Chronic Back Pain After a Car Accident

Years after a car accident, it can be hard to know what continuing back pain means or what to try next. Assessment needs to consider what contributes to the pain now. The original injury matters, but another person’s recovery cannot determine whether your symptoms reflect ongoing injury, altered pain processing or several factors together.

Nora Rodden's interview with the Association for the Treatment of Neuroplastic Symptoms follows years of back pain after she was struck by a car as a pedestrian. Procedures had not brought lasting relief. Later, she entered a study of psychophysiologic symptom relief therapy, often shortened to PSRT.

Her account of improvement is less dramatic than the phrase “recovery story” might suggest. There wasn't one perfect exercise or a single emotional breakthrough. She describes change becoming clearer over time.

The inconsistencies worth discussing

One detail stood out to Nora: carrying a backpack could hurt even when lifting heavier weights at the gym did not produce the same response.

A mismatch like that can be useful to describe at an appointment. It is not proof of a particular diagnosis. The weight, position, duration, setting, and expectations around an activity can all be details a clinician needs to consider.

The practical step is to report the observation accurately. “This sometimes hurts, but this other activity doesn't” is more useful than deciding that either the pain must be dangerous or it must be harmless.

Progress was easier to see over time

Nora says education was especially helpful. Writing exercises didn't initially resonate with her in the same way. Gradual changes in her pain scores made progress more apparent.

She didn't describe a dramatic moment when everything clicked. In her telling, improvement became apparent as she looked back across weeks.

A treatment plan can contain several components, and a person may respond to them differently. It is worth being specific about that in follow-up appointments. Which explanation helped? Which exercise felt confusing? What has become easier in daily life?

Those answers give a clinician more to work with than a verdict of success or failure after every difficult day.

What the PSRT study found

The published pilot trial included 35 adults with chronic back pain across three groups. Eleven received PSRT, which combined education, psychological work, and a structured program. At 26 weeks, seven of those eleven reported no pain, compared with three of twelve in the mindfulness-based stress reduction group and two of twelve receiving usual care. The primary disability outcome also favored PSRT. Read the pilot trial.

These are promising results from a small study. They do not establish that all pain after a collision has the same cause, or that an app, book, or self-guided version will reproduce the treatment's effects.

Questions for a fuller recovery plan

If pain has persisted long after an accident, useful questions include:

• What explanations have been considered, and what remains uncertain?

• Would treatment addressing pain-related fear or distress fit my situation?

• How will we track progress in ordinary activities as well as pain intensity?

Nora also talks about learning to enjoy things without making them productive. That work continued beyond pain relief. A recovery plan can make space for that question too: what do you want your days to include?

Make the next review specific

Bring an example of an activity that hurts and one you can manage, together with the treatments you have tried. Ask what those observations do and do not tell the clinician. Agree on one everyday measure of progress so the next review can consider more than how you feel on that particular day.