After a car accident, get checked, photograph the vehicles and the scene, and write down what happened while it is fresh. Keep moving gently. Do not go to bed. Within the first week, get assessed by someone whose job is the injury.
What you decide in the first week after a crash shapes the next six months more than most people realize.
Why do people underestimate a car accident injury?
Almost everyone underestimates the injury on day one. Adrenaline masks pain for hours. The emergency department rules out what is dangerous right now and sends you home. So you conclude that you got away with it.
Then the second and third days arrive. Inflammation builds. The neck stiffens. A headache shows up that was not there before. That pattern is the rule, not the exception. Knowing it ahead of time is what stops people from brushing it off.
What should you do in the days and weeks after a car accident?
What should you do in the first 24 hours after a car accident?
Get checked if you have not been. Photograph the vehicles and the scene if you are able. Write down what happened while it is fresh — direction of impact, whether you saw it coming, whether your head hit anything, where you first felt pain. Memory for these details fades fast, and they help us make the diagnosis.
What happens on days two to four after a car accident?
Expect to feel worse rather than better. This is when neck and back pain tend to peak. It is also when delayed symptoms show up. Keep moving gently; do not go to bed. If you were given a collar, ask whether you actually need it — keeping the neck still for a long time makes whiplash outcomes worse.
The first week
Be assessed by someone whose job is the injury rather than the emergency. Soft-tissue injury responds best early. An early medical record also carries far more weight than one made six weeks later.
The first month
If pain is not steadily getting better by three to four weeks, that is the point to get a specific diagnosis, not more time. Pain that lasts past this point is much less likely to go away on its own.
What should you not do after a car accident?
The most common mistake is waiting to see whether it settles. It is a reasonable instinct. But it burns the window when the injury is most treatable. Facet joint and ligament injuries respond much better in the first weeks. The diagnostic picture is also clearest before the neck has spent two months guarding itself.
The second mistake is treating a normal X-ray as the end of the search. An X-ray shows bone. It says nothing about discs, facet joints, ligaments or nerve roots. That is where pain after a crash almost always starts. Being told nothing is broken is good news about fractures. It tells you nothing at all about why you hurt.
The third is not mentioning symptoms that seem unrelated. Poor focus, light sensitivity, broken sleep and irritability in the two weeks after a crash are concussion symptoms, not stress. People routinely do not report them because they do not connect them to a neck injury.
When to get help immediately
Go back to an emergency department for a headache that keeps getting worse, repeated vomiting, weakness or numbness on one side, slurred speech, growing drowsiness or confusion, or any change in bladder or bowel control. Anyone on a blood thinner who hit their head should be checked, no matter how well they feel. Severe abdominal pain or shortness of breath in the days after a crash also needs emergency review.
To be assessed, call or text us. We are at 12174 Natural Bridge Rd, Suite 110, St. Louis, MO 63044. No referral is needed and no attorney is required. See accident and injury care.
Related: the injury pattern changes with the vehicle, so read about motorcycle accident injuries, pedestrian and bicycle injuries and truck accident injuries.
Common questions
I feel fine. Do I still need to be checked?
Being checked once costs an hour. Symptoms that show up late are the norm after a crash. An early record is worth a great deal if the pain does arrive.
There is more on this in Delayed Symptoms After a Crash.
Do I need to see a lawyer first?
No. Treatment is a medical decision and does not require anyone to be representing you.
Insurance and Billing After an Accident covers who pays for accident care and why no attorney is needed to be seen.
How long do I have to start treatment?
Clinically, sooner is better and the first weeks matter most. Insurance and claim deadlines vary, and we do not give legal advice on them.
Delayed Symptoms After a Crash sets out how symptoms unfold from day one to week six.
Does a normal X-ray mean I was not injured?
No. An X-ray shows bone. It says nothing about discs, facet joints, ligaments or nerve roots, which is where pain after a collision almost always comes from. Being told nothing is broken is good news about fractures. But it does not explain why you hurt. So a normal X-ray should not end the search for a diagnosis.
When should I go back to the ER after a car accident?
Go back for a headache that keeps getting worse, repeated vomiting, weakness or numbness on one side, slurred speech, growing drowsiness or confusion, or any change in bladder or bowel control. Severe belly pain or shortness of breath in the days after a crash also needs emergency care. If you take a blood thinner and hit your head, get checked even if you feel well.
How long should pain last after a car accident?
Pain often peaks on days two to four and should then improve steadily. If it is not steadily improving by three to four weeks, that is the point to get a specific diagnosis rather than wait longer, because pain that lasts past that point is much less likely to go away on its own.
Sources
- Smits EJ et al. Expert consensus and perspectives on recovery following road traffic crashes: a Delphi study. Disability and rehabilitation, 2022. PubMed 33305970
- Nolet PS et al. Exposure to a motor vehicle collision and the risk of future back pain: A systematic review and meta-analysis. Accident; analysis and prevention, 2020. PubMed 32438092
- Sterling M. Physiotherapy management of whiplash-associated disorders (WAD). Journal of physiotherapy, 2014. PubMed 24856935
- Levin HS et al. Diagnosis, prognosis, and clinical management of mild traumatic brain injury. The Lancet. Neurology, 2015. PubMed 25801547
Hurt in an accident? Start here.
You do not need a lawyer, a police report or a referral to be seen. Bring your symptoms and we will work out the rest.
Monday–Friday, 8:00 a.m. – 4:00 p.m. Same-day appointments are often available for new accident and injury patients.