Getting in touch with ICBC
Should I get examined?
What should I expect from treatment?
So I was just in a car crash.. now what? Who do I call? Should I get checked? What if I feel OK?
The responsibilities of dealing with the aftermath of a crash can feel as sudden as the crash itself. This post will cover the what and why of common injuries and their treatments, as well as offer some resources on dealing with ICBC.
After an accident, contact ICBC as soon as possible to open a claim. You’ll be assigned an adjustor who will guide you through the process. This can be done on the phone, and at http://www.icbc.com/claims/Pages/Report-a-claim-online.aspx. We suggest writing down (or getting someone else to write down) the details of the accident before calling ICBC. This way you can give them enough information from your side, as well as remember finer details incase you aren’t able to call till a later time.
Keep in mind that if you have immediate injuries and need treatment, you do not need to open an ICBC claim first to see a chiropractor. As with your family doctor you do not need a referral, and your chiropractor will examine you and decide the need for treatment or appropriate referral. This brings us to our next key point.
It’s a far too common story where we feel “OK” directly after an accident, go on to report no or very mild injuries, and start to feel the after effects in the days and weeks to follow. Since ICBC is structured so that you can visit your chiropractor at no cost to you, hesitating on whether or not to get examined can only hurt in the long run. A typical exam will consist of range of motion, neurological assessment (sometimes cranial nerves), concussion screen, orthopedic testing, and muscle/joint assessment. If any deficits are found despite you not feeling pain yet (or feeling mild pain), you just swooped in to start the process of treatment and rehabilitation to avoid suffering down the road. If nothing is found, you’ve just been cleared and can rest easy knowing you can return to your activities – still a great situation to be in! TL;DR version: evidence shows that delaying management and hoping it will pass on it’s own increases your chances of chronic pain. Research also points to other prognostic factors to consider.
Common Car Crash [Neuromusculoskeletal] Injuries: Whiplash & Friends
- Whiplash – Whiplash Associated Disorder (WAD). Whiplash injuries are caused by sudden acceleration-deceleration forces on the neck. This can either by front and back (hyperflexion and hyperextension) or side to side. A fender-bender is a classic example, but these are also common in sports like snowboarding or hockey. The WAD system classifies your whiplash injury by the types of structures injured in your head and neck, scoring you from 0 to 4 roughly depending on the severity (think strain vs. fracture). More recently the system also considers psychosocial contributors to pain, as new research tell us that a purely structural view of injuries is no longer appropriate (see our chronic pain post to learn why). This category represents the most common injuries from car accidents, and makes up the majority of car accident injuries we treat at our chiropractic office in Chilliwack.
- Back injuries. Low and mid-back injuries usually come in the shape of strain/sprain combinations, although more serious accidents can lead to a variety of fractures and nerve injuries. Some of these are injury to the front of the ribs (constochondritis), rib fractures, and chance fractures (think whiplash for the mid back). Naturally more severe accidents will take you to the ER from the scene, where you’ll be triaged to rule out more serious injuries. As with WADs your chiropractor will also consider psychological and prognostic factors in predicting your recovery.
- Extremity injuries. Injuries to our arms and legs are usually from bracing for the accident, direct impact of your limbs with your car, or in more severe accidents. The shoulder is prone to bracing injuries in the form of sprains/strains (on the mild side) as we push against the steering while before and during impact. Direct impact injuries can also be shoulder injuries (particularly in side to side collisions) as our shoulders hit the door. Another common direct impact injury is from our knees colliding with the lower dashboard. More seriously this can lead to knee sprains (PCL) and even hip dislocations as the femur is driven backward.
- Brain injury and Concussions. Nowadays concussion awareness seems to be increasing, whether from car accidents or sports injuries. Nonetheless pay attention to the following symptoms after an accident: nausea/vomiting, dizziness, irritability, confusion, fatigue, memory loss, and loss of consciousness. It’s best to consult a medical doctor initially with these symptoms, as they may need to order imaging in order to rule out other causes.
Chiropractic Treatment: Rehab, manual therapy, and more
Following a thorough history and exam, your chiropractor will decide if treatment is appropriate. If more serious issues are found that may have been missed in the ER or have since developed, you’ll be referred appropriately. This will be either for treatment elsewhere, co-treatment, or imaging with your family doctor before proceeding with care.
Your specific treatment will depend in the nature of your injury – things considered are severity of accident, types of tissues injured, your pre-injury status, functional deficits (in exam or with every day activities), and prognostic factors. From here evidence-based guidelines (click here for an example) are used as a resource to direct treatment. This ensures effective and safe treatments are given based on a body of research. Different treatments may include soft tissue therapy, spinal manipulation/mobilization, active rehabilitation, nerve-desensitizing techniques, pain education, and cognitive-behavioral therapy/mindfulness strategies. If a concussion is suspected you’ll undergo a cognitive rest protocol similar to that of sport-related concussions. This is typically two days full cognitive rest, followed by a graded return to activities as tolerated by symptoms. Click on each of the above therapies for a link to more information regarding its safety and effectiveness.
Questions? Call us to book an appointment!
More reading? Visit http://www.bcchiro.com/back-health/health-tips/after-a-car-crash/ for another quick guide, or read the attached links if you’re especially keen.
Thanks for reading,
Dr. van de Wall