OTC Analgesics After Concussion Tied to Faster Recovery, Less Symptom Severity

The use of over-the-counter (OTC) analgesics following a concussion is associated with faster recovery times and reduced symptom severity, according to study results to be presented at the 2025 American Academy of Neurology (AAN) annual meeting, held from April 5 to 9, 2025, in San Diego, California.

Researchers from the National Collegiate Athletic Association (NCAA) and the US Department of Defense Concussion Assessment, Research, and Education Consortium conducted a prospective cohort study to assess whether postinjury OTC analgesic use influences concussion recovery and symptom severity.

The researchers analyzed NCAA athletes and military cadets, categorizing participants based on their postinjury use of OTC analgesics. Medication type was further classified into acetaminophen, non-steroidal anti-inflammatory drugs (NSAIDs), or both. They categorized participants into 2 groups: those who used OTC analgesics after a concussion (n=813) and those who did not (n=848). Additionally, analgesic use was further classified into acetaminophen (n = 660), NSAIDs (n=75), or both (n=78).

The researchers assessed recovery by measuring the time from injury to symptom resolution (daysASYMP) and clearance for unrestricted play (URTP). Symptom and headache severity were evaluated using the Sports Concussion Assessment Tool at 3 time points: preseason (baseline), immediately postinjury, and a median of 3 days post injury.

The researchers found that compared with individuals who did not use OTC analgesics, those who did experienced significantly shorter recovery times. Specifically, analgesic use was associated with faster URTP (hazard ratio [HR], 0.796; 95% CI, 0.697-0.909; P <.001) and earlier daysASYMP (HR, 0.851; 95% CI, 0.744-0.972; P =.034). Furthermore, postinjury symptom and headache severity scores were significantly lower among those who used OTC analgesics, with a logarithmic transformed estimated mean difference of -0.957 (95% CI, -0.944 to -0.959; P <.001) for symptoms and -1.07 (95% CI, -1.06 to -1.08; P <.001) for headaches.

Earlier administration of OTC analgesics postinjury was associated with quicker URTP and symptom resolution (P <.001). However, there were no statistically significant differences in recovery outcomes based on the type of OTC analgesic used, suggesting that both acetaminophen and NSAIDs provide similar benefits in concussion management.

“These findings can enhance our knowledge of treatments for concussion,” the researchers concluded.

Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.