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Health condition · Clinically reviewed

Post-concussion syndrome, why symptoms linger and how recovery is rebuilt.

When headache, dizziness, fatigue or foggy thinking carry on after a concussion, it is frustrating but usually temporary. Most people recover, and a structured plan helps.

Looking for the initial injury? Start with our concussion guide.

Jump to treatment
A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Why trust this guide

  • 01

    Clinically reviewed

    Written by our editorial team and reviewed by a registered UK clinician before publication.

  • 02

    Sourced from guidance

    Checked against NICE NG232, the 2023 Amsterdam concussion consensus and UK headache guidance, all listed at the end.

  • 03

    Current for 2026

    Reflects modern practice - explanation, graded activity and targeted rehabilitation rather than prolonged rest.

Key facts

Post-concussion syndrome at a glance.

The essentials, in plain English - what it is, how long it usually lasts, and why the outlook is good.

  • What it is

    Symptoms that carry on beyond the usual recovery window after a concussion (mild traumatic brain injury) - also called persisting post-concussion symptoms.

  • Usual recovery

    Most adults recover within days to a few weeks. Children and teenagers can take longer, and that is still within the normal range.

  • Common symptoms

    Headache, dizziness, fatigue, poor sleep, slowed thinking, low mood, anxiety, and sensitivity to light and noise.

  • More than one cause

    Symptoms usually have several drivers at once - the neck, balance system, eyes, sleep and mood can each contribute, and each can be treated.

  • Scans

    CT and MRI are usually normal, and a normal scan does not mean the symptoms are not real. Imaging is used to look for red flags, not to confirm this condition.

  • Outlook

    Most people improve, including many whose symptoms have lasted for months, particularly with a structured and active rehabilitation plan.

Why this guide matters

Symptoms are real, and so is recovery.

Lingering symptoms can feel worrying and isolating. The three points below shape everything else on this page.

  • Most people get better

    Persisting symptoms are distressing, but they usually improve. Knowing that, and understanding why they happen, is the first step in recovery.

  • Rest alone is not the answer

    Short rest helps early on. After that, gradual, guided activity and targeted rehabilitation do more than waiting in a dark room.

  • Each driver can be treated

    Neck, balance, eyes, sleep, headache and mood can all be contributing. Finding which ones matter for you is what makes treatment work.

How it is assessed

From lingering symptoms to a clear plan.

The steps a UK GP or concussion specialist will normally follow, in order - so you know what to expect and why.

  1. 01

    Assessing

    Detailed history

    How the injury happened, how symptoms have changed since, previous concussions, migraine, and any history of anxiety, low mood or ADHD.

  2. 02

    Assessing

    Symptom checklist

    A structured symptom score, such as the Rivermead Post-Concussion Symptoms Questionnaire, gives a baseline and lets progress be tracked.

  3. 03

    Assessing

    Neurological examination

    Cranial nerves, strength, sensation, coordination, walking and a check of attention and memory - the aim is to confirm nothing more serious is going on.

  4. 04

    Examining

    Balance, eye and neck examination

    Vestibular and oculomotor tests (such as VOMS) plus a neck examination, because dizziness, headache and visual strain often trace back to these.

  5. 05

    Examining

    Mood, sleep and stress screen

    Short questionnaires for anxiety, low mood and sleep. These are common after concussion and slow recovery if left unaddressed.

  6. 06

    Deciding

    Imaging only if red flags

    CT or MRI is reserved for red-flag features or an unexpected course. Most people with persisting symptoms do not need a scan.

  7. 07

    Deciding

    Personalised plan and review

    The main drivers are identified, a graded plan is agreed, and follow-up is set. Referral to a specialist service follows if progress stalls.

Typical timeline: a first assessment to a settled plan within one or two visits.

Symptoms

What persisting symptoms feel like.

A mix of physical, thinking and emotional symptoms, varying from day to day. You may have some or many of them, and they often fluctuate with effort and sleep.

  • Headache

    Often tension-type or migraine-like, and commonly worse with screens, effort or poor sleep.

  • Dizziness and unsteadiness

    Light-headedness, a sense of motion, or feeling off-balance in busy places or when turning the head.

  • Fatigue

    A heavy, whole-body tiredness that arrives quickly after mental or physical effort and is slow to lift.

  • Sleep disturbance

    Difficulty getting to sleep, waking unrefreshed, or sleeping far more or less than usual.

  • Poor concentration and memory

    Feeling foggy, slower to think, losing the thread, and struggling to multitask or retain new information.

  • Irritability, anxiety and low mood

    Shorter temper, worry and a flat mood are common, understandable and treatable - not a personal failing.

  • Light, noise and visual strain

    Bright lights, busy patterns and noise feel overwhelming, and reading or screens tire the eyes quickly.

  • Neck pain and stiffness

    The neck is often strained in the same event and can contribute to headache and dizziness.

Treatment

How persisting symptoms are treated.

Explanation first, then graded activity and rehabilitation matched to whichever drivers are holding recovery back.

  • Explanation and reassurance

    Understanding what is happening, and that most people recover, lowers worry and improves outcomes. It is a treatment in its own right.

  • Short rest, then graded return

    A brief period of relative rest, then a stepped return to daily activity, work or school, adjusting the pace to your symptoms.

  • Sub-symptom-threshold exercise

    Light aerobic exercise kept below the level that clearly worsens symptoms, increased gradually - usually started once assessed and safe to do so.

  • Vestibular and oculomotor rehabilitation

    Targeted exercises for balance, gaze stability and eye tracking, led by a trained physiotherapist or vestibular therapist.

  • Neck physiotherapy

    Manual therapy, posture work and strengthening when the neck is contributing to headache or dizziness.

  • Cognitive behavioural therapy

    CBT helps with anxiety, low mood, worry about symptoms and sleep, and supports a confident return to normal life.

  • Sleep and headache management

    Regular sleep habits, and a headache plan that avoids overusing painkillers, which can make headaches more frequent.

  • Specialist concussion service

    If progress stalls, referral to a specialist concussion or brain-injury service brings neurology, rehabilitation, physiotherapy and psychology together.

What this guide is based on

The sources behind every claim on this page.

UK national guidance and international consensus, current at the time of last review.

Key references

Guidelines and standards we relied on.

A quiet reminder

This guide is for information, not medical advice.

Your GP or a concussion specialist knows your history and can tell you which parts apply to you. If in doubt, get seen.

  • NICE. Head injury: assessment and early management (NG232).

  • Patricios JS et al. Consensus statement on concussion in sport - the 6th International Conference on Concussion in Sport, Amsterdam, October 2022. British Journal of Sports Medicine, 2023.

  • Ontario Neurotrauma Foundation. Guidelines for concussion/mild traumatic brain injury and persistent symptoms (3rd edition).

  • NICE. Headaches in over 12s: diagnosis and management (CG150).

  • Headway - the brain injury association. Patient and family resources on concussion and post-concussion symptoms.

Red flags

When symptoms need urgent attention.

Persisting symptoms are usually not dangerous. These signs are different - go to A and E or call 999 rather than waiting for a routine appointment.

  • A headache that keeps getting worse

    A headache that steadily worsens, or is the worst you have ever had, needs urgent medical assessment.

  • Repeated vomiting

    More than one episode of vomiting after a head injury, or vomiting that starts days later, needs urgent review.

  • Drowsiness or confusion

    Being unusually sleepy, hard to wake, muddled or behaving out of character is an emergency - call 999.

  • Seizure

    Any fit or convulsion after a head injury needs emergency assessment.

  • Weakness or numbness

    New weakness, numbness or clumsiness in an arm or leg, or slurred speech, means calling 999.

  • Clear fluid from the nose or ears

    Watery fluid, or blood, from the nose or ear can signal a skull-base injury and needs urgent imaging.

  • Double vision or sudden sight change

    New double vision, loss of vision or a change in the pupils after a head injury should be seen straight away.

  • New symptoms after another knock

    A further blow to the head while still recovering deserves fresh medical assessment, not a wait-and-see approach.

  • Severe low mood or thoughts of self-harm

    Feeling hopeless or having thoughts of harming yourself needs prompt help - speak to your GP, call NHS 111, or call 999 if you are in immediate danger.

Living with it

A recovery that is steady, not sudden.

Four things that make the biggest difference day to day - pacing, a phased return to work or school, protecting sleep and asking for help early.

A quiet reminder

A bad day is not a setback.

Recovery is rarely a straight line. What matters is the direction over weeks, not how any single day feels.

  1. 01 Pace

    Pace, don’t push and crash

    Break tasks into short blocks with breaks between, and aim for steady days rather than good days followed by bad ones.

  2. 02 Work

    Ask for a phased return

    A gradual return to work or school with fewer hours, lighter duties and screen breaks helps. Your GP can advise on a fit note, and your employer or school can adjust the workload.

  3. 03 Sleep

    Protect sleep and routine

    Regular waking and bedtimes, daylight in the morning, and cutting back on caffeine and alcohol all support recovery.

  4. 04 Support

    Ask for help early

    If you are not improving, or symptoms are affecting your mood, work or relationships, tell your GP - more support is available.

Frequently asked

Everything we get asked about post-concussion symptoms.

Quick answers on recovery time, scans, rest, exercise and when to see a specialist.

  • What is post-concussion syndrome?

    It describes symptoms that continue beyond the expected recovery period after a concussion - headache, dizziness, fatigue, poor sleep, difficulty concentrating, and changes in mood. It is often called persisting post-concussion symptoms. The label is a description rather than a single disease, and the causes are usually a mix of physical, sleep-related and emotional factors.

  • How long does it last?

    Most adults recover within days to a few weeks, and children and teenagers may take longer. Definitions vary, but symptoms lasting beyond about four weeks are generally treated as persisting and worth a proper assessment. Many people with longer-lasting symptoms still improve well with the right support, so it is worth staying hopeful.

  • Do I need a scan?

    Usually not. CT and MRI scans are normally clear in people with persisting symptoms, because the problem is one of function rather than visible structural damage. A scan is used when there are red flags or an unexpected course. A normal result does not mean your symptoms are not real.

  • Should I rest in a dark room until I feel better?

    No. A short period of relative rest in the first day or two is sensible, but prolonged rest tends to slow recovery. The current approach is to return gradually to normal activity, work or school, keeping to a pace that does not clearly worsen symptoms.

  • Is exercise safe?

    Light aerobic exercise kept below the point where symptoms clearly worsen is a well-supported part of recovery, and is usually started once you have been assessed and red flags excluded. Contact sport and activities with a risk of another head injury should wait until a clinician says it is safe.

  • When should I see a specialist?

    Start with your GP. Ask about a referral if symptoms are not improving after several weeks, are getting in the way of work, school or mood, or if you have had previous concussions. A specialist concussion or brain-injury service can look at balance, vision, the neck, sleep and mental health together. Urgent red flags need emergency care straight away.

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