Care after a car accident

What happens to a neck in a collision

In a rear-end impact your torso is pushed forward by the seat before your head has begun to move. For a fraction of a second the neck is forced into an S shape — the lower segments extending while the upper ones are still flexed — which is a position it is not built to pass through. Then the head whips backward and forward.

The whole event is over in around a quarter of a second. That is faster than any muscle can voluntarily contract to protect the joint, which is why bracing does not help and why passengers who never saw it coming are often hurt as badly as the driver.

What gets injured is soft tissue: the ligaments holding the vertebrae in relation to each other, the small joint capsules at the back of the spine, and the deep muscles that control fine neck movement. None of that shows up on an x-ray, which is why “the x-ray was clear” and “nothing is wrong” are not the same sentence.

Why day three is worse than day one

At the scene, adrenaline and cortisol are doing exactly what they evolved to do — suppressing pain so you can deal with the situation. That wears off over hours.

Underneath it, strained tissue begins an inflammatory response that builds over twenty-four to seventy-two hours. Muscles around the injured joints then splint to protect them, and that guarding is itself painful and self-reinforcing.

So the ordinary pattern is: fine at the scene, stiff the next morning, worst on day two or three. People who declined to be checked because they felt fine are frequently the ones who ring on day four.

What we do

The examination establishes what actually moves and what does not, tests reflexes, sensation and strength in the arms, and screens for anything that needs a hospital rather than a chiropractic clinic. We take x-rays here where they are indicated.

Early care is deliberately gentle. An acutely injured joint surrounded by guarding muscle is not the moment for a forceful adjustment, so the first sessions typically use low-force techniques and soft-tissue work to settle the inflammation and restore a little motion. As things calm down, treatment progresses.

The part people underestimate is the follow-up. Whiplash-type injuries are known for improving to about eighty per cent and then stalling there, and the difference between eighty per cent and resolved is usually consistency over the following weeks. Staying on top of a developing problem is far easier than retrieving one that has been left for a year.

Documentation

If a claim or an attorney is involved, tell us at the first visit. Contemporaneous records — what was examined, what was found, what was done, how it progressed — are worth having, and they are far harder to reconstruct after the fact than to keep as you go.