Back Pain After a Car Accident

By Benjamin McCay, DC, CCSP

Published July 5, 2026

Back pain is one of the most common symptoms reported after a motor vehicle accident. While many people associate car accidents with neck injuries and whiplash, the forces generated during a collision can also place significant stress on the muscles, ligaments, joints, discs, nerves, fascia, and other tissues of the spine.

Some people experience back pain immediately after a crash. Others feel relatively normal at first, only to develop stiffness, soreness, or radiating pain hours or days later.

Understanding the causes of post-accident back pain can help you recognize potential injuries and determine when further evaluation or treatment may be appropriate.

Why Does Back Pain Occur After a Car Accident?

Even in relatively low-speed collisions, the body may be subjected to rapid acceleration and deceleration forces.

During a crash, the spine may be compressed, twisted, bent, or stretched. These forces can affect multiple structures throughout the back.

Potential injuries include:

• Muscle strains
• Ligament sprains
• Facet joint injuries
• Sacroiliac (SI) joint injuries
• Other soft tissue injuries
• Disc injuries
• Nerve irritation

The amount of visible vehicle damage alone does not determine whether an occupant was injured. Injury risk depends on multiple factors, including collision mechanics, occupant position, restraint systems, preexisting conditions, and individual susceptibility.

Common Symptoms of Back Pain After a Collision

Lower Back Pain

The lumbar spine is commonly affected during motor vehicle accidents.

Symptoms may include:

• Aching pain
• Sharp pain
• Pain when standing
• Pain when sitting
• Pain during movement

Mid-Back Pain

The thoracic spine may also become painful after a collision.

Patients may report:

• Pain between the shoulder blades
• Muscle tightness
• Pain with deep breathing
• Stiffness during movement

Muscle Spasms and Guarding

Muscles may tighten following injury as part of a protective response.

This may result in:

• Tightness
• Cramping
• Limited movement
• Increased pain with activity

Pain Radiating Into the Leg

Some injuries may irritate or compress nearby nerves.

Symptoms can include:

• Pain into the buttock
• Pain down the leg
• Numbness
• Tingling
• Weakness

These symptoms should be evaluated, particularly when weakness or progressive neurological changes are present.

Stiffness and Reduced Mobility

Many patients experience difficulty:

• Bending forward
• Standing upright
• Getting out of bed
• Sitting for extended periods

Reduced movement may result from pain, muscle guarding, joint irritation, tissue sensitivity, fear of movement, or a combination of these factors.

What Structures Can Be Injured?

Muscles

Muscles may be strained during a collision.

These injuries may produce:

• Localized pain
• Tightness
• Tenderness
• Painful areas sometimes described as trigger points

Ligaments

Ligaments help stabilize the spine.

Excessive force may stretch or injure these tissues. More significant ligament injuries may contribute to instability, while less severe sprains commonly cause pain and guarding without true spinal instability.

Facet Joints

Facet joints are small joints that connect adjacent vertebrae.

They can become painful or irritated following a motor vehicle accident and may contribute to localized back pain and restricted movement.

Sacroiliac Joint Injuries

The sacroiliac joints connect the sacrum at the base of the spine to the pelvis.

Accident-related SI joint injuries may produce:

• Low back pain
• Buttock pain
• Pain near the back of the hip
• Pain when walking
• Pain when changing positions

Because several lumbar, hip, and pelvic conditions can cause similar symptoms, a physical examination is important when determining whether the SI joint is likely contributing to the pain.

Fascia and Other Connective Tissues

Fascia is part of the connective tissue network that surrounds and connects muscles, nerves, blood vessels, and other structures throughout the body.

Like other soft tissues, fascia can be affected by trauma. However, pain or stiffness after a collision usually cannot be attributed to fascia alone. Muscles, joints, ligaments, discs, nerves, tissue sensitivity, and altered movement may all contribute to symptoms.

Areas that feel tight or tender should therefore be interpreted in the context of the overall examination rather than automatically being labeled as a discrete "fascial restriction."

Disc Injuries

Intervertebral discs help distribute forces between adjacent vertebrae.

A collision may injure a disc or aggravate a preexisting disc condition. Possible findings include:

• Disc bulges
• Disc herniations
• Annular fissures

Disc abnormalities can also be present in people without pain. Imaging findings therefore need to be interpreted together with the accident history, symptom onset, physical examination, neurological findings, and prior imaging when available.

Nerve Injuries

A disc, joint, swelling, or other injury may irritate a spinal nerve.

Possible symptoms include:

• Radiating pain
• Numbness
• Tingling
• Burning sensations
• Weakness
• Reflex changes

Progressive weakness, significant sensory loss, or bowel or bladder dysfunction requires prompt medical evaluation.

Why Does Back Pain Sometimes Appear Days Later?

Many people are surprised when delayed symptoms develop after a collision.

Immediately after an accident, the body's stress response and the circumstances surrounding the crash may temporarily make pain less noticeable.

Over the following hours or days, tissue irritation, stiffness, swelling, and protective muscle guarding may develop or become more apparent.

A delayed onset of symptoms does not necessarily mean that the injury is minor or unrelated to the accident.

Signs You May Need Further Evaluation

Seek medical evaluation if you experience:

• Persistent or worsening back pain
• Numbness or tingling
• Weakness
• Pain radiating into the leg
• Difficulty walking
• Significant loss of movement
• Loss of bladder or bowel control
• Numbness in the groin or saddle area
• Severe pain after significant trauma

Progressive neurological symptoms, loss of bowel or bladder control, saddle numbness, or substantial weakness may require urgent or emergency evaluation.

How Is Back Pain Diagnosed?

Diagnosis begins with a thorough history and physical examination.

A healthcare provider may evaluate:

• Range of motion
• Muscle strength
• Reflexes
• Sensory function
• Joint mobility
• Areas of tenderness
• Orthopedic findings
• Neurological findings
• Functional limitations

Additional testing may be recommended when the results are likely to clarify the diagnosis or affect treatment.

X-Rays

X-rays may identify:

• Certain fractures
• Spinal alignment
• Degenerative changes
• Other bone abnormalities

Normal X-rays do not rule out many injuries involving muscles, ligaments, discs, nerves, or other soft tissues.

MRI

MRI may be appropriate when symptoms or examination findings suggest:

• Disc injury
• Nerve-root involvement
• Significant ligament or other soft tissue injury
• Persistent symptoms when additional information is likely to change treatment

MRI findings should be interpreted together with the clinical examination because disc bulges, degeneration, and other abnormalities can also occur in people without symptoms.

CT Scan

CT imaging may be recommended when an acute spinal fracture or other significant bony injury is suspected.

Treatment for Back Pain After a Car Accident

Treatment depends on the nature and severity of the injury, examination findings, neurological status, functional limitations, and the patient's response.

Chiropractic Care

For appropriately selected patients, chiropractic care may help reduce pain, improve comfortable spinal movement, and restore function following accident-related musculoskeletal injuries.

Treatment may include:

• Spinal manipulation
• Joint mobilization
• Soft tissue treatment
• Mobility exercises
• Rehabilitation exercises
• Activity recommendations

Manual treatment should be viewed as one method of helping control symptoms and improve movement tolerance. It does not directly repair torn tissue or guarantee faster biological healing.

Massage Therapy

Massage therapy may help:

• Reduce muscle tension
• Decrease soreness or stiffness
• Reduce painful tissue sensitivity
• Improve movement tolerance

These effects may make normal movement and rehabilitation easier for some patients. They should not be interpreted as proof that massage accelerates tissue healing or mechanically releases fascia.

Therapeutic Exercise

Exercise is often an important component of recovery.

Goals may include:

• Improving mobility
• Increasing strength
• Improving stability
• Restoring normal movement
• Increasing tolerance for work and daily activities
• Reducing dependence on passive treatment

Exercise should be progressed according to the patient's tolerance and stage of recovery.

Medical Management

Some injuries may require:

• Medication
• Physical therapy
• Advanced imaging
• Pain-management consultation
• Injections
• Orthopedic, neurological, or other specialist referral

Coordination between providers may be appropriate when symptoms are persistent, neurological, or not responding as expected.

How Should Treatment Progress?

Treatment should be individualized rather than based on a predetermined number of visits.

During active recovery, continued treatment should generally be supported by a meaningful clinical benefit. This will usually be demonstrated by improvement in symptoms, movement, function, activity tolerance, work capacity, or other relevant findings.

As improvement becomes stable, treatment frequency should generally decrease while normal activity, exercise, rehabilitation, and self-management take on a greater role.

If the patient is not improving as expected, simply repeating the same treatment indefinitely is not a satisfactory plan. The diagnosis and treatment strategy should be reconsidered. Depending on the circumstances, care may need to be modified, reduced, discontinued, combined with another treatment approach, or supplemented by imaging or specialist referral.

In some patients, however, reducing or withdrawing treatment may reveal that care was helping maintain meaningful function or prevent a recurring decline. If symptoms or functional limitations consistently worsen when treatment is reduced and improve again when treatment resumes, intermittent treatment may still provide a meaningful clinical benefit.

The need for continued care should be periodically reassessed, and treatment should generally be provided at the lowest reasonable frequency necessary to achieve or maintain that benefit.

Can Back Pain Become Chronic?

Yes.

Some people continue to experience back pain for months or longer after a motor vehicle accident.

Persistent symptoms do not necessarily mean that injured tissues remain inflamed or that additional structural damage is occurring. Chronic pain can be influenced by multiple factors, including:

• The original injury
• Persistent pain sensitivity
• Muscle guarding
• Reduced activity
• Altered movement patterns
• Neurological symptoms
• Sleep disruption
• Fear of movement
• Previous health conditions
• Work and daily activity demands

When recovery is slower than expected, the diagnosis, rehabilitation program, contributing factors, and need for additional evaluation should be reconsidered rather than simply continuing the same treatment indefinitely.

Back Pain Treatment in Everett and Lynnwood

At Advanced Chiropractic & Massage, we evaluate and treat patients experiencing back pain following motor vehicle accidents.

Our goal is to identify the likely source of symptoms, determine whether chiropractic treatment is appropriate, reduce pain and muscle guarding, improve comfortable movement and function, and help patients return to normal activities safely and efficiently.

Treatment plans are individualized and reassessed according to the patient's response. When additional care is needed, treatment may be coordinated with physical therapists, primary care providers, imaging centers, physiatrists, pain-management physicians, orthopedic specialists, neurologists, or other appropriate providers.

Whether symptoms begin immediately after the accident or develop several days later, an appropriate evaluation can help determine the nature of the problem and the most reasonable next step in recovery.

Frequently Asked Questions

Is lower back pain common after a car accident?

Yes. Lower back pain is commonly reported following motor vehicle collisions.

Can back pain appear several days after an accident?

Yes. Pain, stiffness, and other symptoms may become noticeable hours or days after a collision as tissue irritation, muscle guarding, and other symptoms develop or become more apparent.

Can a car accident cause a herniated disc?

A motor vehicle collision can injure a disc or aggravate a preexisting disc condition. MRI findings should be interpreted together with the accident history, symptoms, examination findings, and prior imaging when available.

Should I get an MRI for back pain after an accident?

Not necessarily. MRI may be appropriate when symptoms or examination findings suggest nerve involvement, disc injury, significant soft tissue injury, or persistent symptoms for which imaging is likely to affect treatment.

Can chiropractic care help back pain after a car accident?

Chiropractic care may help selected patients by reducing pain, improving comfortable movement, and supporting return to normal activity and rehabilitation. A clinical evaluation is needed to determine whether chiropractic treatment is appropriate for the specific injury.