Treatment guide · 10 min read
Concussion Treatment: What Actually Works Now
For two decades, concussion treatment meant one instruction: stop. Dark room, no screens, no school, no exercise, wait it out. That advice is gone. The 6th international consensus statement now says people can return to light-intensity physical activity during the initial 24 to 48 hours after a concussion.
What replaced strict rest isn't another single protocol. Published guideline syntheses describe concussion care as interdisciplinary and individually tailored to a patient's symptom profile — a clinical way of saying that the right treatment depends on which symptoms you actually have.
This guide walks through what that looks like: the first 48 hours, the signs that mean an emergency department instead, what each therapy does and who delivers it, where the evidence is strong and where it isn't, and how to find a clinician whose job matches your symptoms.
What does concussion treatment actually mean now?
It means a short period of relative rest, an early and graded return to activity, and then — if symptoms stay — specific therapies aimed at the specific systems that are misfiring. There is no single concussion protocol, because guideline syntheses describe treatment as interdisciplinary, drawing on vestibular, vision-oculomotor, behavioral health and cognitive rehabilitation depending on the symptom picture.
That shift matters more than it sounds. Under the old model, everyone got the same instruction and the only variable was how long you followed it. Under the current model, two people with identical injuries can get completely different concussion treatments — one doing gaze stabilization work with a vestibular therapist, the other doing convergence exercises with a neuro-optometrist — because their symptoms point at different systems. The work of getting better starts with working out which system is the problem. If you're not sure yet, our guide to concussion symptoms is the place to start.
What should you do in the first 48 hours?
Cut back, don't shut down. Reduce physical and cognitive load for a day or two — shorter screen sessions, lighter mental work, no sport, protected sleep — while still moving around, walking, and doing the ordinary quiet parts of your day.
Relative is the key word. The consensus statement supports light-intensity activity inside that first 24 to 48 hours, and prolonged cocoon rest beyond it is no longer recommended. For most children, the CDC says most children can return to school within 1 to 2 days of a concussion, with accommodations rather than absence.
Two practical points. Avoid anything carrying a risk of a second impact until a clinician clears you. And watch for symptoms that weren't there at first — the CDC notes that some symptoms may not appear for hours or days after the injury, which is why mild concussion treatment starts with a day or two of paying attention rather than assuming you got away with it. Our guide on how long after hitting your head concussion symptoms can start covers what that watching period should look like and when it stops being watchful waiting.
When is a concussion an emergency?
Some signs mean an emergency department now, not a wait-and-see. The CDC lists a headache that gets worse and does not go away, and losing consciousness, looking very drowsy or not being able to be woken up, among the danger signs in adults.
In children, the CDC adds signs a child can't report in words: a child who will not stop crying and is inconsolable, or who will not nurse or eat. If any of these are present, that is not a treatment decision to research. It's a trip to the emergency department.
One thing that surprises people: being sent home without a scan is not being brushed off. Summarizing the CDC's pediatric mild TBI guideline, American Family Physician states that head CT should not be routinely performed to assess patients with mild TBI. Imaging rules out bleeding; it does not diagnose or treat a concussion, and a normal scan doesn't mean nothing happened.
Does exercise help a concussion, or make it worse?
Carefully dosed aerobic exercise helps, and it's one of the better-evidenced pieces of concussion care. In a 2019 randomized clinical trial in JAMA Pediatrics, adolescents prescribed individualized sub-symptom-threshold aerobic exercise recovered in a median of 13 days, against 17 days in the stretching group.
The dose is the whole point. "Sub-threshold" means below the level of exertion that makes your symptoms flare — which is a moving target, and which is why clinics measure it rather than guess. The Buffalo Concussion Treadmill Test identifies the heart rate threshold of exercise tolerance in concussed patients, and a program is then built underneath that number.
For athletes, the return happens in stages: the consensus statement sets out a six-step graduated return-to-sport strategy and a four-step return-to-learn strategy, covered in our breakdown of the return-to-play stages. The last step is not yours to take alone — the CDC is explicit that an athlete should only return to sports with the approval and under the supervision of their healthcare provider.
Which clinician treats which concussion symptom?
Match the clinician to your dominant symptom, not to the word "concussion". The guideline synthesis describes vestibular, vision-oculomotor, behavioral health and cognitive rehabilitation as the components of interdisciplinary care, tailored individually — so the useful question isn't "who treats concussion" but "who treats the thing that is actually wrong with me".
| If this dominates | Who typically treats it | What the treatment involves | Listings in our directory |
|---|---|---|---|
| Dizziness, imbalance, feeling wrong when you turn your head | Vestibular physical therapist or vestibular audiologist | Gaze stabilization, habituation and balance retraining, graded to tolerance | 1,069 |
| Eye strain, blurred or doubled text, losing your place when reading | Neuro-optometrist or optometrist doing vision rehabilitation | Convergence and oculomotor exercises, sometimes prism or tinted lenses | 405 |
| Neck pain, or headache rising from the base of the skull | Physical therapist trained in the cervical spine | Manual therapy, deep neck flexor strengthening, posture and load management | 1,152 |
| Brain fog, memory lapses, losing the thread mid-sentence | Neuropsychologist | Formal cognitive testing, compensatory strategies, written school or work accommodations | 929 |
| Headache as the main problem, or migraine features | Headache specialist, usually a neurologist | Classifying the headache type, reviewing medication overuse, preventive treatment | 305 |
| Symptoms crash whenever you exert yourself | Sports medicine physician or concussion-trained physical therapist | Exercise-tolerance testing to set a heart rate threshold, then a sub-threshold aerobic program | 1,117 |
| Anxiety, low mood, broken sleep, avoiding what you used to do | Psychologist or behavioral health clinician | Cognitive behavioral therapy, sleep restructuring, graded return to avoided activities | 107 |
Those counts come from the 3,205 verified listings in our directory, as of August 2026. Most people need more than one row of that table, which is where the practical problem starts. If you're not sure which row is yours, the two-minute specialist quiz works through it in a few questions.
What do vestibular and cervical therapy actually do?
Vestibular therapy retrains the balance and gaze-stabilization systems so that movement stops provoking symptoms; cervical therapy treats the neck, which absorbs the same force that concussed the brain. A 2014 randomized controlled trial found 73% of participants given combined cervicovestibular physiotherapy were medically cleared within 8 weeks, against 7% of controls — a striking result from a very small trial of 29 participants in total.
In practice these sessions look unglamorous. Head turns while fixing your eyes on a target. Walking a line. Standing on foam with your eyes closed. Hands-on work at the neck and upper back, plus strengthening for the deep muscles that hold your head steady. It's homework-heavy, and the exercises are meant to provoke mild, brief symptoms — that's the mechanism, not a sign it's going wrong.
A 2023 systematic review found that incorporating visual interventions and cervical manual therapy into early rehabilitation significantly reduced symptoms and time to return to sport. Early is the operative word.
Does vision therapy work after a concussion?
Vision problems are genuinely common after concussion, and for the most common one the evidence has now arrived. Roughly one in five people with post-concussion syndrome have symptomatic convergence insufficiency, and the CONCUSS randomized trial found that immediate vergence therapy left 88% of participants successful or improved versus 8% with delayed treatment for that specific problem. That is a real result with a narrow scope: it validates therapy for one eye-teaming deficit, not vision therapy as a treatment for concussion in general.
That's the honest framing, and it's not a reason to avoid it. Convergence insufficiency has a clear mechanism and a measurable finding, the exercises are low-risk, and many clinicians see people improve. What you should expect is a clinician who measures something at the start, sets a target, and reassesses — not an open-ended package sold up front.
Vision care is also the hardest of these services to reach. Across our directory, vision and neuro-optometry is the thinnest widely-needed category in the country: 405 listings, against 1,069 offering vestibular and balance work.
Is there a medication that treats concussion?
No — there is no drug approved to treat a concussion itself. Medication after a head injury is symptom-targeted and largely off-label: NINDS describes drug classes chosen for the symptoms, and a 2024 review notes there are no FDA-approved medications for impaired attention and concentration in patients with a TBI.
What that means in a clinic: a prescription is aimed at headache, sleep, mood or nausea, and is chosen by the symptom rather than by the diagnosis. Headache is worth watching in particular. Under the international headache classification, post-traumatic headaches are considered acute during the first 3 months from onset, and persistent if they continue beyond that — and frequent use of over-the-counter pain relief can itself drive headaches, which is a common trap. We cover that pattern in more depth in our guide to managing headache after a head injury.
What is the treatment for post-concussion symptoms that persist?
The same interdisciplinary approach, applied with formal assessment behind it. Symptoms are described as persisting when they run beyond two weeks in adults and four weeks in children, and that's the point where care should move from general advice to targeted therapy.
Persistence is common enough that it shouldn't be treated as a failure on your part. The pediatric companion to the Amsterdam consensus reports that up to 30% of children and adolescents experience persisting symptoms lasting 4 weeks or longer, and StatPearls puts the proportion of adults still symptomatic past a year at 10 to 15 percent. You are not imagining it, and you are not unusual.
Post concussion symptom treatment at this stage usually starts with measurement — often the Post-Concussion Symptom Scale, 22 symptoms rated from 0 to 6 — so that change can be tracked rather than guessed at. Psychological support belongs in the mix too: a 2022 systematic review found that cognitive behavioral therapy and graded return to physical activity demonstrated some effectiveness on persistent symptoms. "Some effectiveness" is the accurate phrase, and it's still more than most things on offer. Our guide to persisting post-concussive symptoms covers the diagnosis in full.
How strong is the evidence behind these treatments?
It's uneven, and it's worth knowing which is which before you commit money or months. Early sub-threshold aerobic exercise rests on a randomized trial; cervicovestibular physiotherapy rests on a 29-participant trial; cognitive behavioral therapy rests on a systematic review reporting "some effectiveness"; vision therapy for concussion-related convergence insufficiency has no validated treatment assessed yet.
The same discipline applies to what gets sold around the edges. The Defense Health Agency's Traumatic Brain Injury Center of Excellence notes that the current VA/DOD mild TBI clinical recommendations do not specify any nutritional intervention for treating mild TBI, and that for creatine, given the insufficient evidence, there are no clinical guidelines for its use in TBI. Neither finding says these things don't work — it says nobody has shown that they do. Our review of supplements and nutrition after concussion goes through the individual claims.
A fair question to ask any clinic: what evidence supports this, and how will we know within six weeks whether it's helping you?
How do you find a clinician who actually does this?
Start from your dominant symptom, then find a provider whose listed services include it — because concussion care is scattered across specialties rather than gathered in one place. Across the 3,205 verified listings in our directory, 1,069 offer vestibular or balance work and 405 offer vision or neuro-optometry, but only 186 offer both under the same roof.
That number is the single most useful thing our data says about finding care. If you have both dizziness and reading problems — a very common pairing — you are statistically likely to be booking two appointments at two organizations, and it's better to plan for that than to discover it in week three. Multidisciplinary concussion programs exist to close that gap: 1,117 listings describe themselves that way, and 861 offer four or more service categories at once.
Telehealth fills part of the gap and not the rest. Of the 521 listings in our directory that state they offer telehealth, availability is much higher for neuropsychology (155 of 929 listings) than for vision therapy (40 of 405) — which follows, since vestibular and vision work is hands-on. You can search the directory by service, state and city to see what's within reach of you.
What should you do next?
Work out which symptom is driving the rest, find the clinician whose training matches it, and start the graded return to activity rather than waiting for the symptoms to lift on their own. Those three steps cover most of what current concussion treatment consists of.
If you're inside the first 48 hours, keep moving gently and watch for the CDC danger signs above. If you're weeks out and stuck, that's the point to get assessed rather than to keep resting. Our library of concussion guides covers each stage in more depth, and every provider in the directory has been verified against their own public website — inclusion is free, and listings are never ranked by payment.
Find a concussion specialist near you
Search 3,205 verified concussion clinics and specialists across all 50 states — filter by services like vestibular therapy, vision therapy, and neuropsychology.
Browse the largest state directories: California (148) · South Carolina (136) · Pennsylvania (125).
Not sure which kind of specialist your symptoms point to? Take the 2-minute specialist quiz →
Frequently asked questions
How long does concussion treatment take?
There's no fixed course, because treatment is matched to your symptoms rather than run to a timetable. Symptoms are described as persisting beyond two weeks in adults and four weeks in children, and 10 to 15 percent of adults still have symptoms past a year. Only a clinician assessing you can speak to your own timeline.
Can a mild concussion be treated at home?
Much of early care does happen at home: relative rest for a day or two, protected sleep, gentle movement, shorter screen sessions, and nothing that risks a second impact. Get emergency care for CDC danger signs such as a headache that keeps getting worse or unusual drowsiness. If symptoms are still there after two weeks, that's the point to be assessed rather than to keep waiting.
Do you need a CT scan before starting concussion treatment?
Usually not. American Family Physician, summarizing the CDC's pediatric mild TBI guideline, states that head CT should not be routinely performed to assess patients with mild TBI. Imaging looks for bleeding rather than for concussion, so a normal scan doesn't rule out an injury and isn't needed before treatment starts.
What does concussion treatment look like for a child?
The same symptom-guided approach, with school as the main variable. The CDC says most children can return to school within 1 to 2 days, and that return to sport should happen only with the approval and under the supervision of a healthcare provider. Up to 30% of children and adolescents have symptoms lasting 4 weeks or longer, so persistence in a child is common rather than alarming on its own.
Do supplements help concussion recovery?
No supplement has been shown to treat a concussion. The Defense Health Agency notes that current VA/DOD mild TBI recommendations do not specify any nutritional intervention, and that insufficient evidence means there are no clinical guidelines for using creatine in TBI. That is an absence of evidence rather than proof of harm, but it's a reason to put assessed therapy first.
When should you move from your regular doctor to a concussion specialist?
Around two weeks in adults or four weeks in children, or sooner if dizziness, visual strain, headache or exercise intolerance is dominating. Guideline syntheses describe concussion care as interdisciplinary and tailored to the symptom profile, which is hard to deliver in general practice alone. Our two-minute specialist quiz maps your main symptom to the kind of clinician who treats it.
Educational content only — not a substitute for professional medical advice, diagnosis, or treatment. Reviewed by Jon MacKay, PharmD, BCACP against current clinical guidance; last updated August 2026.