The Accident Ended, But the Body Did Not
The short answer
After a car accident, treatment wrapped up in a couple of months — so why, six months later, is the neck still stiff every morning? The outside healing and the inside finishing do not happen on the same schedule. The final stage of healing does not even begin until two to three weeks after the injury, and it can continue for more than a year. If new weakness or numbness appears, or the swelling and pain keep growing, get it checked first.
Contents
There was a person who was in a car that got hit from behind. That day, nothing happened besides the shock of it, and a few days later the neck grew stiff. Nothing was wrong with the bones, and treatment wrapped up after a couple of months. But six months later, the neck is still stiff every morning, and after sitting for a long time, the shoulder grows heavy too.
This kind of account usually gets one of two answers. Either you're all healed, don't worry about it, or you're not healed yet, keep at it. They are opposites, and neither one actually tells you what is still going on in that body.
I want to lay out what lies between them.
When the outside heals and when the inside finishes are different times
An injured spot does not heal all at once. It passes through several stages in sequence, and the last stage is especially long.
Tissue inside the body passes through the same stages. Only the time each tissue takes differs.
The point at which the outside heals and the point at which the inside finishes are separated by this much. If you use the outside as your reference, you end up counting something as finished when the body is still working on it.
The healing process itself pulls on the tissue
New cells (fibroblasts) fill in the gap. Some of them turn into contractile cells (myofibroblasts). These cells pull the edges of the wound inward and close the gap. Since this narrows the opening, the body is doing its job well up to this point.
But a spot that has healed this way is not exactly as it was before. The forces around it change by however much it was pulled, and the surrounding muscle and fascia take on that share. So the stiffness may not stay confined to the spot that was originally injured.
If surgery was involved, one more layer is added. In addition to the original injury, the incision goes through the same process, and the new blood vessels that grew into the damaged area also take time to recede again. A recent surgery is not something to brush off lightly.
When the receiving end has not finished, even after the tissue has
Everything so far concerns the tissue side.
When a pain signal continues for a long time, the side receiving it does not stay the same either. When the same input repeats, the threshold on the receiving end drops, and stimuli that would once have passed unnoticed start to trigger a strong response. That is why the large part of the problem often settles first, leaving a long tail behind.
And this change is considered reversible.
Even sensations that never carried pain
Not all sensory nerves carry pain. There is a separate sense that reports the body's own posture — how far a muscle has stretched, how much force is on a tendon, how bent a joint is. This is proprioception. The muscle spindle inside the muscle and the Golgi tendon organ in the tendon are responsible for this. We are not conscious of this sense.
But when the sac that wraps a joint (the joint capsule) fills with fluid and stays that way for a long time, even these nerves, which never used to carry pain, begin to fire. That signal comes up as pain.
At that point it becomes hard to put a finger exactly on where it hurts. People find it hard to point to a spot, yet say the discomfort continues. Discomfort that lingers well after an injury sometimes takes this shape. If the fluid released at the injury site does not drain for a long time, that irritation continues right along with it.
How much remains differs from person to person
People go through the same thing and some settle down within a few weeks while others carry it much longer.
There is a study that measured how different people respond to the same repeated stimulus. Some people gradually grew less sensitive and others grew more sensitive, and that direction stayed consistent for each person. "Everyone is different" is, in this case, not an impression but a measured number.
So an average like "an injury this size should heal by about this time" can serve as a reference, but it cannot serve as the standard for any one person.
When to get checked first
If, after an injury, new weakness or numbness appears, if swelling and pain keep growing over time, if fever develops, or if headache, vomiting, or confusion appear after a blow to the head — this is not the territory this article is about. There is something else to check first.
There is one date on which the accident happened. But there are several dates on which the body finishes. The injured spot heals on one schedule; its surroundings adjust to the changed forces on another; and the receiving end returns to its earlier sensitivity on yet another.
That is why neither "it's all over" nor "it's not over yet" fully captures that body. Asking which layer has finished and which layer remains comes closer to the reality.
And a layer that still remains usually still has work left to do. This continues the discussion in why tests come back normal after a car accident but the pain continues.
Written by Dr. Heo Ji-young (PhD in Korean Medicine Pathology, Kyung Hee University · former Research Professor of Herbology, Kyung Hee University)
IF YOU NEED CARE
Have a symptom that's been on your mind?
Choose a time on Naver, or send your concerns before your first visit.