6d. Fatigue



Fatigue is a common symptom many experience after a concussion. It can also happen for many other reasons as all of us are aware. As such, it is called a nonspecific symptom. Fatigue can make the road to recovery more challenging and can worsen many of the features of a concussion – balance, visual, cognitive, headache, neck, sleep and mood. Conversely, it can also be caused by the same problems. Some examples of other common factors that can cause fatigue are:

  • Life stress
  • Poor diet
  • Overwork – too many hours or too much intensity at work
  • Poor balance in life – not enough enjoyable playtime
  • Physical deconditioning
  • Medications/supplements – over-the-counter and/or prescription
  • Other medical conditions (other than concussion, if present)


Because of its nonspecific and interdependent nature, it can become tough at times to pin down the cause of fatigue – usually it is caused by many factors. Moreover, the symptoms of fatigue can wax and wane depending on the time of day, or the task at hand, or because of differences in any of the factors listed above. For these reasons, many patients will experience the symptoms of fatigue differently. Some possible symptoms of fatigue, also non-specific in nature, can include:


  • Physical symptoms: headache, yawning, blank stare, flush face, red eyes, poor posture, slow movements, restlessness, body pain, malaise.


  • Cognitive symptoms: problems starting and/or maintaining a desired activity; difficulty following a conversation or reading; poor executive functioning; poor concentration.


  • Emotional symptoms: any mood issues, discussed in the next section “Post-concussive mood problems”.


  • Behavioural symptoms: disinhibition, passiveness, aggressiveness, impulsivity, impatience, irritability.


Because of the subtle nature of these symptoms, it can be challenging at times for patient to recognize them; this can lead patients not to seek help for the same or only seek help when they are really fatigued. As we can see, fatigue can lead to feelings of frustration and effective management of fatigue is integral to successful rehabilitation.


By educating patients about fatigue, fostering awareness of its symptoms and its hand in daily activities, patients can assist the healthcare team in uncovering its causes and deciding on its treatment.


There is no wonder drug to eliminate fatigue; there are several strategies to investigate the underlying causes of fatigue and others to manage the symptoms of fatigue. As such, the management plan has to be custom made for each specific patient. An occupational therapist is the healthcare professional that has the unique set of expertise to work with the patient and the other members of the healthcare team to create the ideal management plan. Additionally, all the other topics covered in this handbook offer strategies that will also improve fatigue.


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