The nervous system after trauma
After a motor vehicle collision (or similar trauma), pain and dysfunction come from two sources:
- Tissue injury: muscles, ligaments, discs, and nerves are stretched, strained, or bruised.
- Nervous system sensitization: the brain and spinal cord stay on high alert and can turn up pain signals.
From the start, both are present. Early after injury, pain comes from tissue damage and the body's alarm response. Stress, fear, and poor sleep can raise pain signals right away. As recovery continues, the nervous system may keep interpreting normal sensations as threats—so pain can last even after tissues improve.
Key idea: Pain doesn't always mean harm. Your nervous system can relearn calm with safety, routine, and gradual movement.
Coordinating care and calibrating input
Every intervention—physical treatment (chiropractic, PT, soft-tissue), counseling, exercise, medication, or injections—is an input to a sensitive system.
The goal isn't to do more or less. It's to give the right input at the right time so the body feels safe, not overwhelmed. Good timing and communication make results faster and longer lasting.
My role as an Injury Physiatrist
I can help at any stage—early, middle, or late—and match my approach to where you are. My strength is connecting the physical, nerve, and emotional parts of your recovery and linking you to the right resources.
If issues like stress/PTSD or post-concussion vision/vestibular problems are slowing progress, I identify them early and help coordinate care with your team.
A coordinated recovery sequence
Early: calming and safety
- Gentle treatment to reduce guarding and restore motion.
- Counseling and sleep strategies to calm the nervous system.
- Education about pain and expected healing.
- Light movement and breathing to reconnect with body awareness.
Intermediate: guided reactivation
- Posture work, graded exercise, and coordination training.
- Hydrostatic IMS can help after ~6 weeks, often most useful in the 6–12 month window.
- Diagnostic clarity—exam patterns, sensory mapping, EMG/NCV, and targeted imaging—to confirm the main driver (muscle vs nerve) and build confidence.
Late: strength and integration
- Targeted conditioning for endurance and daily function.
- Focal procedures if needed (Hydrostatic IMS; sacroiliac, facet, epidural; steroid vs prolotherapy vs PRP).
- Translate gains from the clinic into real-life activities.
Legal/coordination: transition & resolution
If your case involves legal steps, I provide clear documentation and clinical summaries to support a smooth close to care.
Where different treatments fit
- Physical treatment: early & middle phases to restore motion and reassurance.
- Psychological care: throughout recovery to reduce stress and improve sleep.
- Exercise therapy: middle & late phases to rebuild strength and confidence.
- Medical & interventional care: clarify diagnosis (EMG, imaging) and address focal muscle or nerve drivers when needed.
- Self-care: breathing, sleep, walking, and pacing connect all the parts.
No single tool fixes everything; coordination is the treatment.
Practical pacing: avoid over-stimulation
Pacing doesn't mean "doing less"—it means matching the input to your current state to avoid flare-ups.
- Match input to state: go easier on flare days; add challenge slowly on good days.
- Right dose, right order: gentle work → movement → recovery.
- Progress gradually: increase volume slowly to avoid spike-and-crash cycles.
- One change at a time: adjust intensity, duration, or frequency—then observe.
- Shared notes: keep providers aligned and patient-centered.
When to add diagnostics or targeted procedures
- New red flags or neurologic deficits.
- Unusual patterns (e.g., persistent distal numbness/weakness).
- Plateau despite steady, coordinated care.
In these cases, confirm the main driver—muscle, nerve, or joint—and consider focused options (e.g., Hydrostatic IMS, classic TPI, nerve-directed care) within the same coordinated plan.
Your role as the patient
- Share openly: what helps, what flares, and what matters to you.
- Practice daily skills: sleep routine, breathing, short walks, and simple exercises.
- Trust the sequence: calm the system first, then build strength so gains last.
In summary: After trauma, pain often lasts because the alarm system stays active. Recovery works best when care builds safety first, strength second. With calm, coordinated care, most people move from protection to progress—and stay there.