When recovery stalls or symptoms linger after a car crash
A rehabilitation physician on getting a fresh look at your care without blaming yourself
You may hope each week will beat the one before. Recovery often isn’t that tidy. A rough day can come right after a good one. [1, 2]
A single hard day can’t tell you what’s wrong. A pattern is different. Function that stalls, symptoms that worsen or a new problem calls for another look. A rehabilitation physician would ask how your daily abilities have changed, as well as where you hurt. [1, 2]
Lasting symptoms can have more than one cause. Pain, broken sleep, medicines, concussion effects, stress and being less active can overlap. Don’t decide a symptom is “all physical” or “all emotional” until a clinician has looked at the whole picture. [1, 2, 3]
Track what you can do from week to week
Pick three everyday activities that matter to you. Examples include walking to the mailbox, following a conversation and sleeping enough to get through the morning. Once a week, note what you could do and what stopped you. Also note how long it took to bounce back afterward. Add any new symptoms and medicine changes. These notes give your clinician a pattern to assess without an hour by hour diary. [1, 2]
A good report sounds like this: “Two weeks ago I could walk for 10 minutes. Now I stop after three because my left leg feels weak.” That gives your team more to act on than “I am not better.” Bring the date things changed and anything related, such as a fall or a new medicine. [2]
Ask for a new look when the plan isn't working
Tell your team if an exercise keeps making symptoms worse or a medicine causes troubling effects. Speak up, too, if your visits aren’t helping the task you care about. Ask which diagnosis the evidence supports and what is still uncertain. Find out what else could explain the problem. [1, 2]
A change in treatment may mean adjusting the dose, the activity, the referral or the goal. More tests or stronger medicine won’t automatically be the next step. [1, 2]
- What change do you expect by our next review, and how should I measure it?
- Which symptoms need another exam or a different specialist?
- If this plan fails, what’s the next reasonable option?
For a possible concussion, the CDC says to contact a clinician if symptoms haven’t gone away after two to three weeks. The same goes if they get worse once you return to regular activities. That advice is meant for mild brain injury only. Other injuries need their own follow up plan. [1]
Make sure support targets the real problem
When pain lasts, treatment may include rehab, medicines and approaches that help with sleep, stress and daily function. Being offered emotional support is no sign that your pain is imagined. Chronic pain, or pain that lasts, can affect your mood and relationships. Those effects need care too. Ask how the treatment you’re offered should improve a specific part of your life. [2, 3]
Say so if you’re missing work, can’t take care of yourself or are avoiding travel you need. Those are important outcomes to report. A social worker or occupational therapist may help with practical adjustments while the medical work goes on. [3]
Tell a sudden change from slow progress
Some changes can’t wait for a routine review. Get help if a symptom suddenly turns severe or a new brain or nerve problem shows up. After a possible head injury, emergency care is needed for a headache that keeps getting worse, repeated vomiting, seizures or weakness. The same goes for growing confusion or trouble waking up. For warning signs tied to your specific injury, follow your discharge instructions. [4]
Sum up the stall in one sentence
Write one sentence that says what you still can’t do, when that changed and what you’ve already tried. Send it to the clinician in charge of your plan. Ask for a date to review it instead of waiting with no end in sight.
Sources and further reading
- 1CDC: What to do after mild TBI
- 2MedlinePlus: Chronic pain
- 3MedlinePlus: Rehabilitation
- 4CDC: Concussion danger signs
General U.S. education from the view of a rehabilitation physician. It can’t pinpoint why you have a symptom or say how long recovery will take. Get your own assessment for problems that are new, getting worse or not going away.
Keep learning
Safe Driving Resource Center
Guides, self-checks and articles for drivers, parents of new drivers, and families recovering after a crash.
