Concussions have been in my mind lately. I have begun treatment of a few patients this year suffering from post-concussion problems. The topic has been big in the media lately with a movie (Concussion starring Will Smith), headline news, and lawsuits (CFL BC Lions). So I thought I would put together some information about concussions / traumatic brain injury and how acupuncture can help in the recovery process.
What is a Concussion?
“A concussion is a complex physiological process induced by a bump, blow, or jolt to the head or body, transmitting a force that causes the brain to literally bounce around or twist within the skull” 2
The brain is a delicate organ similar to gelatin in its consistency. It is protected from damage by the hard skull. A cushion of cerebrospinal fluid fills the space between the brain and the skull to keep the brain from bumping against the skull during normal head movements. A blow to the head, hard fall or sudden direction change (such as a car accident) causes the brain to slosh around inside the skull. When this gets violent enough it can cause the brain to knock against the inside of the skull and sustain an injury.
Here’s a short video full of information about how concussions occur, symptoms and recovery:
How Chinese Medicine Views Concussions
TCM considers the acute/sub-acute stages of many traumatic injuries to be at least partially due to blood stasis. Signs of blood stasis include pain that is fixed and stabbing in nature and is sensitive to pressure (hurts to touch). There can also be visible signs such as bruising, varicose or spider veins or dry & cracked skin. Your TCM doctor will also note signs such as a dusky or purplish tongue colour with distended veins under the tongue and changes in the quality of your wrist pulses.
Blood Deficiency is another common TCM pattern that applies to traumatic injuries. This is easy to understand when it applies to the whole body in cases of severe bleeding. It can also occur in small regions of the body. In the case of concussion there may have been rupture of small vessels in the brain leading to local bleeding. Cell damage and vessel damage lead the body to constrict the small arteries in an area to restrict blood flow to the injury in an attempt to prevent further blood loss. Muscle spasms in the neck – from a reflexive tensing in an attempt to prevent the head injury – can also inhibit blood flow to the brain. Signs of blood deficiency in the head include cognitive impairment, memory difficulties, headache (dull pain that feels better with pressure), restless sleep and fatigue.
After any injury the body mobilizes its resources to heal the injury. In the case of the brain – our “seat of consciousness” and the body’s “command centre” – it takes priority over every other body system so all resources are diverted there. Underlying health issues, which may have been under control & symptom free prior to the injury, can suddenly become noticeable after the injury when all healing resources are diverted away. This can explain some of the varied symptoms seen in each individual head injury.
Traditional Western advice leans toward anti-inflammatory medication and rest for treating a concussion. People are also advised to lay off activity until all symptoms are gone and to protect against further injury as successive concussions can lead to serious impairment. The Centre for Disease Control has a pamphlet available online: Facts About Concussion & Brain Injury, that talks about how to recognize a concussion, what symptoms might be experienced and tips for healing.
TCM treatment will involve a thorough assessment not just of the current injury but also of the rest of the body. This will involve questions about the head injury (how it happened), what symptoms are being experienced as well as questions about the general state of physical and mental health prior to the injury. Your TMC Doctor will also look at your tongue and feel your wrist pulses. This information will allow your TCM Doctor to create a comprehensive picture of the patterns of disharmony in your body. After the intake process, you will receive an acupuncture treatment. The first appointment will be 1 hour and follow-up appointments will last 45 minutes.
Acupuncture points will be chosen to help relieve current symptoms: headaches, insomnia, fatigue, cognitive issues, changes to sight/smell/hearing, dizziness and nausea. There will also be points for improving blood flow and balancing any underlying issues that are preventing your body from recovering. Herbal Medicines may be recommended. For concussion these are generally aimed at improving blood flow and reducing pain and swelling.
How Long Will it Take to Recover?
The total number of treatments will vary from person to person. Recovery will depend on the severity of the brain injury and its symptoms, state of health prior to injury and how long ago the injury occurred. It is always best to start treatment as quickly as possible after a concussion takes place, as long as you have the appropriate medical clearance. Generally it will take from 8 to 16 total treatments to achieve sustained relief from most Post Concussion Syndrome symptoms. Some people notice immediate improvement while others may take 3 or 4 treatments to begin to feel improvement. In all cases the improvement won’t be sustained without the appropriate number of follow-up treatments.
Treatment frequency depends on a variety of factors; general health and the severity and duration of the problem are the most important. More information on treatment frequency can be found in the article: “How Frequently Should I Get Treatment“. Patients may want to come for once a month treatments for health maintenance or just because they enjoy the feeling they get from acupuncture treatments. Those are, of course, “optional”.
Things You Can Do to Help Your Recovery
1. Eat a well-balanced, healthy diet. Supply your body with the nutrients it needs for healing. A 2011 study done by the U.S. Department of Defence found that extreme trauma to the brain sends it into a hypermetabolic state, leaving it needing more energy, more quickly. The study recommended eating foods high in protein right after the injury and for two weeks following. Some people notice a lower appetite or feelings of nausea after a head injury so small frequent meals may be more suitable than three large meals daily. High-quality fish oils, red grapes, turmeric, ginger, and other anti-inflammatory foods can also be helpful.
2. Get plenty of sleep. It is during sleep that our body does the most healing.
3. Extend your acupuncture treatment benefits with this self-acupressure routine for concussions.
6. Helms, J.M. & Walkowski, S.A. HMI Auricular Trauma Protocol: An Acupuncture Approach for Trauma Spectrum Symptoms. Medical Acupuncture. 2011 Vol 23, No 4. pg 209-213. (https://hmieducation.com/pub/publications/hmi_5061b01a0ed92.pdf)