The first 72 hours after a car accident

You told the EMTs you were fine. You drove home, or got a ride. Then the next morning you couldn’t turn your head.

“I felt fine at the scene” is the most common thing accident patients tell us, and the delay is normal. In a crash, your body floods with adrenaline. It is built to get you out of danger, and it covers pain while it does. Meanwhile, muscle and ligament in your neck and back got stretched faster than they could brace, and swelling moves in over the next hours and days. For a lot of people, the second or third morning is worse than the first.

Here is what to do with those first three days, in order.

Hour zero: at the scene

Anyone hurt, or might be? Call 911, and don’t move them. Otherwise: get out of traffic if you can, hazards on. Call the police and get the officer’s name and the report number. Swap information: name, phone, insurance company, policy number, license plate, and photograph their insurance card and license. Take pictures of both cars, every side, the scene, and any marks on you. A witness’s name and number is enough. And if anyone asks whether you’re hurt: “I don’t know yet. I’m getting checked.”

Day one: get checked, get it written down, start one folder

1. Get examined. If you have any of the warning signs below, go to an emergency room now. If you don’t, get an injury evaluation today or tomorrow, not “if it gets worse.” An exam in the first days is better medicine, and it puts your injuries on record while they are fresh.
2. Write down what hurts. All of it, even the small stuff. A headache or a tight shoulder on day one is often the thing that matters by week three.
3. Photograph any marks. Seat-belt bruising, a knee that hit the dash, a wrist from the airbag. Bruises fade in days; the photo doesn’t.
4. Start one folder. Paper or on your phone. The police report number, the other driver’s information, your claim number, and every letter, text, voicemail and bill from here on.
5. Report the crash to your own insurance company. Give them the facts of the crash: where, when, who. About your injuries, the accurate answer is still “I’m getting examined.” Don’t tell anyone you are fine. You don’t know that yet.

Go to the ER today, not to an appointment, if you have any of these

• Weakness, numbness or tingling in an arm or leg that is getting worse
• New loss of bladder or bowel control, or numbness in the groin or inner thighs
• A headache that keeps getting worse, confusion, repeated vomiting, or trouble staying awake
• Chest or abdominal pain, or trouble breathing
• Severe pain that is getting worse instead of better

Already been to the ER? Good. Their job is to rule out the dangerous things: fractures, bleeding, a head injury. Once they have, the next job is the injuries they don’t treat, the strained and torn soft tissue that will decide how your neck and back feel in three months. That is what an injury evaluation is for.

Days two and three: what it usually feels like

• A stiff neck that won’t turn all the way to one side
• Headaches that start at the base of the skull
• Soreness across the shoulders and upper back
• A low back that locks up getting out of the car
• Trouble getting comfortable at night
• Feeling foggy, off, or just “not right”

None of that means you are exaggerating, and none of it means you should wait to see if it goes away.

The weeks right after a crash are when care has the most say in how you heal, while the body is still laying down new tissue and can be guided back to full motion.

Torn muscle and ligament get patched with new tissue that is laid down fast, in whatever position you are holding. Guard a sore neck for a month and the patch sets in stiff. Keep it moving, with the right care, and it heals flexible. That is the whole reason the first days matter, and it is why whiplash can hurt more at month three when it is left alone.

What the first visit here looks like

Same-day appointments are held for accident patients. Plan on about ninety minutes: your exam, your first treatment, and before you leave, a conversation about how your care gets paid for. Most accident patients start with hands-on care. If the exam or your symptoms call for an MRI, we order and arrange it, and the MRI decides whether anyone needs injections. If your injury calls for medication, a medical provider is part of the same building. And if imaging shows a disc injury in your neck or back, spinal decompression is available here too. Your chiropractor, your medical provider and your imaging, under one roof.

How long does care take? It depends on the extent of the injury. Your progress is measured at each exam, and you are released when your exam shows you have recovered or reached maximum medical improvement.

Watch

What a proper spinal exam looks likeThe exam we run on every accident patient, run on Dr. Barton.

Watch

Cervical decompressionYes, it treats necks. When a crash has injured a disc in the neck, this is the treatment for it.

Who pays: the short version, for Texas

• Your first visit costs you nothing out of pocket. We bill the coverage responsible for your accident.
• You may already have coverage you have never used. Texas auto policies include at least $2,500 per person in Personal Injury Protection (PIP) unless the policyholder turned it down in writing. It pays regardless of who caused the crash.
• If the other driver was at fault, their insurance is ultimately responsible for your accident-related care.
• Letters of protection are accepted. If you have an attorney, your care goes forward under their letter of protection without you paying up front. No attorney? You don’t need one to be treated here.

The call you’ll get

Within a day or two, the other driver’s insurance company will probably call you. The person on the phone is friendly, and they will often ask to record the conversation. Somewhere in it comes the question: how are you feeling?

• Don’t say “I’m fine.” You don’t know yet. A recorded “I’m fine” on day two is hard to take back in week four, when the stiffness has turned into headaches and your hand has started to tingle.
• Don’t give a recorded statement about your injuries before you have been examined. You don’t have to.
• Don’t sign a release or cash a check before you know what is hurt. A fast offer usually comes with a release of everything, including injuries that haven’t shown up yet.
• Hang up on a stranger who calls offering a doctor and a lawyer. In Texas, soliciting accident victims that way is illegal. You choose your own care.

Do stick to the facts of the crash: where, when, what happened. When they ask about your injuries, say “I’m getting examined.” It is fine to say you will call back. And write down every call: who called, which company, the date, and what they asked.

Day three and beyond

• Keep your appointments. Each visit builds on the last, and gaps slow your recovery.
• Move gently, inside a pain-free range. Movement beats bed rest. Skip heavy lifting and high-impact exercise until you have been examined.
• Track how you are doing, weekly. Pain, what you can and can’t do, sleep. That is how you, and we, see progress.
• Tell us about anything new. Tingling, pain moving into an arm or leg, headaches that change. New symptoms can change the plan, including whether you need an MRI.

We put the whole first month into a free guide, Your First 30 Days After a Wreck, with the day-by-day checklists and a symptom log you can print. Email yourself a copy here.

You don’t have to figure out the rest today. Just the next step.

Get examined. Today or tomorrow, same-day appointments are held for accident patients, and it costs you nothing out of pocket at your first visit.

Book your no-cost injury evaluation

This article is educational and is not a substitute for an examination and diagnosis. Individual results vary and no outcome is guaranteed.