Florida Pain Medicine is a rotation site and teaching facility for USF Health ACGME Pain Medicine Fellowship and Physical Medicine and Rehabilitation Residency.
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Why Is Pain Sometimes Delayed After a Car Accident?

Why Is Pain Sometimes Delayed After a Car Accident?

You can walk away from a car accident feeling fine and thankful you didn’t suffer injuries. Then, in a few hours or days, the delayed pain suddenly strikes. 

Maybe you can’t move because of back pain. You might also have an intense headache or sharp pain radiating from your neck when you move.

Delayed pain occurs because your body’s survival instincts immediately go into high gear after a car accident. Stress, trauma, and injuries trigger a massive hormonal response that diminishes the pain. 

As pain management physicians and experts in physical medicine and rehabilitation, our Florida Pain Medicine team specializes in evaluating, diagnosing, and treating pain caused by auto injuries.

We know first-hand that our patients are often confused about how they can be injured and not feel pain. Let’s explore this phenomenon and learn why late-onset pain can cause complications.

About survival mode

Your body is perfectly designed to protect you during times of stress, whether you face the first day of a new job, a car accident, or a life-threatening event.

The moment you feel anxious, worried, or stressed — like that split second when you realize you can’t prevent an impending car accident — your brain goes into survival mode by triggering the fight-or-flight response.

During this instinctive reaction, your brain shuts down unnecessary body functions and energizes the systems you need to survive.

Your heart rate rises, extra blood goes to your muscles, blood sugar surges (for rapid energy), and you become intensely focused. Your brain also releases two hormones responsible for delayed pain: adrenaline and endorphins.

Adrenaline’s role in delayed pain

During survival mode, the hypothalamic-pituitary-adrenal (HPA) axis goes into action. The HPA axis is connected to your endocrine and central nervous systems. They all work together to balance hormones and produce a rapid body-wide response to stress.

Adrenaline, a critical fight-or-flight hormone, floods your bloodstream during a car accident. What’s one of its primary roles? Adrenaline diminishes your ability to feel pain, allowing you to fight or run from danger despite having an injury.

As long as stress keeps adrenaline in circulation, you can block out pain.

Endorphins ease pain

Endorphins are hormones and neurotransmitters released by the pituitary gland and hypothalamus when you face the stress and physical injury of a car accident.

You may hear endorphins called “feel good” hormones because they improve your mood. They’re renowned for giving people a runner’s high because their levels rise when you exercise.

But endorphins are also potent pain relievers. They attach to the same cellular structures (receptors) as opioids, producing a pain-relieving response more powerful than morphine.

It’s easy to understand how endorphins lead to delayed pain. You won’t start to feel the pain until endorphin (and adrenaline) levels decline.

How long you might feel their effect can’t be predicted. It depends on your ongoing or sustained stress.

Delayed pain complications

The problem with delayed pain is that it hides potential injuries, which can be dangerous. Car accident injuries like whiplash, concussions, and lower back pain only get worse the longer they go untreated, prolonging your recovery, and increasing your pain.

It’s especially worrisome if you have a concussion and stay active until head pain or other symptoms appear. Returning to your usual activities significantly increases your risk of having a second concussion, which can cause permanent brain damage.

Protect your health with an evaluation

You should always schedule a medical evaluation after a car accident, whether or not you have pain. We can find problems before symptoms appear and start treatment that puts you on the road to healing and may diminish your symptoms after adrenaline and endorphins wear off.

Call Florida Pain Medicine, or request an appointment online right after you’re involved in a car accident.

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