Pain After Vehicle Accidents

It is very common that immediately after a vehicle accident, one quite often does not feel much in the way of pain or stiffness. This is because the hormone adrenaline, often called the “flight-or-flight” hormone, floods your system to allow you to deal with the immediate crisis. It is common for injured patients not to call 911 or to decline to be immediately evaluated by a medical professional, thinking, “I just got a little shook up and I’m probably going to be fine in a few days.” In the vast majority of cases, nothing could be further from the truth. As the adrenaline surge wears off and the swelling of the injured tissues increases (which both take a few days), it is extremely common for symptoms to reach their maximum on the second or third day. I cannot recommend strongly enough, if you have any remaining symptoms by the third day, that you be evaluated as soon as possible by a medical professional with a significant amount of experience in treating vehicle-accident-related injuries. This is not only extremely important to document your injuries so that they can receive the best medical care, but also to document your injuries should any litigation be involved in the future. If you have absolutely no symptoms a week after the accident, then you are the fortunate few that truly have not been injured at all in the accident. Let me emphasize that, although this does occur occasionally, it is rare and the vast majority of patients are injured enough that it is wise to seek medical care.

As one goes through what is often up to several months of rehabilitation (which in our office includes physical therapy and exercise therapy), the physician or physician’s assistant who initially evaluated you, will monitor your progress on a regular basis to make sure that you are improving appropriately for the kind of injuries you received. Much of that evaluation is based upon objective findings. The word objective means what the physician or physician’s assistant finds on their examination, or radiological tests, such as X-rays, CT scans, MRI scans, DMX studies, or Nerve Conduction Studies. Although we do rely upon the patient’s input as to how they feel their pain is improving, this is referred to as a subjective finding and is based upon how that patient perceive pain. We are all “wired differently” in this area, and let me share a rather humorous example about my wife and I.

We were hiking in a very rural part of Africa, off the beaten path, when Sue fractured her ankle after stepping in a large unexpected hole. We were approximately five miles from camp and were both carrying moderately heavy backpacks. Sue merely bent over, tied her hiking boots as tight as she could to limit the swelling and to act as a splint, and continued her five-mile walk down the mountain. If I had been in a similar situation, I I would have sat down and radioed for a helicopter to pick me up because I definitely “feel pain” more than Sue does. We all feel pain quite differently, and in this example it didn’t mean Sue was tougher or better than me. It’s just the way we are. In fact, people who are able to suppress pain quite often end up injuring themselves more in the long run, because the body’s warning sign of pain is ignored and they will continue activities that further aggravate their injuries. Physicians sometimes express this difference between patients as having a high or low pain threshold (meaning that you either tolerate pain very well, or less well). While well meaning, I have always found this a little demeaning, particularly as I am one of those with a lower pain threshold. I have often found that patients, like myself, somehow feel inferior, a “wimp”, or somewhat less than “a real man” when labeled with such a term.

I have learned to share with my treating physicians that I tolerate pain, particularly ongoing pain, somewhat worse than average. They can then take that into account as they evaluate my symptoms. In closing, the more accurate and honest information you can give your treating medical provider, the more they will be able to help you in your recovery.

A Better Way to Get Better,
Adrian Lewis
Adrian Lewis, MD