Post-Concussion Syndrome: Symptoms, Risks And Treatment
September 08, 2025
Most people recover from a concussion within a few weeks, but for some, symptoms linger and affect everyday life. This condition is called post-concussion syndrome (PCS). PCS can last weeks or even months, leading to long-term concussion symptoms that impact school, work, sports and quality of life.
How Post-Concussion Syndrome Affects Patients
Sachin Mehta, MD, a physical medicine and rehabilitation physician who practices at Franciscan Physician Network Rehabilitation and Spine Specialists Indianapolis, explained that post-concussive syndrome often involves multiple symptoms at once.
“We notice a lot of our patients who have post-concussion syndrome struggle with balance, neck pain and spasms, vision issues and difficulty focusing on screens," he said. "Others notice problems with memory, concentration and multitasking.
“You can exercise those mental skills, just like you exercise physical issues. And those are done under the care of a speech and language pathologist or a speech therapist,” Dr. Mehta said.
Recovery isn’t just physical. Mood changes such as depression or anxiety are also common. Dr Mehta explained, “When people aren’t getting better, it affects their mood. Neuropsychologists treat the behavioral and mood issues that are associated with prolonged recovery.”
A structured, team-based approach through a concussion rehabilitation program offers the best outcomes. “It treats post-concussion syndrome where the rehab physicians, the physical, occupational and speech therapists all work together. And the best success stories for people who suffer these ongoing symptoms is that team approach,” he said.
The model has helped many of the 10 to 30 percent of patients with lingering symptoms return to school, work and sports.
Post-Concussive Syndrome Symptoms
Brad Keck, a physical therapist with Franciscan Health Indianapolis, explained that post-concussive syndrome can look very different depending on the patient.
“There are primary headache concussions and primary dizziness concussions," he said. "There’s an emotional/cognitive form of concussion where they have that as their primary lingering symptom.”
Preexisting conditions can make post-concussive syndrome worse. People with migraines, attention-deficit hyperactivity disorder (ADHD), post-traumatic stress disorder (PTSD), anxiety or depression may find that these conditions intensify after a concussion. Keck said physical therapy often addresses headaches, balance and dizziness. For example:
- A strained neck or cervical spine can worsen headaches, so therapy may focus on reducing muscle strain and tension.
- Balance and walking problems often improve once dizziness and disorientation are treated, though progress is carefully monitored with testing.
- Sensory overload is common in noisy or busy settings like cafeterias, workrooms, grocery stores or stadiums. Therapists teach strategies to manage disorientation.
PCS doesn’t just cause physical symptoms — it can also create challenges with focus and memory, often called cognitive fatigue.
Cognitive Fatigue And Recovery Challenges
Kayla McConnell, a speech-language pathologist, said cognitive fatigue is one of the biggest struggles. “Often, patients can mentally complete a complex task, but the amount of mental effort it takes is astronomically more than what it would’ve previously cost them.”
She explained that mental and physical health are intertwined. “Cognitive health and physical health are like a good marriage. They depend on each other,” she said.
PCS can feel like living with a chronic illness.
“Just as the flu brings headaches, fatigue and foggy thinking, concussion symptoms linger for much longer, making daily tasks harder,” she said. As physical symptoms like headaches, dizziness or vision problems improve, cognitive function often improves too.
Therapies that support recovery:
- Physical therapy: Addresses neck and spine issues that contribute to headaches, and teaches strategies for handling dizziness and sensory overload.
- Occupational therapy: Helps patients return to daily routines at home, work or school with the right accommodations.
- Vision therapy: Supports patients with eye strain, double vision, poor tracking, light sensitivity and depth perception problems.
- Speech therapy: Focuses on executive functioning, which involves planning, memory, attention and cognitive endurance.
What Happens If A Concussion Goes Untreated?
Most concussions heal with time and care. But leaving it untreated can increase concussion risks like worsening symptoms, serious neurological injury or even death if another concussion occurs before recovery. Patients who don’t recover within the usual timeframe may struggle with daily functioning if post-concussion syndrome is not addressed.
Early diagnosis and treatment can prevent future complications. “Starting therapy sooner helps prevent long-term issues,” said Craig Voll, PhD, PT, a sports medicine athletic trainer with Franciscan Health. For children, untreated concussions may lead to school difficulties, depression or behavior problems. Adults may miss work or struggle to keep up with responsibilities.
Concussions And Brain Health
Researchers are studying how concussions may affect brain health in the long term. A large Canadian study of more than 186,000 people found that those who had a concussion were more likely to develop:
Their risks were roughly 40 to 70 percent higher than those of people who had not sustained a concussion during the 25-year study period.
Experts caution that the study shows correlation, not cause and effect. For example, children with ADHD may be more likely to sustain a concussion, complicating the relationship between the two. The study also found what’s called a dose-response effect: adults with three or more concussions were at much higher risk for Parkinson’s than those with only one.
It’s important to note that most people in the study, concussed or not, did not develop Parkinson’s, dementia or ADHD. Depression and anxiety were more common across the board, with a stronger link seen among women.
While concussion rates in youth sports remain relatively low, millions of children and teens play sports each year, making concussions a significant concern. Certain sports put kids at higher risk, such as football, boxing, wrestling, lacrosse, volleyball and hockey, but experts stress that physical activity remains important for overall health.
Supporting Recovery From A Concussion
Post-concussive syndrome can be frustrating and overwhelming, but recovery is possible. Early diagnosis and treatment through a structured rehabilitation program help patients address physical, cognitive and emotional symptoms.
If you or a loved one is struggling with lingering concussion symptoms, request an appointment or learn more about concussion recovery treatment at Franciscan Health.
