If there are no signs or symptoms that suggest a more serious brain injury has taken place, most cases of concussion can be treated at home.
There are a number of self care techniques you can use to relieve mild concussion symptoms. If more serious symptoms start to develop, seek immediate medical treatment.
Some self care techniques for mild symptoms of concussion are outlined below.
- apply a cold compress to the injury to reduce swelling – a bag of frozen vegetables wrapped in a towel could be used, but never place ice directly on the skin as it's too cold; apply the compress every two to four hours and leave it in place for 20 to 30 minutes
- take paracetamol to control pain – do not use non-steroidal anti-inflammatory drug (NSAID) painkillers such as ibuprofen or aspirin as these can sometimes cause bleeding at the site of the injury
- get plenty of rest and avoid stressful situations where possible
- avoid drinking any alcohol or taking recreational drugs
- only return to work, college or school when you feel you have completely recovered
- only drive a car or ride a bike when you feel you have completely recovered
- do not play any contact sports for at least three weeks without seeing your GP first – this includes sports such as football and rugby
- make sure you have someone to stay with you for the first 48 hours after the injury – this is in case you experience more serious follow-up symptoms
When to seek follow-up advice
Sometimes the symptoms of a more serious brain injury do not occur for several hours, or possibly days, after the initial injury has taken place. This means it's important that you remain alert for signs and symptoms that could suggest a more serious injury has occurred.
If you or someone in your care has any of the signs or symptoms listed below, go to your nearest accident and emergency (A&E) department as soon as possible:
- unconsciousness or lack of consciousness, such as problems keeping your eyes open
- mental confusion, such as forgetting who or where you are
- any drowsiness that goes on for longer than one hour when you would normally be wide awake
- any problems understanding or speaking
- any loss of balance or problems walking
- any weakness in one or both arms or legs
- any problems with eyesight
- a very painful headache that will not go away
- any vomiting
- any fits or seizures
- clear fluid coming out of the ear or nose
- bleeding from one or both ears
- sudden deafness in one or both ears
Returning to sports
Despite being one of the most common sport-related injuries, there is no internationally agreed consensus on advice about when it is safe to return to playing a contact sport, such as rugby, after a concussion.
Most national sporting federations and organisations recommend a "step-wise" approach, where you wait until you are free from symptoms and then resume a low level of physical activity.
If the symptoms do not return, you can step up to a more intense level of activity. If symptoms are still under control, continue to step up through the levels, eventually returning to playing the sport.
A 2013 conference of experts in sports medicine recommended these steps:
- complete rest until symptoms have passed for at least 24 hours
- light aerobic exercise, such as walking and cycling
- sport-specific exercises, such as running drills for football or rugby (but no activity that involves impact to the head)
- non-contact training, such as passing drills for football
- full training, including physical contact such as tackling
- return to play
If you are symptom-free, you should be able to return to play within a week. If you experience a return of symptoms, rest for 24 hours, drop down to a previous step, and then attempt to move up again.