Why Do Simple Fender Benders Cause So Much Pain?

Insurance assessor inspecting damaged vehicle and taking photograph
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In a car accident—even at low impact—muscles that are deconditioned and already tight are under sudden forces that can cause them to go into spasm. This is why even a small car accident causes so much pain, even when there is no fracture.

The situation and amount of strain on our muscles can cause a condition known as myofascial pain. This refers to some of the tissues, including the muscles of our neck and back, that become stretched, inflamed, and aggravated after shear types of injury.

What Happens During a Car Accident?

In a car accident, our muscles and ligaments undergo a sudden strain and then counter-strain after the car is suddenly impacted. Some people speak about three types of impact that occur even in a simple car accident. This includes the impact to the car, the impact to our bodies and the impact to our internal organs, which we may not be able to see.

It is usually very easy to visualize the damage to the vehicle, which often appears minor in a car accident that occurs at a low rate of speed. But human damage may not be as easy to see.

Sometimes X-rays or even an early physical exam done at the scene of the accident or the emergency room may be unrevealing. This is especially true if there is no bruising, fractures or obvious external signs of bleeding and trauma.

Myofascial Pain

It is often what we do not see, the internal strain and sometimes even microtears that occur in the soft tissue and muscles of the neck and back, that set up the cycle of pain.

This pain, called myofascial pain is hard to diagnose and treat and often worsens days, weeks and sometimes months after a car accident is over. The soft tissues are often trying to repair themselves and a process of inflammation occurs. The accident victim feels stiff, sore all over, and unable to move as easily as they did before the accident.

Previously referred to as whiplash, myofascial pain can become chronic and needs to be recognized early after someone is in a car accident. Physical exam findings usually include tender spots, trigger points, and areas of soreness in the muscles of the back that can be small or large. The spots and points can lead to spasm and even patterns of weakness that most chiropractors, sports medicine practitioners, and orthopedists have learned to recognize.

It is important not only to be seen by a doctor immediately following a car accident but also regularly for the next three to six months to diagnose whether myofascial pain is present.

Diagnosing and Treating Myofascial Pain

One of the easiest signs to recognize is that the head and neck movement is limited or hurts at the end of bending, rotation or extension.  The individual often experiences tenderness in the muscles to touch and a feeling of aching, deep or strong pressure.

A natural reaction may be to rest and not stretch for several days or weeks.

Unfortunately, this can lead to a worsening of myofascial pain, to the point where even small movements of the neck or back cause severe pain.

Treatment includes a combination of active and passive approaches. Rest should only be for a very short period of time, usually not more than 1-2 days. Most people recommend icing during that time if the muscles are very tender to the touch.

If the pain is deeper and aching and does not resolve, many people use heat especially if there is a feeling of tightness, constriction or limitation in the muscle. Over-the-counter patches and even prescription medicated patches with anti-inflammatory or anesthetic medications are available. These help to penetrate below the surface and calm inflammatory mediators down. Massage, gentle stretching and slow movement exercise can then begin to initiate and promote healing.

It is very helpful for people to see a physical therapist who can initiate a slow but steady program of facilitated exercise to improve the myofascial pain. This may include active release or trigger point release strategies that help the person to recover full range of motion. If physical therapy Is not sufficient, patients may be a candidate for acupuncture or trigger point injections which directly target the muscles in spasm. The goal of all these treatments is to promote soft tissue and muscle healing before chronic pain completely limits activity and quality of life.

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