Should You Go To Work Or Not With PCS?

One of the questions that we often get asked by new Post-Concussion Syndrome (PCS) patients is whether or not they should be working. While about 9 out of 10 patients that I see are on disability or are unable to attend school, the other 10% are still trying to continue with their lives, despite their symptoms.

The pressure to return to work after an injury can be a major stress factor, but it is important to not rush back into things or try to push through the pain. An early return to work can greatly impact the recovery process for concussion patients, especially those experiencing PCS.

In the tenth video in our Post-Concussion Syndrome (PCS) series, we will discuss how to assess whether you should go back to work or not. Find out when you should rest and when you can try to push your limits in this video.

Do Your Symptoms Get Worse At Work?

When trying to assess whether a patient should go back to work or not, the question we always ask them is, ‘Do your PCS symptoms get worse while you are working?’

If the answer is ‘yes’, then based on our experience, you shouldn’t be working. If your work is aggravating your symptoms, it typically means you are pushing your injured brain pathways to the point of failure.

Pushing through the pain does not make your brain pathways stronger and can actually injure them further. Patients who try to push themselves to continue working will often experience a ‘crash’ after working and must sleep for several hours to recover.

Taking this approach will often delay a full recovery and return to work. We typically recommend that patients take things more incrementally and monitor their fatigue levels, as we’ll explain below.

Finding Your Time to Fatigue & Increasing Your Limit

If you are trying to work with a brain injury it’s very important that you do not push yourself to the point where you start to develop increased symptoms. You need to be systematic about what you are doing.

If you are going to be working on a computer, then you need to track how long it takes before your symptoms begin to re-emerge. This is your baseline ‘Time to Fatigue’.

If it only takes a few minutes for your symptoms to reappear, then you shouldn’t be working at all. If it takes a few hours for your symptoms to return, then it may be possible for you to return to work with limited or reduced hours. Making modifications to how you’re working can also be a good option and may help lengthen your Time to Fatigue (see below).

Going forward, you should only work within that time limit and try to avoid hitting the point where symptoms return. After a week or so, if you have not had issues with your old symptoms, you can try to push past your original Time to Fatigue and see when the symptoms develop. This will allow you to establish a new Time to Fatigue.

If your injury is not too severe, you may find that you are getting stronger and able to increase the time incrementally every few days or every week. This will allow you to start working for longer on a daily basis. Just remember to stop working as soon as your symptoms reappear.

This same basic strategy can be helpful in building your tolerance for physical exertion as well. To be systematic, you simply have to pick an activity that you can measure and avoid going past your limit. However, if you hit a wall or plateau that you can’t get past, you may need to see a functional neurologist to properly address the injured pathways.

Modifications To Help You Return To Work

Depending on the type of work you do, it may be possible to make an early return to work with some modifications that will lengthen your Time to Fatigue.

Most PCS patients are light sensitive. If you are trying to work with PCS, you will likely find that working on a computer screen will aggravate your symptoms. Sometimes it’s just the light or the flicker of the screen, but most of the time it’s a combination of the light and the effort of tracking the characters on the screen.

Most brain injuries do not allow eyes to work well enough to track small characters. As a result, scrolling up and down on a computer screen will be a very difficult activity for most PCS patients.

If you need to work on a computer screen, then there are a number of options available to you. Tools like green filters or green glasses can help alleviate issues with light sensitivity, while ear plugs can help improve your ability to tolerate a busy workplace.

These types of modifications will allow you to return to work in a limited capacity, but you should continue to monitor your level of fatigue.

If you need to return to work and you want to take the next step in your recovery, we can help. Contact the team at Northoak Chiropractic today to learn more about our PCS treatment.

Woman with a post-concussion syndrome eats healthy food