Mark Heisig Mark Heisig

Understanding the Role of NSAIDs After a Concussion

Hey there! I’m Dr. Mark, and today we’re diving deep into a topic that often comes up after a concussion: the role of non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and aspirin. As a concussion specialist with years of experience, I’ve seen a wide range of cases, from collegiate athletes to non-athletic individuals, and I’m here to help you navigate this important aspect of concussion recovery.

What Are NSAIDs and How Do They Work?

First, let’s get a quick overview of what NSAIDs are. These medications include standard options like ibuprofen and naproxen, and they work by blocking specific enzymes in the body known as COX-1 and COX-2. This action reduces the production of prostaglandins, which are chemicals involved in pain, fever, and inflammation. So, when you take an NSAID, you’re generally looking to alleviate pain or swelling.

NSAIDs & Prostaglandins (Source: Dynamed)

Why Avoid NSAIDs in the First 48 Hours?

Now, here’s the kicker: if you or someone you know has just experienced a concussion, it’s crucial to avoid taking any new medications, including NSAIDs, for the first 48 hours post-injury. Why? Because during this acute red flag period, we don’t want to mask any potentially serious or life-threatening symptoms. If you take an NSAID for a headache, you might inadvertently hide a severe issue that requires immediate medical attention.

Recognizing Red Flags

So, what are these red flags? The Concussion Recognition Tool 6 (CRT 6) outlines key symptoms to watch for:

  • Severe or increasing headache

  • Repeated vomiting

  • Loss of consciousness

  • Double vision or loss of vision

  • Increased confusion or deteriorating consciousness

  • Weakness or numbness in limbs

  • Seizures

  • Visible deformity of the skull

  • Agitation or combative behavior

  • Neck pain or tenderness

If any of these symptoms appear, it’s vital to seek emergency medical care.

After 48 Hours: Can You Take NSAIDs?

If you’ve cleared the red flag stage after 48 hours and are still experiencing headaches, you might be tempted to reach for that ibuprofen bottle. Here’s the blunt truth: while NSAIDs can reduce your headache, they won’t necessarily speed up your recovery from a concussion. They won’t hurt your recovery, but they’re not a magic bullet either.

Symptom Severity and Recovery

When looking to clear someone for return to play, especially athletes, it’s essential to have a clear understanding of their symptom severity. We want to see a low symptom score and normal physical exam findings. If NSAIDs are masking symptoms during these evaluations, we can’t accurately assess recovery. It’s like taking the batteries out of a smoke alarm; just because it’s quiet doesn’t mean there’s no fire.

Consensus statement on concussion in sport—the 5th international conference on concussion in sport held in Berlin, October 2016

Key Takeaways

To summarize:

  • No new medications, including NSAIDs, for the first 24-48 hours after a concussion.

  • Be aware of and monitor for red-flag symptoms.

  • After the initial period, NSAIDs can be used for headache relief but won’t necessarily aid recovery.

  • Avoid taking NSAIDs for more than 10 consecutive days to reduce the risk of serious side effects.

  • Always consult with a concussion specialist to ensure safe recovery.

So, there you have it! Understanding the role of NSAIDs in concussion recovery is crucial for making informed decisions about your health. If you’re looking for more information on concussion management, check out my blog on sleep after a concussion and caffeine use post-concussion.

Thanks for tuning in, and until next time, stay safe!

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