Car Accident Treatment
We thought that it would be informative to fill you in on the healing process of injuries that people typically get from an auto accident that does not involve internal injuries or broken bones. The following will help you understand what to expect should you need treatment for this type of injury.
First, let’s look at the car accident itself. Whether rear-ended, broadsided, or hit from behind which causes your car to hit the one in front of you, you have definitely sustained some degree of whiplash injury. This means that your body, and most definitely your head and neck, have been “whipped” back and forth, or side to side, very, very rapidly. Your head may even have hit something in the car and you may not realize it. The time it takes for this action to happen is a few brief seconds, but in that time frame damage is definitely done. The action is so quick and so violent even without striking anything that most of the time we don’t even realize that our body has been shaken, let alone injured. It is common for a victim of whiplash to feel no pain right after an accident, and it is quite common for pain to begin to show up days later. When you go to the emergency room after an accident, the doctors there are primarily concerned with whether or not you have sustained any fractures or internal injuries. If you haven’t, you are generally dismissed with a diagnosis of sprain and strain injury, possibly given some medications, and sent on your way. This, unfortunately, is quite often far from the truth, which we shall see as we read further.
One important distinction to make before we go into detail about the injuries is that the damage to the car has little to do with the severity of injury to the occupant of the car, contrary to what the insurance companies insist is true. Just as it doesn’t take much force to jostle milk in a half full gallon milk jug, for example, it also doesn’t take much force to a car to jostle, or whiplash, the occupants inside. Insurance companies most often look at how much damage has been done to the car to determine how much damage has been done to you, and, consequently, how much treatment you should get and how much it should cost. Your car’s damage is not a reliable indicator of how much you have been hurt.
Whiplash injuries are sprain and strain injuries. These are injuries to the soft tissues of the body, meaning the muscles, the connective tissues, the tendons, and the ligaments. Sprains and strains can be mild to severe. A diagnosis, though, of sprain and strain injury only tells us half of what happened in the accident. Because all soft tissues are connected to bones and joints, a chiropractic examination in which not only the soft tissues, but the bones and joints are examined is a necessity. In the emergency room, as mentioned, the doctors are looking for fractures, and examine accordingly. During a chiropractic examination, we are looking for dysfunction, or less than full mobility, of bones and joints. We usually find some degree of this simply because violent strain to soft tissues creates a corresponding injury to the joints that the soft tissues are attached to. Without this assessment, joint damage and dysfunction will be overlooked, and the most common reason for chronic joint problems will have been ignored.
Chiropractic treatment can consist of various therapeutic modalities. The chiropractic adjustment is designed to get joints functioning properly again, as well as reposition the attached soft tissues, reducing the tension on them, and allowing them to go through their healing process without the stress. Massage therapy directly addresses the soft tissue injuries, so most often we combine the two treatments during one visit, as the massage facilitates better adjustments and faster healing. Using appropriate trigger point and other injections using natural substances to soft tissues and/or joints speeds up the healing process considerably by reducing inflammation and curbing pain rather quickly. Ideally, this process should not be prolonged, but typically will take 1-3 months in a healthy individual. The problem comes when an “unhealthy” individual has an accident, and by that I mean one who comes to the accident in a neuromusculoskeletally (involving nerves, muscles, and bones) weakened state, such as one who has degenerative arthritis in many of the injured joints. Unfortunately, this is how most of us are. It will take longer for the healing process to take place, and many people may take 6-12 months to fully heal. By the way, healing is not simply absence of pain. Healing is about gaining optimal neuromusculoskeletal function, which most often is accompanied by very little or no pain.
Healing from injuries sustained in an auto accident can be daunting. My special rule about them is that the process will always take longer than you want it to. This requires patience, which may be in short supply due to the frustrations that certain limitations of injury may present. Your life may change drastically because of your injuries, or simply because you have to fit in a lot of appointments into an already busy schedule. Be assured that sticking to the doctor’s program is the best bet for not having long term consequences from these injuries. The inconvenience of several months of treatment far outweighs the problems that can come up years later from incomplete healing.
There may be quirkiness to the healing process. A typical pattern may present with, within the first week or so, rapid decrease in frequency and/or intensity of pain in some or all areas. You may think that you’re going to finished with treatment very soon. In the coming weeks, though, we usually find that people’s rapid decrease becomes a much slower decrease, and often will plateau, such that there doesn’t appear to be any further improvement. Often, multiple areas of pain will become a single area of pain that persists at, for example, 70% improvement and stays that way for weeks. Often, a single area will have improved, then begin to hurt again. This is the “bump in the road” to recovery that most often only lasts a very short time before improvement resumes. The slowing of improvement is quite normal, with significant improvement continuing after the plateau phase has run its course. 100% improvement for many is attainable, and, of course, that is always the goal. Yet for some that will not happen, and there will be a residue of discomfort, low key and maybe not always there, that will require continued treatment on a maintenance basis ongoingly.
This is the process of healing that has been observed by this office in 30 years of treating hundreds of patients who have been involved in auto accidents. The patterns described above continue to show up over and over in patient’s of all types. We find that a willingness to go through this process and involve oneself in treatment, following all of the doctor’s recommendations, and keeping all appointments, produces the best outcome.
Dr. Perlstein is always open to answering any questions that may arise for you. If you are not yet a patient, you may wish to schedule a consultation to discuss your particular case. We’re here to help you get back on your feet.