Key takeaways

  • A typical crash exam has four parts: the history, the physical exam, findings and a diagnosis if they support one, and a written plan.
  • The physical exam usually tests how you move, what reproduces the pain, and nerve function such as reflexes, strength and sensation.
  • If the head was involved, expect questions and checks aimed at concussion symptoms.
  • You can say stop at any point. Pain that a test reproduces is information, not a test you failed.
  • Some exams end with a referral or imaging. That is the exam working.

The desk's first visit guide covers what Missouri Injury Clinic publishes about its auto injury lane, what to bring and what to say on the phone. This guide goes one level deeper, into the hour itself. What follows is what a crash exam at a chiropractic injury clinic typically involves. The clinic does not publish a step-by-step script of its exams, so treat this as the general shape, and ask the office about anything specific.

Before you walk in: wear the right clothes

Loose, comfortable clothing that lets you bend, turn and raise your arms. Shoes you can slip off. If you are coming straight from a shift or an office downtown, bring a change. It sounds minor. It makes the movement tests easier and faster.

Part one: the paperwork and the history

Expect intake forms: contact details, insurance, a medication list, past injuries and surgeries, and a body diagram where you mark what hurts. Fill in the diagram carefully. It is often the first thing the clinician reads.

Then the history, which is a conversation. Expect questions about:

  • The crash: date, which way you were hit, speed as best you know, where you sat, where your head was.
  • What happened after: whether you went to an emergency department, what they did, what they told you.
  • Each symptom: where, what it feels like, when it started, what makes it better or worse.
  • Your head: headaches, fog, dizziness, trouble with screens or light, sleep changes.
  • Your life: your job, your commute, what you cannot do now that you could before.

Whether you were hit on 270 at Dorsett or in a lot in Affton, the physics are the same kind and the questions are the same kind. Answer what you know. "I don't remember" is a fine answer.

Part two: the physical exam

The National Institute of Arthritis and Musculoskeletal and Skin Diseases describes a back exam as examining the spine and posture, asking you to bend or lift your legs to see how movement affects pain, and testing reflexes, muscle strength and sensation. A crash exam of the neck and back typically covers similar ground:

Looking

How you stand, sit and move when you are not thinking about it. Whether you are holding one shoulder higher or guarding one side.

Range of motion

Turning your head left and right, tipping it toward each shoulder, looking up and down. Bending forward, backward and to the sides at the waist. The clinician notes how far you go and where it hurts. These measurements often become the baseline every later visit is compared against.

Touch

Pressing along the muscles and joints of the neck and back to find tender areas, tight muscle and spots that reproduce your pain.

Movement tests

Specific positions or gentle pressure designed to see which structures are irritated. Some reproduce the pain on purpose. Tell the clinician what you feel, and say stop if you need to.

Nerve checks

Tapping reflexes at the elbow, knee or ankle. Pushing and pulling against the clinician's hands to test strength. Light touch on the arms, hands, legs or feet to check sensation. If you have tingling or numbness, these are especially important.

If the head was involved

Questions about concussion symptoms, and possibly checks of balance, eye movement or tracking. Missouri Injury Clinic publishes a TBI and concussion rehab lane whose named tools include oculomotor rehabilitation for dizziness, blurred vision and balance. Mention your head on the phone so the office knows before you arrive. The desk's concussion guide goes further.

Part three: findings and a diagnosis

After the exam, the clinician should explain what they found in words you can repeat, and give a diagnosis if the findings support one. Ask for the plain version if you hear a term you do not know. Write it down or ask for a copy. That dated entry is the start of the record.

Part four: the plan, or the referral

Missouri Injury Clinic publishes its auto injury lane as diagnosis and a treatment plan after a crash. The plan should cover what treatment involves, how often, what to do and avoid at home and work, and when you will be re-checked.

Or the exam may end with a different answer: you need imaging first, a physician, a specialist, or an emergency department. That is not a wasted hour. It is the exam doing its job.

Four questions before you leave

  1. What did you find?
  2. What is the plan, and when will we check whether it is working?
  3. What should I avoid until the next visit?
  4. What would make you send me somewhere else?

Crash this week, anywhere in the metro? Start with an exam. Hazelwood (314) 627-1411, Tesson Ferry (314) 530-5480, O'Fallon (636) 280-0990. All three close 12 to 2 daily.

If the exam cannot wait

Anything on the emergency list, such as a head injury with vomiting or worsening confusion or new trouble with bladder or bowels, skips the clinic exam entirely and goes to an emergency room now. Everything on this desk is educational and is not medical advice.