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MyOrthoSpineMDDr. Miguel Jimenez, MDEspañol

After an emergency room visit

The ER said nothing was broken. So why do you still hurt?

Because “nothing broken” and “nothing wrong” are two different findings — and the emergency department was only being asked the first question.

If you were seen after a crash, cleared, sent home, and you’re now three or four days in with a neck that won’t turn or pain running down an arm, you are not imagining it and nothing has gone wrong with your care. You’ve simply reached the point where a different kind of evaluation is useful.

Speak with an orthopedic spine surgeon by phone within 24 hours. No referral needed.

Go back to the emergency room now if any of this is happening

  • New or worsening weakness in an arm or leg
  • Numbness that is spreading
  • Loss of bladder or bowel control
  • New difficulty walking or keeping your balance
  • Severe or worsening headache, confusion, or repeated vomiting
  • Chest pain, difficulty breathing, or severe abdominal pain

These are not follow-up symptoms. Call 911 or go to the nearest emergency department.

What an emergency evaluation is designed to do

An emergency department after a car accident is answering one question, quickly and well: is there anything here that could seriously harm this person in the next few hours?

That means fractures. Internal bleeding. Head injury. Organ damage. Anything unstable.

If they cleared you of those things, that is real, useful information — and it’s good news. It’s also the answer to a narrower question than the one you’re now asking.

What the imaging did and didn’t show

Most people leave the ER after a crash having had an X-ray, a CT scan, or both. It’s worth understanding what those are good at.

X-ray and CT are excellent at bone. Fractures, dislocations, alignment. CT is also very good at finding acute bleeding. If you had either and they were clear, a significant fracture is unlikely.

Neither one shows soft tissue well. Ligaments, muscles, tendons, discs, and nerves barely register on the imaging typically done in an emergency setting. A torn ligament in your neck and a healthy one look much the same on an X-ray.

MRI is what shows those structures — and MRI is rarely performed in an emergency department unless there’s a specific red flag, because it isn’t the right tool for the question the ER is asking.

So a clean scan tells you your bones are intact. It doesn’t tell you whether a disc has been pushed against a nerve root, or whether the ligaments that stabilise your neck were strained.

Do you need an MRI after a car accident?

The other half of the problem is timing.

Soft tissue injuries build up inflammation and stiffness over 24 to 72 hours. Much of what’s now bothering you may not have been bothering you yet when you were examined.

What a spine evaluation adds

A follow-up evaluation with an orthopedic spine surgeon asks a different set of questions:

  • How did the injury actually happen? Direction of impact, whether you were braced, whether you saw it coming, seatbelt and airbag. Mechanism tells us where to look.
  • What has changed since? Symptoms that are improving, stable, or worsening mean very different things.
  • A focused physical examination. Range of motion, strength, reflexes, sensation, and specific provocative tests — the parts of a spine assessment that no scan replaces.
  • Imaging only if the examination points to it. If MRI is warranted, we’ll say so and explain why. If it isn’t, we won’t order it.

The result is a diagnosis and a plan, rather than a rule-out.

Symptoms that are worth having looked at

None of these are emergencies. All of them are reasons to have someone examine you properly rather than wait it out.

  • Neck pain or stiffness that hasn’t started easing after several days
  • Low back pain that began after the accident
  • Pain radiating into a shoulder, arm, hand, hip, leg, or foot
  • Numbness or tingling anywhere, even if it comes and goes
  • Weakness — a grip that feels unreliable, a leg that feels heavy
  • Headaches that started after the crash, particularly at the base of the skull
  • Pain that was mild at first and is now worse
  • Trouble sleeping, or waking up markedly stiff

One rule of thumb: anything involving the nerves — numbness, tingling, weakness, radiating pain — is worth having evaluated sooner rather than later.

What kind of doctor to see after a car accident Symptoms after an accident

The quickest way to find out whether this matters

You don’t need to book an appointment to get an opinion.

Tell us what happened and what the ER told you, and within 24 hours you can talk it through by phone with Dr. Jimenez — an orthopedic spine surgeon who trained at the Mayo Clinic and the Hospital for Special Surgery and has been treating accident injuries in Georgia for over 23 years.

He’ll tell you whether what you’re describing warrants an in-person examination, whether imaging would be useful, and what to watch for meanwhile. Sometimes that conversation ends with an appointment. Sometimes it ends with him telling you this sounds like it will settle, and here’s what would change that.

What the 24 hours covers.

A response within 24 hours, and a phone conversation with Dr. Jimenez in that same window if you want one. An in-person appointment often follows quickly, but that depends on scheduling and we won’t name a specific day before we’ve spoken.

A few things people ask at this point

Do I need a referral from the ER?
No. The discharge paperwork may have suggested following up with a specialist, but you don’t need anyone’s permission to do it. You can contact us directly.
Should I bring my ER records?
If you have them, yes — discharge paperwork, imaging reports, and the images themselves if you were given a disc or a link. If you don’t have them, it isn’t a problem; we can work from what you tell us and request records later.
Do I need an attorney first?
No. You don’t need an attorney to contact us, to speak with Dr. Jimenez, or to be treated. If you have one, we’ll coordinate with them.
How does payment work?
For car accident care we don’t bill regular health insurance. Self-pay and lien-based treatment are both available, and we’ll go through which fits when we talk. More about payment
It’s been a few weeks, not a few days. Is it too late?
No. Sooner is better, but persistent symptoms weeks after a crash are still worth evaluating. Don’t let elapsed time put you off getting in touch.

If it still hurts, it’s worth a conversation

You were cleared of the dangerous things. That’s the emergency department having done its job. What’s left is the question of what’s actually causing the pain — and that’s a different appointment.

Norcross · Lawrenceville · Dalton · Monday – Friday, 9:00 AM – 5:00 PM · By appointment

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