Conservative Management of Acute Sports-Related Concussions: A Narrative Review

被引:1
作者
Kureshi, Sohaib [1 ,2 ]
Mendizabal, Maria [2 ]
Francis, John [2 ]
Djalilian, Hamid R. [2 ,3 ]
机构
[1] Neurosurg Med Clin, San Diego, CA 92111 USA
[2] TBI Virtual, San Diego, CA 92111 USA
[3] Univ Calif Irvine, Dept Otolaryngol Neurol Surg & Biomed Engn, Irvine, CA 92697 USA
关键词
concussion; mild traumatic brain injury (mTBI); central sensitization; sports-related concussion; peripheral sensitization; glymphatic system; neuroinflammation; pain catastrophizing; TRAUMATIC BRAIN-INJURY; MEDICINE POSITION STATEMENT; LOW-BACK-PAIN; CENTRAL SENSITIZATION; POSTCONCUSSIONAL-SYNDROME; BREATHING EXERCISES; CONSENSUS STATEMENT; RISK-FACTORS; SYMPTOMS; RECOVERY;
D O I
10.3390/healthcare12030289
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
This review explores the application of the conservative management model for pain to sports-related concussions (SRCs), framing concussions as a distinct form of pain syndrome with a pathophysiological foundation in central sensitization. Drawing parallels with proven pain management models, we underscore the significance of a proactive approach to concussion management. Recognizing concussions as a pain syndrome allows for the tailoring of interventions in alignment with conservative principles. This review first covers the epidemiology and controversies surrounding prolonged concussion recovery and persistent post-concussion symptoms (PPCS). Next, the pathophysiology of concussions is presented within the central sensitization framework, emphasizing the need for early intervention to mitigate the neuroplastic changes that lead to heightened pain sensitivity. Five components of the central sensitization process specific to concussion injuries are highlighted as targets for conservative interventions in the acute period: peripheral sensitization, cerebral metabolic dysfunction, neuroinflammation, glymphatic system dysfunction, and pain catastrophizing. These proactive interventions are emphasized as pivotal in accelerating concussion recovery and reducing the risk of prolonged symptoms and PPCS, in line with the philosophy of conservative management.
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页数:21
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