Car Accident Care

What to do after a car accident

Have you been in a collision recently and found yourself unsure whether you actually need to see anyone?

It is one of the most common situations we encounter, and it is entirely understandable. The vehicle is dealt with, the paperwork is filed, and you feel more or less as you did before. Life resumes. Some days later, something in your neck catches when you turn your head, or a headache arrives in the afternoon that was not there the week before.

The purpose of this page is to explain what happens to a spine during a collision, why the effects so often appear later, and what a thorough evaluation ought to include. Whether you choose to be seen here or somewhere else, you deserve to understand what you are dealing with.

The first forty-eight hours

If you have been in a collision recently, the following will serve you well.

Seek medical evaluation, even if you feel well. Fractures, internal injury and head trauma are ruled out through emergency medical care. This should always come first.

Write down what happened while it is fresh. The direction of impact, where your head was turned, whether you saw it coming, whether your head struck anything. Whether your muscles were braced or relaxed at the moment of impact changes the injury considerably, and this detail is easily forgotten within a week.

Pay attention to what your body reports over the following days. Stiffness, headache, tightness, difficulty turning your head, disturbed sleep, trouble concentrating. Note when each begins.

Rest, but do not immobilize yourself completely. Tissue heals better with gentle, appropriate movement than with prolonged stillness.

Ice can help in the early days. Brief applications several times daily can ease discomfort and support the healing response.

Have your spine evaluated properly, and do it early. The reason for the urgency is explained further down this page, and it is the most important thing here.

When to seek emergency care immediately

Chiropractic care is not the right first step for everything. Go to an emergency department, or call 911, if you experience any of the following:

A headache that is worsening rather than easing
Numbness, tingling or weakness in an arm or leg
Confusion, memory difficulty, or feeling mentally slowed
Changes in vision, or slurred speech
Loss of consciousness at any point, however brief
Severe neck pain accompanied by fever
Difficulty controlling the bladder or bowel
Pain that is severe and unrelenting

If any of these are present, this page is not what you need right now. Please seek emergency care.

"It was only a fender bender"

This is the belief that costs people the most.

The damage to your car is a measure of what happened to your car. It is not a measure of what happened to you. Those are two different structures with entirely different tolerances, absorbing the same event in entirely different ways. A vehicle can come through a collision looking essentially untouched while the people inside it did not.

This is precisely why CBP researchers, after documenting a collision that produced a measured fifteen degree loss of cervical curve, concluded that radiographic screening for cervical structural change is warranted following motor vehicle collisions generally — not only after severe ones.

The biomechanics literature explains why that recommendation is a reasonable one:

Brault, Wheeler, Siegmund and Brault (1998) studied forty-two volunteers, half men and half women, in controlled rear-impact testing. Roughly twenty-eight percent sustained symptoms at a speed change of only two and a half miles per hour. At five miles per hour, the figure rose further. These were healthy adults, screened beforehand, who knew the impact was coming.

Bartsch and colleagues (2008) examined one hundred and five real-world low-speed rear collisions with an average speed change of about four miles per hour. Despite those speeds, the struck vehicles averaged 1.4 g of acceleration, and one hundred and thirteen occupants sustained four hundred and twenty-seven documented injuries within five weeks.

Related analyses have found an injury rate of roughly twenty-one percent in collisions producing under five hundred dollars of vehicle damage, and a notably higher rate of injury among women than men at the same impact speed.

Researchers who have looked for a speed below which injury becomes impossible have not established one. Being caught by surprise, having your head turned at the moment of impact, or sitting out of position all raise the risk considerably — and none of those are visible on a bumper.

What creeps up afterward

Here is the part that concerns me most, and the reason I would rather see someone unnecessarily than miss them.

A stretched ligament heals, but it does not always heal to its original length or its original stiffness. When that happens, the segment it was holding becomes slightly less stable. Your spine responds the way any structure responds to a weakened joint: it redistributes load and it stiffens the area to compensate.

That compensation is silent. It produces no pain for a long while.

But load that is redistributed is load that is now travelling through tissue that was not designed to receive it. Over years, that altered loading is associated with accelerated disc degeneration and arthritic change at the affected levels. CBP researchers have described abnormal cervical curvature as substantially increasing the mechanical loads a spine must carry.

So the person who says "I was fine after that little accident" is often correct about the following month, and wrong about the following decade. The neck that becomes stiff at fifty-five, or the arthritis that appears on an image at sixty, frequently traces back to something that seemed like nothing at thirty.

None of that is inevitable. But it is far easier to address early than late, and it is impossible to address at all if nobody looks.

If you were told that you are fine

Many people arrive here having already been evaluated. They were seen in an emergency department or by their primary physician, they were told nothing was broken, they were given anti-inflammatory medication or a muscle relaxant, and they were sent home to wait for the symptoms to settle.

That care is appropriate and it is important. I want to be careful here, because this is not a criticism of those clinicians.

It is that emergency evaluation is designed to answer a different question than the one you now have.

An emergency assessment exists to determine whether something is immediately dangerous. Is there a fracture? A dislocation? Bleeding? Head injury requiring intervention? The clinical decision rules used in emergency departments were developed and validated specifically to identify clinically important fractures. They work, and they save lives.

But consider what that evaluation does not do:

Standard imaging shows bone. A ligament stretched past its elastic limit but not torn through generally produces no finding at all.
Nobody measures your cervical curve in degrees. It is not part of the assessment, because curve loss is not a medical emergency.
Nobody measures how far your head sits forward of your shoulders. That measurement, anterior head translation, is central to how CBP evaluates a spine and is simply not part of an emergency workup.
Medication addresses the symptom rather than the structure. More on this immediately below.

So when you are told you are fine, what has usually been established is that nothing is life-threatening. That is genuinely good news and worth having.

It is not the same as establishing that your spine is structurally unchanged. Those are two different questions, answered by two different examinations, and only one of them was performed.

What medication does, and what it does not do

Decisions about your medical care belong to you. Our part is to make certain you have the whole picture when you make them.

Medications can provide real relief. In a crisis, or in the acute aftermath of a serious injury, they can be necessary, and many people are grateful for them.

What is equally true is what they actually do. Anti-inflammatories, muscle relaxants and analgesics cover, mask and numb. They interrupt the signal. They do not resolve the condition producing the signal, and they do not change the shape of a spine.

That distinction leads somewhere important.

Your symptoms are one piece of the puzzle, and they are not the most reliable piece.

Consider what that means practically. A great deal of structural change produces no pain at all until it has progressed considerably. Pain also frequently resolves well before the structure underneath it has recovered — which is the single most common reason people stop care too early and find themselves back where they began.

So if symptoms can be absent while a problem is present, and present after a problem has begun resolving, then symptoms alone cannot tell us what is wrong, cannot tell us what will happen next, and cannot tell us what your care should be.

Prognosis and treatment require objective findings — measured and calculated precisely.

The degree of your cervical curve. The distance your head sits forward of your shoulders, in millimetres. How those measurements compare to a normal spinal model, and how they change over time.

That is a different question than "how do you feel today," and answering it requires actually measuring.

The second question is the one this practice exists to answer.

Why you can feel well and still be injured

Your body is designed to heal and to regulate itself. It repairs, adapts and compensates continuously without waiting for your instruction. Health, understood properly, is not the absence of symptoms. It is the capacity your body has to adapt to what it encounters.

This is precisely why a person can walk away from a collision feeling unremarkable. The body absorbs the event and begins adapting immediately, and it will often carry an imbalance for a considerable time before it says anything about it at all.

To understand what it is adapting to, it helps to know what actually happens to a neck during impact.

For many years whiplash was described as the head being thrown backward and then forward. Research at Yale University by Dr. Manohar Panjabi and colleagues, using instrumented cervical spine specimens and high speed photography, showed something more interesting. In the first fraction of a second after impact, the neck does not move as a single unit. The lower vertebrae extend backward while the upper vertebrae bend forward at the same moment, so that the neck briefly assumes an S-shaped curvature it was never designed to hold.

That phase lasts a small fraction of a second, and it is when the injury occurs. The lower segments travel beyond their normal limits before the muscles can respond. Your protective reflexes, remarkable as they are, are simply not fast enough.

Does it make sense, then, that the speed of a collision tells you very little about the injury you may have sustained?

The ligaments are usually stretched rather than torn. Researchers describe this as a subfailure injury — genuine damage that stops short of a complete tear. Microscopic collagen fibers begin to fail at only three to five percent of strain. A torn ligament is visible on imaging. A stretched one frequently is not.

Yet those ligaments are not simply straps. They are richly supplied with mechanoreceptors, small sensors reporting the position and movement of your neck to your brain continuously. Your brain depends on that information to coordinate the muscles holding your head upright.

Injure the ligament and you injure the sensors within it. Dr. Panjabi described the consequence directly: ligament subfailure injuries lead to muscle control dysfunction. Your nervous system is now attempting to run a precise system of coordination using corrupted information. Muscles that should relax remain engaged. Muscles that should stabilise do not respond in time. The compensation continues day after day, and in time the compensation itself becomes the difficulty.

This is why discomfort arrives late. It is also why waiting to see whether it resolves so often disappoints, because nothing about a corrupted signal repairs itself simply through the passage of time.

The window that matters

A multicenter study published in 2025 examining collision-related whiplash reported that half of these injuries result in chronic neck-related disability, and roughly thirty percent of those are moderate to severe. The same research notes that poor long-term recovery is associated with little or no improvement by the three month mark.

Three months is not an arbitrary figure. It is the point at which the pattern tends to set.

That is the strongest argument I can offer for having your spine evaluated early rather than waiting to see what happens. Not because something dreadful is certain, but because the window in which correction is most straightforward does not stay open indefinitely.

What a thorough evaluation should include

Here is where approaches genuinely differ, and it is worth understanding before you choose anyone.

Traditional approaches ask how you feel and what your pain rating is today. Those questions matter and we ask them too. But pain is a poor measure of what has happened structurally, because a great deal of structural change produces no pain whatsoever until it has progressed considerably.

Chiropractic BioPhysics measures where you started and calculates what changed.

A thorough post-collision evaluation should determine the actual shape of your spine, in degrees, rather than estimating it. Your neck is meant to hold a curve — a gentle arc sweeping forward that allows it to carry the weight of your head efficiently while protecting the spinal cord within.

A collision tends to flatten that arc. In one documented case, a motor vehicle collision produced a measured fifteen degree loss of cervical lordosis. Once the curve diminishes, the head begins to rest forward of the shoulders, and a head carried forward of where it belongs becomes a load the neck must resist during every waking hour.

The original impact lasted a fraction of a second. The mechanical consequence can continue working on you for years.

This is why we use digital radiographic analysis and digital posture screening. Not because imaging is impressive, but because you cannot correct what you have not measured, and you cannot demonstrate progress without a starting point to compare against.

What the research shows

Chiropractic BioPhysics is the most researched chiropractic technique in clinical practice today, based on the number of peer-reviewed publications. CBP NonProfit, the research foundation founded in 1982, has published more than three hundred peer-reviewed studies.

Some of what that research has found in collision-related injury:

Measurable structural deficits in collision patients. The 2025 multicenter series examined fifty-one patients presenting with post-collision neck pain and disability. Their cervical curvature averaged −10.3 degrees against an ideal near −42, and anterior head translation averaged 28.5 millimetres against an ideal of zero. These patients were treated beyond the three to four month point at which recovery ordinarily stalls.

Correction is measurable, and it holds. A 2023 case report documented a collision producing a fifteen degree loss of cervical curve. Two rounds of CBP care recovered twenty-one degrees and then a further twelve and a half, with the improvement maintained at six and a half month follow-up. The authors concluded that radiographic screening for cervical structural change is warranted following motor vehicle collisions generally.

Late does not mean hopeless. A 2020 case report followed a patient whose chronic headaches had persisted thirteen years after a motor vehicle collision. Restoration of the cervical curve was accompanied by resolution of those headaches, maintained at one year.

It can help where other care has not. A 2018 report documented cervical extension traction, as part of a multimodal programme, relieving whiplash-associated disorders in a patient who had not responded to previous chiropractic treatment.

Correction can reach conditions that begin with trauma. Fibromyalgia symptoms frequently begin after a physical trauma such as a motor vehicle collision. A randomized trial conducted at Cairo University enrolled eighty patients aged forty to sixty-five who had lived with fibromyalgia for four years or longer. Both groups received the same multimodal programme of cognitive behavioural modification, functional exercise and education. One group additionally received Denneroll cervical extension traction. At one-year follow-up, the traction group showed significantly greater improvement across every outcome measured — pain, disability, general health, anxiety and depression.

Structural correction outperforms symptom care over time. In randomized trials by Moustafa, Diab and Harrison, patients whose care included traction aimed at restoring the cervical curve retained their improvements at one and two year follow-up, while comparison groups did not — even though both groups improved in the short term.

That last finding deserves emphasis. In several of these studies, both groups felt better at first. The difference appeared later. Feeling better and being corrected are not the same thing, and only one of the two tends to last.

Five things that cost people

Waiting to see whether it resolves. The three month figure is the reason.

Saying "I'm fine" and meaning it. You may well be fine. But feeling well at the scene tells you almost nothing about what your ligaments experienced.

Assuming minor vehicle damage means minor injury. A bumper and a cervical ligament have entirely different tolerances.

Accepting care without measurement. If nobody measured your spine at the outset, nobody can show you what changed. You would be asked to take your progress on faith.

Stopping when the pain stops. Pain generally resolves before structure does. This is the most common reason people find themselves back where they started.

How we approach it here

At Chiropatrick Chiropractic Center we practice Chiropractic BioPhysics, and we chose it because of the research record behind it.

That means digital radiographic analysis and digital posture screening to determine what has actually changed. It means Mirror Image® adjustments delivered opposite to your particular distortion, corrective spinal traction that remodels tissue in a way brief adjustments alone cannot, and Mirror Image® exercises to retrain muscles now working from better information. It means re-examination with objective comparison, so your progress is shown to you in your own images rather than described.

Your care is not decided before we understand your spine. We examine first, and we review your findings and recommendations with you at your third visit, because what you need cannot honestly be determined in advance.

And if we do not believe we can help you, we will tell you so and point you toward someone who can.

Where to begin

If you have been in a collision, whether last week or some years ago, the useful question is not how much pain you are in today. It is whether the structure has changed, and whether it can be restored.

That question has an answer, and it does not require a guess.

Call Chiropatrick Chiropractic Center at (207) 781-2003 to arrange your consultation, examination and posture analysis.

Serving Falmouth, Portland, Cumberland, Yarmouth, Freeport and the greater Portland area. Located on Route 1 in Falmouth.