts in the rehab of patients through adjustment techniques and massage therapies. At the same time, neurologists are experts at medications.

2. What not to do with post-concussion syndrome?

Things like physical activities, thinking, light stimulus, and sound stimulus may worsen the symptoms of PCS.

3. How can I speed up the recovery of PCS?

Speeding up recovery from Post-Concussion Syndrome (PCS) involves a multidisciplinary approach, including regular chiropractic care, ocular and cognitive exercises, and maintaining a healthy lifestyle with proper sleep and nutrition. These strategies together can help alleviate symptoms and expedite the healing process.

4. How do you reduce brain inflammation after a concussion?

Speeding up recovery from Post-Concussion Syndrome (PCS) involves a multidisciplinary approach, including regular chiropractic care, ocular and cognitive exercises, and maintaining a healthy lifestyle with proper sleep and nutrition. These strategies together can help alleviate symptoms and expedite the healing process.

5. What is the best position to sleep in with a concussion?

The best position to sleep with a concussion is to elevate your head slightly. This can be achieved by using a few additional pillows, as this position can help reduce any swelling or discomfort you might be experiencing.

Bottom Line

In conclusion, chiropractic care proves to be an effective treatment approach for Post-Concussion Syndrome (PCS). This natural, non-invasive method, incorporating spinal adjustments, ocular exercises, and cognitive therapies, offers relief from debilitating PCS symptoms and encourages a swift and healthy recovery.

For those struggling with PCS, consider seeking the expertise of chiropractors for Post Concussion Syndrome. Just as in J.Laughlin’s case, you may find it to be the solution you’ve been seeking. Remember, your health comes first; don’t hesitate to explore all avenues of treatment to enhance your quality of life.

Special thanks to Dr.John for his collaboration.

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