If the Pain Is Worse at Night After a Car Accident
The short answer
Why does pain feel worse at night after a crash? Less distraction and hours in one position can amplify it, but pain that worsens nightly needs reassessment.
Contents
"I manage in the daytime. Lie down and it's worse."
Common after an accident. And when you can't sleep, the next day hurts more. It becomes a loop.
There are a few reasons for the night.
Lie down and the inside gets loud
In the daytime there is a lot to see and a lot to do. Pain is only one of them.
Turn the light off and lie down and all the outside input drops away. What's left is the sound from inside. A 5 in the day feeling like a 7 at night isn't always the pain growing — sometimes what was covering it has gone.
And you spend six hours in one position
This one is bigger.
Injured tissue stiffens if you leave it. Six hours overnight in one position and it settles to fit that position. Which is why getting up is the stiffest moment and it takes some moving to loosen. (If you are especially stiff in the morning)
The trouble is that if the position is bad, you stiffen the bad way every night. Release it for an hour in the day and put six hours back the other way, and nothing is left.
That is why the night is half the treatment.
What I look at in the position
If it's your neck, the pillow comes first. Too high and the neck is bent forward all night. Stand in that position in the daytime and it would hurt — you just don't know it while asleep.
If you sleep face-down, this is the window to skip it. Face-down turns the neck all the way to one side. For six hours.
On your side, put something between your knees and the pelvis twists less. Especially with a hurt back.
None of this needs equipment. One pillow height can take weeks off.
I start by asking about your sleeping posture
I release what stiffened in the day, and I ask which position you sleep in. Usually it turns up there.
And I watch how sleep pushes the pain back up. Can't sleep, hurt more the next day; hurt more, can't sleep. This loop can be broken from either side. Sometimes I bring the pain down to let you sleep; sometimes I get the sleep to bring the pain down. Which is easier for the person is the thing to look at.
That said, if it hurts even at rest, or the night pain is steadily worsening, that is a different story. Then we look again.
However good the daytime treatment, the night is six hours.
An hour by day, six hours by night — it is clear enough which holds the body longer.
Written by Dr. Heo Ji-young (PhD in Korean Medicine Pathology, Kyung Hee University · former Research Professor of Herbology, Kyung Hee University)
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