Glen Carbon patients get concussion and TBI treatment at our Woodson Road clinic, about thirty-five minutes away via I-270 west. Treatment starts with structured testing. It separates the concussion from what keeps it going: a headache coming from the neck, vestibular dysfunction and convergence insufficiency.
Here is the most common reason a concussion recovery stalls. The persistent headache is coming from the neck, but it is being treated as part of the concussion.
The headache that is not the brain injury
A blow to the head also slows the neck sharply at the same moment. The upper cervical (neck) joints and the occipital nerves are injured along with the brain. The headache that follows then gets folded into the concussion diagnosis and waited out.
It does not resolve on that timetable, because it is a different problem. Picture pain that starts at the base of the skull and travels up over the back of the head. It is sometimes behind one eye. There is a tender point where the nerve exits. That pattern describes occipital neuralgia rather than post-concussion headache.
Occipital neuralgia versus concussion covers how the two are told apart. Telling them apart matters, because one of them has a specific and effective treatment.
Why it gets missed for months
Because both followed the same event, people assume there is one injury. Nobody examines the neck. The headache is blamed on the concussion, and the patient is told these things take time.
The exam that settles it takes a few minutes. We palpate (press on) the points where the occipital nerves exit and on the upper cervical joints. Then we check whether that reproduces the pain you actually have.
What else stalls recovery
Vestibular dysfunction (a problem in the balance system) and convergence insufficiency are the other two. They produce symptoms — dizziness, tired eyes, trouble in busy places — that are easy to blame on anxiety.
All three can be found on structured testing. All three respond to targeted treatment rather than to more rest. How treatment is structured sets out that targeted plan.
Loss of consciousness shows up in only about 5 to 9 percent of concussions. It also fails to predict who develops persistent symptoms — a 1,507-athlete study found that. Recurrent injury, amnesia, concentration difficulty, insomnia and light sensitivity all predicted post-concussion syndrome in that study, while loss of consciousness did not. Concussion without loss of consciousness sets out the evidence.
The metabolic side of recovery
A concussion is in large part a metabolic injury. It is an energy crisis in cells that briefly cannot meet demand. That is why mental and physical effort bring on symptoms while the brain’s fuel supply is still limited.
It also means the body’s wider metabolic state matters. Poor glucose control, a high inflammatory load and disrupted sleep all make that crisis harder to resolve. All three can be changed.
Concussion recovery and the metabolic terrain covers the mechanism, and the pathophysiology covers what is happening in the cells.
Exercise as treatment, not a reward
Sub-symptom-threshold aerobic exercise is one of the better-supported treatments for a stalled recovery. That means exercise kept just below the point where symptoms start. It surprises people who were told to rest until they felt normal.
The principle is to work just below the level that brings on symptoms, and to raise that threshold step by step. Done properly, it shortens recovery. Done by feel, it produces a cycle of overdoing it and crashing.
It needs a starting point set from testing rather than guessed. That is a large part of what the assessment is for.
The visual symptoms, specifically
Words swimming on a page. Trouble tracking a moving object. Eye strain and headache after twenty minutes of reading. Trouble in visually busy places. All are common, and all are frequently blamed on tiredness.
They are oculomotor (eye movement) findings, and they are testable. Convergence insufficiency in particular (the eyes failing to work together up close) is common after concussion. It is simple to identify. It responds to targeted rehabilitation rather than to rest.
Who else is involved
Depending on findings, we coordinate with vestibular therapy. We work with optometry where the oculomotor picture needs dedicated work. And we work with your own physician throughout.
The point of the assessment is to decide which of those are actually needed. Referring everyone everywhere wastes time and money, and it is its own kind of unhelpful.
Light sensitivity, and what helps
Photophobia (light sensitivity) after concussion is common. People frequently handle it badly by wearing dark glasses indoors. That increases sensitivity over time rather than reducing it.
What helps is reducing glare rather than light. That means matte screens, indirect lighting, and avoiding fluorescent flicker where possible. Tinted lenses have a narrow legitimate role and are not a long-term answer.
How long treatment runs
Usually weeks rather than months, with review points built in from the start. Vestibular and oculomotor rehab produce measurable change fairly quickly. That holds when the right system is being targeted.
Say there is no measurable change by the agreed review. Then the answer is to reassess rather than continue. Open-ended treatment with no endpoint is a warning sign wherever you see it.
Common questions
My headache has not shifted in months. Is that just the concussion?
Possibly not. A cervical (neck) or occipital source is common after a head injury. It is treated differently: telling them apart.
Should the neck be examined after a head injury?
It should, routinely. The same event injures both, and the neck is the part most often left out.
Is dizziness in busy places a concussion symptom?
Frequently. It usually comes from a balance system problem, called vestibular dysfunction. That can be tested and treated: the assessment.
How far is the clinic from Glen Carbon?
About thirty-five minutes via I-270 west to 4477 Woodson Rd, Suite 105, with parking at the door.
Getting here from Glen Carbon
Concussion Center
4477 Woodson Rd, Suite 105, St. Louis, MO 63134
Monday–Friday, 8:00 AM – 5:00 PM
From Glen Carbon, I-270 west across the river and south toward the airport — around thirty-five minutes.
Related reading: concussion treatment for Maryville, IL patients and concussion treatment for Troy, IL patients.