You had an auto accident and now your head hurts. What’s the plan? Where do you go from here? Why won’t your headache go away? How long is this going to last? Do I have a concussion? What is a concussion? Every one of these questions will go through your mind at some point after a car accident if you start having head pain. Even if your head doesn’t hurt it doesn’t mean that you are in the clear when it comes to head injuries. Having a concussion or mild traumatic brain injury (mTBI) does not necessarily mean that you hit your head. Brain injuries can occur just from the force of your head whipping back and forth from a car crash. It is a common misconception that in order to have a concussion or an mTBI you have to hit your head. Your brain actually floats inside your head with cerebrospinal fluid surrounding it. The cerebrospinal fluid does two main things. The first is supplying the brain with another method of receiving nutrients from the body as well as getting rid of the waste after the brain has used those nutrients. The second is for a cushion. Because the brain is surrounded by this fluid, it naturally forms a barrier when our head moves quickly. However, when forces on your head are too strong they can cause your brain to crash into the front or back of the inside of your skull causing acute trauma to the brain. In either scenario, if you hit your head or there is enough force to cause your brain to shift inside the skull, it is highly likely that you could have sustained a concussion or an mTBI.
A concussion or mild traumatic brain injury is something to take very seriously. When we say that it is a mild traumatic brain injury there is nothing mild about it. In sports, it is automatic to remove a player when they could have possibly sustained a concussion. When you have been in a car accident it is vital that you seek medical care to assess your injuries. Not all cases of concussions will have the victim knocked unconscious or passed out. There are many common symptoms that follow a concussion:
Delayed or sluggish speech, responsiveness or movement
Lack of balance
Some of these symptoms can be immediately after an mTBI or they can show up days or even weeks after the initial injury. It’s important to remember that even though there may not be physical signs of head trauma like small cuts or bruises, that there may not be something going on inside. Some of these symptoms can also mimic symptoms of other serious head injuries such as intracranial bleeding or uncontrolled swelling in the brain. These head injuries are more life-threatening and should be evaluated by competent medical personnel, like a trained chiropractor or medical doctor, through the use of imaging such as a CT scan or MRI. In our office, we will always order an MRI immediately following any sign of head trauma. Sometimes concussions can be missed while being treated in the emergency department and even if a doctor in the ER says that you don’t have a concussion it would be wise to follow up with a primary care doctor or chiropractor if your symptoms persist or get worse. If needed, your doctor can make a referral to a neurologist who specializes in traumatic brain injuries so that proper care can be taken. Everyone is different so there will not be a hard and fast rule on when you can expect everything to heal and recover, but the sooner you can seek care the quicker you can get on the road to recovery.
Typically these symptoms will subside within a few weeks to a month after the auto accident. If your symptoms don’t improve and linger after this time period then you could have what is known as a post-concussive syndrome (PCS). PCS is very treatable just like a concussion but can be aggravating to those who want to continue on with life after a car crash. Oftentimes these symptoms can interfere with daily life and can make each day frustrating. PCS can linger months or even years after the head trauma has occurred so it is important to find care after a concussion so that you don’t find yourself in a situation where you are still struggling months or years after a car accident.
What’s most important is getting you back to activity. Rest is also important shortly after an mTBI, but too much rest for too long can actually be a hindrance to your recovery. Bed rest is now considered “old fashioned” and primal when it comes to head trauma and concussions. After the initial injury rest is helpful for the first few days, but after the acuteness has receded it becomes vitally important to begin to slowly transition back into normalcy. As you start to return to your life again, you should keep activities limited to sub-symptom levels. What that means is being active in your life and doing things that do not cause symptoms to come back or increase in intensity, frequency or duration. During your recovery, you should be able to maintain a gradual progression toward returning to normal. Rest and a gradual increase in your normal daily habits are critical because if you were to jump back into things too soon before your symptoms subside, and if another car accident or other head trauma occurs it could lead to serious complications that can be fatal. This is called second impact syndrome and it is characterized by rapid swelling of the brain. This condition is rare and more likely to happen with athletes but important enough to always be cautious after suffering from a concussion. We want you to be at your best and find someone who can treat you for an mTBI following a car accident.
The most common symptoms that we see are headaches, dizziness, and feeling like you’re in a fog. Unfortunately, these symptoms are also the most long-lasting. Brain fog can subside more quickly, however, usually after a week. Dizzy spells and headaches will continue over the course of weeks to months. You will notice that over time those symptoms will decrease in intensity, frequency and duration. With the combination of chiropractic care and neurocognitive rehabilitation, you can be certain that you are on the right path to getting better.
Some of the more challenging symptoms are the ones that conflict with each other. Restlessness and sleeplessness almost seems unfair. During the day you might feel sleepy but also you may feel like you have to be up and doing something. Then almost cruelly when you try to go to bed because you are exhausted you find yourself unable to sleep. This can be taxing and almost like you can’t catch a break. You need rest to recover and heal but you just can’t seem to grab a hold of a good night’s sleep and it can be maddening. Continue to try your best to get some of those glorious hours of sleep and build up to getting a full night’s sleep.
More arduous symptoms that people around you may visually see are the changes in your behavior. Sometimes people will have dramatic mood changes such as being happy go-lucky to intense anger and frustration. You could also experience depression because of the slow progress of your healing, those pesky mood changes and exhibiting symptoms that you may not have otherwise been experiencing before the car accident. If you were one who did not have a lot of headaches before and now it almost seems like you have one 24/7 can be a lot for someone to handle. Your own changes in behavior could lead to feeling like you aren’t the same person as before the car accident. Counseling and therapy are wonderful tools that can aid in your healing process. An excellent support network such as friends and family are also vital to your cognitive and mental health. Feedback from loved ones in recognizing signs of a concussion or an mTBI can not be overemphasized. If you are someone who is close to someone else who may be experiencing these signs and symptoms do not hesitate to talk with the person who has been in a car accident and lovingly encourage them to seek help from a chiropractor or other medical professionals who can help them get the care that they may need.
Oftentimes when someone has been in a car accident and they are transported to the emergency department at a hospital, they will more than likely be given a pain medicine prescription. This can be detrimental because pain medication can mask symptoms of concussions and if not properly evaluated these same medications can cause life threatening problems if there is something more sinister other than a concussion. It is more common practice to be conservative with pain medication. A lot of instances pain medicine is contraindicated or not advisable when treating a person with a mTBI or concussion. Be safe and try not to take anything that may dull the sensitivity of what your body is telling you about how things are functioning or not functioning well.
Be patient with your recovery. A brain injury is not like any other trauma to the body. Broken bones, ligament sprains, muscle strains, bruising and cuts and scrapes all heal relatively quickly compared to brain trauma. Neurons, which are cells within the brain and nerves, take much longer to recover and heal. In a head injury, the normal processes and communication that occur in the brain have been disrupted. Your brain is trying to figure out how to continue to function and take care of all the information it was used to handling in different ways. Pathways that your brain has mapped out to do normal things have been thrown into disorder and now your brain is going to try and make new pathways in order to accomplish necessary tasks. These new pathways are our brain’s way of rewiring the neural signals for sensory input as well as muscle control and coordination. Sometimes the pathways are not as efficient as they once were. In some cases the brain will make these new pathways and these new neural highways pass through areas of the brain that are not intended to do a specific task. Areas of the brain can become lazy or over worked. This is when neurocognitive therapy enters the picture. Neurocognitive therapy is beneficial because it helps to correct areas of the brain so that they can do their specific responsibilities and not off-load them to areas that aren’t meant to do those types of jobs. These cases can be difficult to overcome if you are a patient or loved one because it leads to longer lasting effects and problems. This is what leads to the brain fog, irritability, mood swings, depression, lack of balance, headaches, memory loss and difficulty concentrating. It just takes time. Be willing to go with the flow when it comes to healing. One day may be really good and the next you may feel like you took four steps backwards. Give yourself and your brain some slack. It is a tremendous injury that you are trying to overcome and it is more than possible to accomplish the goal of getting back to living life to the fullest.
Concussions and mTBI’s are not to be treated lightly. We encourage you to seek care and help because not getting the treatment you need can have life-altering and long-lasting effects. Concussions are being diagnosed more and more because of ongoing research that is being done. We are finding that more often a concussion or TBI can be diagnosed even if you have had a small “fender bender”. In our changing world we are moving at a more rapid pace and things are moving more quickly either on the road or in sports or in various aspects of our lives. Because such events are taking place it is becoming easier to experience head trauma and concussions. After a head injury or concussion, it is important to slow down and not try to keep up with everything that is going on around you. It may seem that you want to jump right back into where you left off but you may find yourself frustrated and irritated because the symptoms of a mTBI or even the trauma itself can limit you and your ability to function and thrive. We are here to be your advocate to getting the treatment and care that you need to overcome the obstacles of having a mTBI. Don’t hesitate, if you feel in any way that you might be suffering from any of the mentioned symptoms and other signs then reach out so that we can help.