Go to the ER now for any of these
These are not things to watch. Call 911 or go to the nearest emergency room.
- New or worsening weakness in an arm or leg
- Numbness that is spreading
- Loss of bladder or bowel control
- New difficulty walking or keeping your balance
- Severe or worsening headache, confusion, repeated vomiting, or loss of consciousness
- Chest pain or difficulty breathing
- Severe abdominal, neck, or back pain
- Severe or uncontrolled bleeding
If you are not sure whether something needs the ER, you can call us — and after talking with you, we may decide that you do need to go.
Why feeling fine at the scene isn't the whole picture
Two things happen at once. In the minutes and hours after a crash, adrenaline masks pain very effectively, and then it wears off. Meanwhile, inflammation from injured muscles, ligaments and joints builds over the next one to three days.
So a neck that felt like nothing on the evening of the crash can be hard to turn two mornings later. That is the usual pattern, not a sign that something was missed — and it is why "I felt fine" is not a reason, on its own, to stop paying attention.
What can show up over the next few days
- Neck pain or stiffness that isn't easing
- Lower back pain, especially pain that is getting worse rather than better
- Pain that runs into an arm, a hand, a leg or a foot
- Numbness or tingling anywhere, even if it comes and goes
- Weakness — a grip that feels unreliable, or a leg that feels heavy
- Headaches at the base of the skull
- Waking up very stiff, or trouble sleeping because of the pain
None of these is an emergency on its own. All of them are worth having examined, and anything involving the nerves — numbness, tingling, weakness, pain that travels — is worth having examined sooner.
The injuries behind those symptoms
- Whiplash and neck strain — the quick back-and-forth movement of a collision stretches the muscles, ligaments and discs of the neck.
- Lower back strain — the lumbar spine bridges a pelvis held by the seat belt and an upper body that keeps moving.
- A disc injury — disc material pushed against a nerve root, felt as pain running into an arm or a leg, often with numbness or weakness.
- Nerve irritation — a compressed or irritated nerve sends pain, burning or pins and needles along its path.
- Facet joint injury — the small joints at the back of the spine, loaded hard in an impact.
- Headaches from the neck — a neck injury felt in the head.
This practice treats the spine. Pain felt in a shoulder, an arm or a leg is often coming from the neck or the back, which is why it is worth mentioning even when it seems like a separate problem.
If you already went to the ER
The ER's job is to find and stabilize what could seriously harm you right now — bleeding, fractures, injuries to the head and organs — and it does that job well. It is not set up to direct the weeks of recovery that follow.
Muscle, ligament, disc and nerve injuries often do not show on emergency imaging, and they may not have fully appeared in the hours you were there. If you were told to follow up if symptoms continued, and they have, a physician evaluation is that follow-up. Keep copies of everything the ER gave you and bring them along.
Questions people ask
What are the most common injuries in a car crash?
Injuries to the neck and the lower back — whiplash, muscle and ligament strain, and less often a disc pressing on a nerve. They are also the ones most likely to show up a day or two after the crash rather than at the scene.
How long after a crash can symptoms appear?
Commonly over the next one to three days, as inflammation builds and adrenaline wears off. Day two is not a reliable picture of day five. If something has changed since the crash, it is worth mentioning, whenever it started.
I feel fine. Should I still be checked?
It is worth being looked at. Feeling fine in the hours after a crash is normal and is not reassuring on its own, because the most common injuries are the ones that surface later.
Do I need an attorney or a referral to be seen?
No to both. You can contact the practice directly, and you can be treated here whether or not you ever speak to an attorney.
Care here is directed by Miguel Jimenez, MD, an orthopedic spine surgeon — residency at Mayo Clinic, spine fellowship at Hospital for Special Surgery, and 23+ years in practice in Georgia. Full background