Pain After Car Accident Delayed?

Pain After Car Accident Delayed?

pain after car accident delayed

Can There Be a Delay in Car Accident Symptoms and What to do About Late Appearing Car Accident Injuries?

The typical scenario after a car accident is to feel neck or back soreness and tightness, headaches and other symptoms within a day or two of the accident. However, not all injuries show up so soon. The medical literature points out that a delay in symptoms of days, weeks and even months can occur.

What Causes a Delay in Symptoms After a Car Accident?
There are a couple of factors at play that may contribute to a delayed onset.

Initial Shock

There is an initial “shock” response you suffer after an accident in which your body releases endorphins which numbs your senses. This may last 1-2 days after a trauma masking your injuries.

Minimizing Behaviors

Willful disbelief can occur in which due to a collision that does not appear to be “that bad” because vehicle damage is low, or the impact was perceived to be a slow speed, you simply cannot believe you could be hurt and therefore minimize your pain or blame it on “sleeping wrong,” exercise or “coming down with the flu.” It isn't until the pain persists and is undeniable that you allow yourself to accept and experience the pain and seek attention.

Similarly, if you suffer relatively mild symptoms, you may put off seeing a doctor until weeks or months later when you realize it just isn't going away. By the time you report it, an inexperienced doctor may write in your file that is was a delayed onset when in fact it presented right away, you just delayed treatment.

Multiple Injuries

Multiple injured areas with high intensity levels of pain may mask other, lesser, injured areas. Your brain can only keep track of so many injuries and give priorities to the ones that cause the most immediate pain. Therefore you could have a neck injury that shoots severe pain down your arm that masks the fact that your knee is mildly injured. As your neck and arm pain begin to subside, your brain now allows you to “feel” the knee pain. You may believe it just started, but the injury could have been there all along unknown to you.

Gradual Progressing Injuries

Some injuries are like a slowly deflating tire. Car accident injuries to the discs between your spinal bones can occur, but take a while to show up. The outer fibers of the disc become torn or cracked which may not initially be painful, but in time inflammation increases and symptoms appear. Additionally, the inner gel like substance of your disc can slowly begin migrating through the cracks in the outer fibers until it reaches the nerves and causes pain. Like air gradually escaping a tire, the disc slowly malfunctions leaking pressure and gel until it is noticeable.

“Dashboard knee” is another commonly delayed injury. Your knee may fly up and strike the dashboard on impact. The force crushes the cartilage underneath the knee cap, but not cause immediate symptoms. After a couple of weeks inflammation eventually causes you to feel the pain. In other cases, the inflammation never reached a noticeable level, but because of the injury the cartilage begins trio break down and deteriorate and then you feel it. This could take several months to occur.

What to Do About Pain Delayed After a Car Accident?

It's vital to report all symptoms and changes in symptoms to your doctor. Do not assume a slight change or little ache or pain is irrelevant, sometimes they are, but sometimes they are a clue to an injury that was previously hidden. An experienced car accident doctor will understand this and be able to determine if it is related to the accident or not.

If you've struck your head, elbow or knee in the collision, report it to the doctor even if they do not hurt, as these are common places to show a delayed injury.

Late appearing car accident injuries are not uncommon. There are many reasons for them and they may confuse you and insurance companies into thinking they are not related to your collision. A true car accident specialist doctor will know how to decide if they are related and plan appropriately for treatment.

It is Always Best to Be Evaluated by a Doctor Specializing in Car Accident Injuries as Soon as Possible After a Car Accident. Hidden Injuries May Be Found and Treated before They Become a Problem. Orange County Car Accident Doctor Barry Marks, DC Serving OC Car Accident Injury Specialist Since 1986.

Call for an Evaluation Today (714) 938-0575

What is a Sprain?

What is a sprain?

neck sprain torn ligaments

Practically everyone at one time or another has suffered a “sprain,” but while it is a common problem, most people do not understand exactly what it is.

The casual use of the word “sprain' adds to the confusion. Additionally, because the word is often incorrectly used, the severity and long-term consequences of these injuries are often minimized. If you've been unlucky enough to be injured in a car accident, you may hear the opposing insurance company say things like “it's just a sprain” or “just a soft tissue injury” it's not a serious injury. You may have also heard someone say these injuries heal by themselves rather quickly with no consequences.

To make a sprain injury more understandable, let's take a look at what a sprain actually is from a medical standpoint.

If you were to search on the internet the term “sprain” you will likely see this definition:

To sprain is to wrench or twist the ligaments of (an ankle, wrist, or other joint) violently so as to cause pain and swelling but not dislocation.


A sprain is the result of a wrench or twist of the ligaments of a joint.

This definition is incomplete. It does show that a sprain has a traumatic cause, which is true and it also states that it is an injury to a ligament, also true. What it doesn't describe is the actual medical, anatomical injury and that is very important in understanding this type of "soft tissue" injury.

Compare the above definition with the definition from the American Academy of Orthopedic Surgeons.1


A sprain is a stretch and/or tear of a ligament, a strong band of connective tissue that connect the end of one bone with another. Ligaments stabilize and support the body's joints. For example, ligaments in the knee connect the thighbone with the shinbone, enabling people to walk and run.

A sprained knee can be the result of a sudden twist, and a wrist sprain can occur when falling on an outstretched hand.


Sprains are classified by severity:

Grade 1 sprain (mild): Slight stretching and some damage to the fibers (fibrils) of the ligament.

Grade 2 sprain (moderate): Partial tearing of the ligament. There is abnormal looseness (laxity) in the joint when it is moved in certain ways.

Grade 3 sprain (severe): Complete tear of the ligament. This causes significant instability and makes the joint nonfunctional.

So as you can see the more precise definition is a traumatic jerking or twist of a joint that results in “overstretching” of a ligament that causes damage, tearing of the fibers of the ligament. The severity of the sprain depends on how many fibers are torn. The reason this is important is because, especially in a medical-legal scenario, automobile insurance adjusters often claim a “sprain” in the spine is just an “injured” or “damaged” ligament and not an actual “torn” ligament. They classify this as only a "soft tissue injury."

ligament sprain gradesA sprain is a torn ligament

You now know the truth, that a sprain is in fact a “torn” ligament to some degree. A Grade 1 sprain basically heals with little treatment over a period of weeks and leads to no discernible instability. A Grade 2 takes much longer to heal, months in fact, and NEVER returns to the same strength or elasticity as before because enough fibers have been torn to permanently affect the function of the ligament. It is a serious injury. A Grade 3 sprain is a very serious injury that involves a complete tear of the ligament and the joint is rendered totally nonfunctional and requires surgical repair.

Why are sprains serious?

Remember the function of a ligament is to hold a joint together. If the ligament loses its strength and elasticity it cannot properly hold the joint together. It's similar to the elastic in your socks; once its stretched too far, your socks will never stay up. When this happens, the joint malfunctions and osteoarthritis sets in within 5 years. In the spine it is especially problematic because excessive motion of the vertebral bones in the spine can lead to damage to nerves. If the instability is severe enough, it is classified as a very high degree of permanent impairment.

How do I know what Grade of sprain I have?

If you twist an ankle, and you experience only mild pain on walking and there is only slight swelling and no bruising in the area in the next 24 hours, you have a Grade 1 sprain. Let's say in the same injury you have difficulty walking and notice more swelling that obscures part of your ankle bone and you notice bruising in the area within 24 hours, you likely have a Grade 2 sprain. A Grade 3 sprain will be very painful, enough to totally prevent walking and the ankle may seem very loose and or make popping or cracking noises. Swelling will be severe and much bruising will be seen.

What about a sprain in the spine?

Spraining ligaments in your spine requires a high amount of stress on the ligaments. Car accidents and high intensity sports injuries are the most common causes. Because the ligaments are deep, you will not see swelling or bruising. An MRI can sometimes show larger tears in a spinal ligament, but not always. Additionally, an MRI is a static test, meaning the patient is lying still and not moving so you have no idea if any function is altered. You cannot see joint laxity or instability on a static MRI.

The best method for determining ligament damage in the spine is not by “seeing” the actual damaged ligaments, but by seeing the evidence of abnormal function due to ligament tearing.2 Remember a Grade 2 or 3 ligament sprain will allow for excessive movement in the joints. This can be viewed on motion or stress x-rays. In the spine x-rays are taken from the side in the neutral position, then with head flexed forward and again with the head extended backward for the neck or bending forward and back at the waist for the lower back. The spinal bones are then analyzed as they move to see if excessive motion exists. The amount of excess movement is measured and compared to a normal value. Bones that move too far are due to ligaments being “torn” to some degree and unable to hold the bones together properly. A Grade 2 sprain will show up as unstable motion on a bending x-ray, a Grade I will not. A Grade 3 would show extreme instability, enough to require surgery immediately. Grade 1 sprains often have very mild symptoms, so these victims often do not seek medical attention. Grade 2 sprains occur in around half of rear impact car accident cases, while Grade 3's are not nearly as common.

To recap, a sprain is a traumatic injury to a ligament in which the ligament is overly stretched. The severity of the sprain depends on how much of the ligament fibers are torn. A Grade 1 sprain is an overstretching with very little tearing, a Grade 2 is a partial tearing of the ligament and causes instability of the joint. A Grade 3 is a complete tear that results in total loss of joint integrity and requires surgery. Grade 2 & 3 sprains are common and serious injuries after a car accident that can be documented on “stress x-rays.”



American Academy of Orthopedic Surgeons

Brownstein SP, Jefferey Cronk DC, Joseph Cioffi BA. Evaluation of Spinal Ligamentous Injuries using Computerized X-ray Interpretation. Orthop Rheumatol Open Access J. 2015;1(1): 555551. DOI: 10.19080/OROAJ.2015.01.555551


Chiropractor for Whiplash

Chiropractor for Whiplash

Chiropractors are uniquely qualified through training to diagnose and treat car accident whiplash injuries. This video gives a brief explanation of why your best chance for recovery after a car accident is to see a chiropractor.

Rather than seeing just any chiropractor, you might want to consider a chiropractor who is a recognized expert in Orange County, a doctor who since 1986 has logged hundreds of hours in post-doctorate specialty training in whiplash and brain trauma, auto accident reconstruction, orthopedics, legal aspects of personal injury and more. A doctor who has also taught other doctors and lawyers in the practice of personal injury.

Dr Barry Marks, Chiropractor, Car Accident Injury Expert
1745 W Orangewood Ave #114
Orange, CA 92868

Chiropractor for Whiplash Orange County

Chiropractor for Whiplash Orange County

chiropractor for whiplash orange county

Looking for an Orange County Chiropractor for your whiplash injury? Consider Dr Barry Marks, Chiropractor and car accident injury specialist in Orange.

Chiropractic is the Best Treatment for Whiplash Injuries

Many studies have been done over the years proving that neck and back injuries caused by automobile accidents respond best to chiropractic treatment. Because chiropractor pain relief treatment focuses on healing and restoring spinal joint function, it is getting to the root cause of whiplash pain. Medicines merely mask or cover up the pain leaving the joint injured and allowing it to deteriorate over time. And although physical therapy does work on movement of the muscles and joints, physical therapy does not address underlying biomechanical misalignment and malfunction making the treatment incomplete.

Did You Know There are Chiropractors Specializing in Car Accident Whiplash?

Many chiropractors treat whiplash, but there are a handful of chiropractors who have dedicated their professional lives to the specialty of whiplash and brain trauma. Like any other specialist, these doctors spend years in the classroom learning the intricate details of not only spinal trauma, brain injury, rehabilitation and other medical topics, but they also study forensic principles, legal issues, courtroom procedures, depositions and trials, admissibility of evidence and more to be fully capable of handling a case from first treatment all the way to providing expert witness testimony in court if needed. It is estimated that less than 10% of chiropractors actually specialize in whiplash through formal specialized training.

What to Expect When You See a Chiropractor for Whiplash?

Car Accident Paperwork

Like any professional, you will be asked to complete the usual demographic paperwork, but if you are seeing a car accident injury specialist, you will also complete forms asking about the details of your accident and how you felt immediately after and what you did following the accident. You will also be asked to fill out specialized questionnaires that are designed to determine what level of injury you have and its affect on your daily activities. These questionnaires are sued by specialists world-wide and document such complaints as stress caused by the collision, dizziness, headaches, sleep disruption, neck pain, back pain and others. The questionnaires are repeated after a period of treatment to assess your recovery. Objective forms like these are used by specialists to inform insurance companies, lawyers and juries that an injury did take place, how the injuries responded to treatment and if there are any residual or left over impairments in your daily activities.

Car Accident Examination

Once you have completed paperwork, your chiropractor will discuss the accident and your answers to questions before performing an examination. The examination of a traumatic injury needs to be thorough. It should encompass evaluating your muscles, bones, joints, nerves, brain, and motion. The exam should also include a specialized chiropractic spinal function exam to determine where any malfunctions are occurring in the spinal joints. The exam should be the equivalent of getting an examination by an orthopedic specialist, a neurologist as well as a chiropractor. It will take some time; you will be asked to move in certain positions, the doctor will touch (palpate), move various joints, push and pull on your body, and various other activities to find injured tissues. If your exam is a 5 minute touch here and there and hit your knee reflexes and then done, you have not had a proper examination. There is no short cuts in an auto accident injury exam, every possible injury must be looked for and if found, properly documented.

Car Accident X-rays

X-rays are mandatory after a car collision. Mandatory. Fractures and dislocations can occur, but are not common, but the reason x-rays are mandatory is that a whiplash expert will analyze your x-rays, take measurements and categorize the severity of your injury based on the findings. Many non-specialist doctors do not know the proper method of x-ray analysis and documentation that is acceptable in courts as evidence and often miss the opportunity to document a serious injury that requires specialized treatment and deserves a higher settlement.

Car Accident Spinal Motion Testing

Actual measurements of your spinal motion using an electronic device is a very good practice. Most medical doctors and chiropractors merely analyze motion by observation and make “guesstimates” of degrees of motion by eye. This is unacceptable. Motion analysis in this manner is easily defeated by insurance medical defense experts and will not carry any weight in a courtroom if it is even allowed into testimony. Objective verifiable data using accepted methods is the best procedure.

Car Accident Report of Finding and Recommendations

Once your exams and x-rays are completed, your specialist chiropractor should then sit down with you and explain all the findings, explain in common language what is wrong with you, what the severity is, what treatments are available and what your prospects for recovery are. Please note that at least half of all whiplash injuries involve some degree of permanent injury. Your chiropractic doctor must explain this to you fully. An agreement should then be made to commence treatment.

Treatment for Whiplash from a Car Accident

Many pages can be written on chiropractic treatment for whiplash injuries from a car accident. The basics are that any treatment given needs to be accepted by mainstream chiropractic standards, must be acceptable and defensible in court and must provide relief of treatment AND as much as possible repair or restore normal mechanics and function to the injured spine. There are scores of chiropractic “techniques” or systems of analysis and treatment. Many are well respected and acceptable in a car accident injury case. Some however, are not. This is not to delegitimize some chiropractic theories. Some theories of practice that are not well received by courts of law may well work, but you do not want to complicate your case by having to defend the use of controversial treatments when a car accident case is already an uphill battle. Again, this is where a specialist in auto accident trauma is your best bet because they will only use accepted forms of treatment. After your case you may return to your general chiropractor and pay for any treatments you feel comfortable with.

Treatment should include therapy modalities to relive pain, decrease inflammation and muscle spasm and promote healing. Heat, ice, electrical stimulation, ultrasound, cold laser are all modalities that are not only effective in relieving your condition, but also make the treatment more tolerable and relaxing. Exercises should be given immediately and the intensity of exercise should gradually increase throughout care. Of course the main treatment that separates chiropractic from all other forms of care and is the number one reason it is so successful is chiropractic spinal manipulation or adjustments. Gentle movements of your spinal joints by hand unlock stuck joints, give motion to areas that are lacking motion and stimulate the nerves to reduce pain. It may seem counter intuitive to have someone move your spine around when you are in pain, but a good chiropractor will be able to move your spine with little discomfort and restore motion when other methods cannot. Adjustments allow the spine to function more optimally which allows the body to heal. There may be times your chiropractor decides not to adjust based on your symptoms and exam findings, that is up to the individual doctor and he or she should have a compelling reason to avoid adjustments. Treatments will start out at multiple times per week then scale down as you improve. Total treatment duration for whiplash depends on many factors, but very mild injuries may be resolved in 1-2 months, moderate injuries in 3-6 months and more severe injuries can take a year or more.

Chiropractor for Whiplash Orange County

You have just learned why chiropractic is successfully used for car accident whiplash injuries. You have also learned that not all chiropractors are the same and that a small percentage of chiropractors actually specialize in this field. Lastly you learned what to expect when visiting a chiropractor for a whiplash injury. You are now able to make a more educated decision on who you want treating your painful injuries.

Orange County residents suffering from a whiplash or brain injury after a car accident should consider Dr Barry Marks, Chiropractor and whiplash specialist. For a now up front cost visit with Dr Marks to see if you can be helped, call (714) 938-0575.

To review Dr Marks' extensive credentials go to About

Car Accident Pain

Car Accident Pain

car accident pain

Pain After a Car Accident
Orange County, CA

Pain after a car accident may be mild or more severe and may begin immediately or take days to weeks or longer to fully emerge.

What Happens to Your Body During a Car Accident?

A car crash is a very traumatic event. Even slow speed crashes that leave little vehicle damage, causes a great deal of energy to be transmitted to your body. Upon impact your body will feel as it is being jolted or thrown towards the striking vehicle. The jolt or jerk is extremely quick and sudden. When your body twists and turns so quickly due to the crash, your muscles and ligaments ability to protect your spine is exceeded and they become damaged.

What Becomes Injured After a Car Accident?

The sudden impact of a car wreck causes damage to the following tissues:

  • Muscles
  • Ligaments
  • Discs
  • Joint cartilage
  • Brain
  • Nerves
  • Bones

Where is My Car Accident Pain Coming from?

Each tissue that becomes injured has a particular pain pattern or sensation

Muscles usually exhibit injury by a burning, cramping, spasming or grabbing pain usually on movement.

Ligaments are often the cause of sharp pains or deep burning pain within a joint at rest and on movement. If your ligament is badly damaged you may feel a popping, clicking or clunking on movement.

Disc pain comes in two varieties; if the disc itself is torn or damaged it will cause a deep ache around the midline of the spine near the site of the injury. If the disc is damaged and becomes herniated (an inner gel substance pokes out) it can irritate nerves causing numbness, tingling, sharp shooting pain, electric shock sensations, burning into an arm/hand or leg/foot. Neck discs cause arm/hand pain. Low back discs cause leg/foot pain.

Joint cartilage can be damaged when joints suddenly collide together due to force. The pain is commonly an ache, burn or poking sensation when the joint is compressed. If you bend your neck backwards and sideways simultaneously and you feel pain poking into the shoulder blade or upper back, then it is likely you have a damaged joint.

Brain injuries can cause wide ranging symptoms, the most common are headache, daytime sleepiness, dizziness, lack of mental clarity, anger, sadness, forgetfulness and more

Nerves can be irritated by disc herniations or your nerves can be injured by being stretched or compressed by excessive motion of the spine. Nerve pain is electric, shooting, burning, tingling or you may have areas where you feel nothing at all, numbness.

Bones can be fractured in an auto accident due to the extreme forces involved. You could have a fracture and not have extreme pain. Bone pain is mostly deep aching, burning, boring in nature.

Pain Intensity Has Nothing to Do With Injury Severity

Some people experience very little pain despite the fact that they have suffered ligament damage or a concussion. Others feel severe pain, but show very little actual tissue damage. Pain is an individual experience; no two people experience it the same way. Your pain is yours only and you should not compare yours to others, even people who may have been in the same car as you. What matters is that you explain and describe your pain clearly and completely so your doctor will be able to determine what tissues are damaged and perform the appropriate examinations and tests. It is only through a competent, specialized exam and imaging studies can the severity of your injury be found.

It doesn't matter whether your car accident pain is mild or severe after a car accident, the important thing is to seek an examination with a doctor specializing in car accident injuries.

For an evaluation by Dr Marks, one of Orange County's most experienced car accident injury specialists, call (714) 938-0575.