Ask the Doc:

What about concussions?
Mar. 19, 2014 @ 10:34 AM

Q: I've heard a lot about concussions recently. What is the best way to treat them?

A: Do nothing. Absolutely nothing. And it seems to work well.

Concussions have been a significant focus of attention in medicine and media in recent years because of the feared consequences of multiple concussions contributing to impaired thinking, memory loss, depression, and erratic behavior later in life. A lawsuit by former NFL players has brought this issue to the forefront in the news from a medical and financial standpoint.

There are more questions than answers, but progress is being made. Coaches, trainers and officials are much more aware of an athletes behavior during a ballgame and will bench a player if suspected of having a concussion. Sideline screening tests are more reliable and testing performed before the season can be used to assess a players level of concussion in the days between games.

But what is the best treatment for a concussion? It is difficult to evaluate because concussions are not easy to measure. There is no scan or blood test that will give an indication of injury, outside a rare, severe life threatening bleed on the brain which can also occur in sports.

A recent study in the Journal Pediatrics shed some interesting light on a trend we may see in concussion treatment.

It found that "nothing" works for concussion.

No, really, nothing. As in no reading, no school attendance, no school work, no school tests, no athletic practice and no strenuous activity.

This is the point that teenage athletes are saying "Yes!"

But the study went on to say no texting, no video games, no loud music, minimal TV and minimal thinking or conversations. Simply, lie in bed quietly with no interactions at all.

Teenage athletes: "Huh?!"

Minimal thinking might be easily embraced by teenagers, but no texting, video games, loud music or TV? For at least five days? Or until they start improving? Good luck with that one.

The teenage athlete might not be very excited with this new suggested remedy.

The study showed in a group of about 350 athletes with concussions, those who stuck with the Nothing Therapy were usually symptom free after 40 days. The athletes who were allowed to continue texting, school work, video games and all the other common mental activities of teenagers while they recovered, had symptoms last until nearly 100 days.

That is a significant difference.

The current theory is that a storm of chemicals are released in the brain after blunt trauma affecting the membranes of the cells of the brain. The absence of mental activity supposedly allows the brain to "heal" itself, restoring normal chemical levels and repairing the walls of the cells membranes.

It makes sense, actually, in a common sense kind of way. Athletes with concussions often don't want to hear a lot of noise, have trouble focusing on school work, and try to avoid bright lights. The brain simply is telling the body what is needs to heal.

But it makes me wonder about this form of therapy and whether there is a bigger lesson here for all of us.

Could it be that time away from the daily digital display, data and information flood, audio avalanche (even from the shelves in stores as we shop) takes a toll if we don't take time away from it all and enjoy nothing? Literally, nothing?

Maybe this is part of the reason a hike in the mountain seems to provide such mental clarity. Or maybe sitting on a beach enjoying nothing but sunshine and the sounds of the waves coming ashore.

Maybe that vacation needs to have less details and more sitting tails.

Maybe we need to consider the value of finding time, say, oh, weekly, to rest, with minimal input or activity from the outside world and allow our minds to rest and recover from the constant input we receive during the week. Or else, we too, might be prone to depression, anxiety, difficulty with remembering things and other such conditions. It would be interesting to research.

Maybe science of concussion research will lead to the suggestoin we take one day a week, or a portion of one day, to completely rest our brains. To allow healing. To allow the "chemicals" to come back into a balance.

Fascinating. Seems like I've read about the idea of taking one day a week to rest before.

Eric J. Littleton, M.D. is a family physician in Sevierville, Tenn. His new office is located at 958 Dolly Parton Parkway. Topics covered are general in nature and should not be used to change medical treatments and/or plans without first discussing with your physician. Send questions to askdrlittleton@gmail.com.