Slow Recovery can literally be a headache
A 42 year-old female gym teacher came to our program with a heavy burden of post-concussion syndrome symptoms: headache, dizziness, imbalance, poor sleep, irritability, difficulty controlling her emotions, visual blurriness and pain when trying to do near work, discomfort in crowded places, fatigue, neck pain, etc. She had tried to manage her injury on her own, with the help of her GP and a practitioner of sports physiotherapy in Vaughan, but after she felt that she had plateaued in her recovery efforts with this strategy, she searched for a post-concussion syndrome specialist in Toronto and found that our Aurora Rehabilitation location was conveniently located.
Our sports doctor, chiropractor and physiotherapist identified some of the biomechanical problems she had in the way she moved her neck and her whole-body movement strategies in general. She did exercises to train proper movement patterns and this matter was put to rest. This helped reduce the burden of her headaches greatly but also paved the way to facilitate vestibular therapy and vision therapy.
She remained with a slew of vestibular issues: spatial awareness difficulty, visual motion sensitivity and dizziness and imbalance that seemed to be constant. These symptoms always got worse with stress and cognitive tasks like trying to tell a story while doing something else like walking. Like many of our patients, she tried to bite of more than she could chew in terms of her daily activities but once our medical and occupational therapy team held her to a schedule, it became apparent that her symptoms were not constant but episodic. This explained her sluggish response to vestibular therapy and in fact, her vestibular system was retested at a time when she was feeling relatively “well” and she aced it. The vestibular symptoms she was getting were in fact a type of migraine called vestibular migraines. In fact, one can get the vestibular symptoms without the headache in vestibular migraines.
She preferred not using pharmacotherapy to treat her migraines, although there is strong evidence for benefit from the same. She did agree to try CBD oil and was referred to a local cannabis clinic for the same. She used this in conjunction with headache management strategies, CBT-i, energy management strategies and executive functioning strategies.
She is also treating her binocular vision abnormalities at our Thornhill physiotherapy clinic in addition to learning biofeedback strategies at our location for physiotherapy in Aurora, Ontario. She is also participating in a cardiovascular exercise program overseen by our team. Once the burden of her disease reduced sufficiently, our medical and occupational therapy team helped reintegrate her to work without giving up the ideal balanced lifestyle this process helped her develop.
Written by: Dr. Taher Chugh
Last update: July 2018