Why Do I Still Have Pain Years After My Car Accident

Have you had a car wreck and it feels like your neck hasn’t been right ever since?  Are you having pain, even though your MRI came back as “normal”?  Do you have a loved one whose whiplash injury seems to have completely changed their personality?  

Dr. Danesh

For many patients, healthcare feels like a medical machine that turns out one-size-fits-all solutions with surgery and whitewashes problems with pills. I’m Dr. Danesh, native Kentuckian, and the Medical Director of Wellward Regenerative Medicine,  Where we empower patients with a new way of thinking about pain issues, hence we’ve created this 50 Shades of Pain show. Our goal is to help empower you, the patient, to get the healing that you deserve. So we encourage you to follow us on Facebook and Instagram or visit us at wellwardmed.com. James, what are we talking about today? 

Dr. James

Well, Dr. Danesh, we’re just back from a conference in Buffalo, New York and we’re excited about today’s subject. Whiplash—persistent pain after someone’s had a car wreck. Here’s a question for you guys at home. Have you had, or maybe a family member had a car wreck, and they hurt their neck, and that pain is still sticking around a lot longer than you think it should? Is it years later and your neck still isn’t right? If you’ve got pain, it still shoots down your arm or maybe you’ve had problems in your hand like carpal tunnel, or maybe you’ve had some sort of constant headaches afterwards? Or, is your memory not quite right? Do you still get dizzy? All these things can happen from whiplash. You’re not crazy. This is real. 

Dr. Danesh

You’re right, James.  These symptoms are real.  Let’s delve into whiplash with a little bit of basic physics.  You’ve heard the expression an object in motion stays in motion. Essentially, everything has inertia, meaning that their mass, once it’s put into motion wants to stay in motion. But if you look at the body, you’ve got different parts of it that have different densities, and so they’re going to move and accelerate at different rates. So, for instance, a really heavy ball set into motion is going to keep moving more than a little ping pong ball. Imagine if the two balls were connected in some way. And then all of a sudden, they came to a stop. Well, that heavy ball is going to resist that intention to stop, whereas the little ball is going to stop immediately. What happens in our heads and our brains and our bodies when we experience a whiplash injury is that our body is going at 50 miles per hour. And now all of a sudden it comes to a stop. That momentum is going to continue all over our body, but our bones are going to keep moving more than all the soft tissue behind it.  Understandably, things get pulled and stretched in ways that they weren’t designed for, and we know that when things are stressed in an unintended way, it can be broken and then it causes pain. Okay, those are the basics of whiplash. 

Dr. James

Ah, so that’s what happens to somebody’s head when a car stops suddenly and there’s a car accident? 

Dr. Danesh

Right.  Let’s imagine a person’s brain.  Let’s say the person is going at 30 miles per hour and all of a sudden, he stops. Well, the bone is going to keep moving, but the brain is going to come to a stop, faster than bone. So, what happens is that the brain slams against the back of the head and then slams against the front of the head. And that essentially causes the damage that evolves into some of the memory issues, some of the confusion, and the concentration problems after a car accident. That’s typical early on. And then later on,  we see a lot of the muscle joints and aches and pains. 

Dr. James

Well, let me ask about the brain thing one more time. How is it that people could still have some dizziness or memory issues way later on from a car wreck? 

Dr. Danesh

It’s the sequence of different nerves connecting in different patterns and firing at different rates. These essentially are thought, memory, and emotion. So, everything in the body is moving, and then all of a sudden stops. You can imagine that different parts of the cells are actually going to have acceleration and deceleration at different rates. And so these, these very thin frail layers can actually be injured as well.  And that damage then can show up later on. Just by sheer fact that you’re going to have different nerves that are going to degrade at different rates. As a result of that. 

Dr. James

So we think that could be a reason why people who have concussions can suffer headaches or dizziness for years afterwards… 

Dr. Danesh

Absolutely. But there’s another problem because we have the concussion from the brain injury, but you also get a lot of damage in the neck. And we know that neck pain often leads to headaches. Intricate nerves go up the back of the head. They’re sandwiched between the muscles of the neck. And when there’s a segmental injury, those muscles are tightening down on those nerves. Over time, it can cause stress on that nerve, which leads to headaches. So you really get two causes of headaches, a car accident or whiplash injury. One is the bruising that takes place inside of the brain and the skin that surrounds the brain, but you also get it from the nerves that run on the outside of the head, because all of those nerves kind of coalesce in the same part of the spinal cord.  So one signal is going to be distracting to all the other ones and it just kind of creates a vicious cycle where everything fires off. 

Dr. James

So, when your head bangs around, what happens to your neck tissues? 

Dr. Danesh

I mean we’ve talked before about how, you know, if you look at the neck, you’ve got ligaments that stabilize all of these different segments. And if the bone is moving, and the ligament has already stopped, that’s going to tear those ligaments or injure those ligaments. And unfortunately, MRIs and imaging don’t really show ligament injuries as well as we would like them to. So, a lot of times these go underdiagnosed, and people just don’t know why they have these persistent pains. That’s when you start to get that shifting and erosion on the disc. And everything tightens up to try to maintain the integrity of that segment. But, that tightness in and of itself can be a source of pain. 

Dr. James

Why do people have tingling, arm pain, and other symptoms, even well after that whiplash injury? 

Dr. Danesh

That can be from a lot of different sources as well.  If a segment in your neck becomes unstable, that’s going to set you up for a prolonged period of degeneration. A lot of people think that degenerative disc disease is just a random event. But it’s always related to the other segments– the other structures that stabilize that segment. If everything is loose, it’s going to have an effect, and that’s going to degrade the joint or the disk.  Remember how we talked about the jelly doughnut? If I bite into a jelly doughnut and then I push on it, it’ll squeeze all the jelly out. But if it’s a whole donut that hasn’t been bitten into, it has a lot more resiliency, and it doesn’t squish the jelly out. It’s that jelly goes into the spinal canal and irritates those nerves that can be a cause of that pain. 

Dr. James

I just want to make sure I understand this. Whiplash can cause the nerves in the back of the neck to get strained and inflamed, and you can have that same nerve injury all the way down your arm with a stretching of nerves and inflammation of those nerves too? 

Dr. Danesh

So, yes, so that when I say there are multiple causes, you’re alluding to the next one that I should talk about.  The same thing that’s happening in the brain where you get those injuries, you can get them in your arm as well. There’s a cluster of nerves that leave your neck, and they become kind of like spaghetti. And they come in and out and course through muscles and other tissues, and to get to the arm – they’re your Brachial plexus. That Brachial plexus is weaving in and out of muscle tissue so if you have any kind of injury that shears those muscles or nerves that run through those muscles, either of those situations can cause an irritation or compression of the nerve outside of the spinal canal, with the persistence of pain in your arm. 

Dr. James

So pretty much anytime your neck is yanked on and over stretched fast enough, your brain, the ligaments in your neck, the disc, and even the nerves that go down from your fingertips, all that can be hurt in the snap of a finger? 

Dr. Danesh

Absolutely.  It becomes really difficult to tease all that apart because you don’t get great radiologic studies that will indicate where along that whole chain of events. A physical exam is actually often more telling than the radiology.  These are things that can take a while to figure out, which is why we have our healing methodology that starts with hearing the message that your body’s trying to convey. That’s really dissecting the underlying causes and figuring out where along the path, whether it’s from the brain, the disc, the ligaments, the nerve muscles, any one of those can be problematic and cause the same exact symptoms. 

Dr. James

So let’s say somebody had a whiplash injury from a car wreck.   They went to the emergency room. They did their x-rays, and they’re told the x-rays look good.  They’re prescribed a muscle relaxer and told they should be fine, but they’re not fine.  

Dr. Danesh

They’re not crazy.  That’s often why people come to us after an injury like that.  They ask us, “Is this in my head?  Am I just making it up?”  And we absolutely, unequivocally need to reassure people that it is not in your head.  Just because it’s not being found on conventional studies, doesn’t mean that this is a made up scenario, or that you’re just willing it to happen. You can’t will it away, nor can you will it to occur. We have to remember that an emergency room is just that—it’s an acute setting to make sure that nothing catastrophic has gone wrong. Nothing that’s going to kill you or disable you in the short term, but we also know that there are a lot of changes that your body will undergo in the chronic setting, as things evolve. An emergency room will rule out the absolute life threatening emergencies. At Wellward, we figure out where or what happens during that time after the accident. What is happening and what could be causing the symptoms that will potentially lead to disability. 

Dr. James

It sounds like people need to see some specialists who have a multidisciplinary approach to be able to figure out what’s going on. Looking at them from head to fingertips, appreciating all this stuff. And then they’ve got to figure out what to do about it. Maybe we should do an entire show just on some subjects of taking care of these patients according to their symptoms. 

Dr. Danesh

I absolutely agree with you. There are a lot of layers to recovery, everything from diet, nutrition, lifestyle, exercise, regenerative therapies…   We do all this at Wellward, and it’s all geared towards getting your body to move and function the way it was designed.  We’ll get into specifics for this, for the second whiplash episode we have next week. 

Are you wondering if you’re still suffering the effects of whiplash?  The Wellward team is ready to help you find the source of your pain and/or dizziness. Please reach out to us to ask any questions or to set up an appointment.  Phone:  859-275-4878.  Fax:  859-276-5400.  We look forward to speaking with you and helping you on your journey to healing and better health. www.wellwardmed.com.