Rear-End Collision Injuries: Symptoms, Treatment Timelines, and How Recovery Works

Ryan Bradley | January 19, 2026 | Car Accident

A rear-end collision can happen anywhere in St. Louis, whether on a busy highway or in stop-and-go traffic downtown. You may walk away from someone slamming into your car, feeling shaken but fine. The next morning, you can barely get out of bed, your back screaming with every movement.

Rear-end collision injuries often show up hours and even days after a crash. Insurance companies know this, but still use any delay in treatment to argue your injuries aren’t real or weren’t caused by the accident. Seeing a doctor early and documenting your injuries are the keys to getting the recovery you deserve.

Our guide explains the injuries commonly resulting from rear-end impacts, what symptoms appear late, and how to protect your right to compensation.

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Key Takeaways:

• Rear-end collision injuries often appear hours or days after the crash. Whiplash, concussions, and herniated discs don’t always hurt immediately. You may feel nothing at the crash scene, with adrenaline masking your pain. That’s why it’s crucial to see a doctor as soon as possible.
• The way your body moves during a rear-end impact causes specific injuries. When you’re hit from behind, your head jolts forward then backward, causing neck strain. Your knees may slam into the dashboard, and your seatbelt can fracture ribs. Understanding rear-end biomechanics is crucial to recognizing (and documenting) injuries.
• Delayed treatment gives insurance companies ammunition to deny your claim. Adjusters specifically look for gaps between the crash and your first doctor’s visit. Waiting days or weeks to seek care can sink your claim. Early treatment protects your rights and compensation claim.

Rear-End Crash Statistics

Rear-end collisions are some of the most common types of crashes in Missouri and across the United States. And, far from being harmless fender-benders, rear-end crashes can lead to severe injuries and even fatalities.

Missouri Crashes and Injuries

Missouri saw 136,847 total crashes in 2023, according to the Missouri State Highway Patrol’s 2023 Missouri Traffic Crashes Statistics. Those accidents resulted in 50,375 injuries and 991 deaths across the state. St. Louis and Kansas City see particularly high crash rates due to congested highways like I-70, I-270, and I-44.

U.S. Roadway Fatality Trend

National Highway Traffic Safety Administration (NHTSA) early estimates project 39,345 traffic deaths nationwide in 2024, representing approximately a 3.8% decrease from 2023. While any decline is positive, tens of thousands of families still lose loved ones on U.S. roads every year. Rear-end collisions contribute significantly to the fatality statistics, especially when they occur in fast-moving traffic.

Why Rear-End Crashes Are So Common

Rear-end collisions make up roughly 29% of all crashes nationally. Distracted driving, like checking phones or adjusting the GPS, is often responsible. Following too closely is another major contributor.

Missouri law requires drivers to maintain a safe following distance under Mo. Rev. Stat. § 304.017, but many drivers tailgate and are unable to stop in time. Rear-end crashes are almost inevitable when drivers aren’t paying attention, especially in bad weather and in stop-and-go St. Louis traffic.

What To Do After a Rear-End Accident in St. Louis

After any accident, your health should be your priority, followed by preserving your legal rights. Here’s a short overview of what to do:

Get Checked Even If You “Feel Fine”

Going to the emergency room or urgent care immediately serves two vital purposes: doctors can identify injuries that aren’t immediately obvious, and you’re creating a medical record. Getting checked right away helps you counter insurance adjusters arguing that you weren’t really hurt.

Don’t trust your body immediately after an accident. Adrenalin can suppress pain for hours or even days. You might walk away from the collision scene feeling completely normal, and then wake up the next morning unable to move.

Document Symptoms That Start Later

Soft tissue injuries like whiplash don’t always hurt immediately, and concussion or traumatic brain injury (TBI) symptoms can appear 24 to 48 hours after the impact. Herniated discs might not become painful until days after the crash.

Make sure to keep a daily pain journal. Write down every symptom you experience, even minor ones. Take photos if you develop visible bruising or swelling. This documentation is critical evidence for your claim.

What to Say (and Not Say) to Insurance

The other driver’s insurance company may contact you within a day or two. Never give a recorded statement to the other driver’s insurer, as this could be used against you. And don’t worry about politely declining to give a statement: Missouri law doesn’t require you to talk to insurers.

Important: don’t sign any releases or accept settlement offers until you’ve talked to a lawyer and know the full extent of your injuries. Once you hire an attorney, they’ll send a letter of representation that stops insurers from contacting you directly and twisting your words.

Read our full guide on what to do after a rear-end collision.

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Common Injuries from Rear-End Accidents in St. Louis

The way your body moves during a rear-end collision causes predictable injury patterns. Your head whips forward, then back, and your knees typically slam into the dashboard. The seatbelt locks across your chest. Understanding specific rear-end biomechanics helps you recognize injuries that might not hurt immediately but will show up in the coming days.

Neck Injuries

Neck injuries, specifically whiplash and cervical strain, are some of the most common injuries seen in rear-end collisions. The sudden forward-and-backward motion your head makes during impact (even at low speeds) puts enormous stress on the cervical spine and surrounding soft tissues.

Symptoms of whiplash include:

• Neck pain and stiffness
• Reduced range of motion
• Headaches starting at the base of your skull
• Shoulder pain and upper back pain
• Tingling or numbness in your arms
• Dizziness or blurred vision
• Memory problems or difficulty concentrating

Sometimes, these symptoms show up right away, but they may also develop gradually over the next few days. Your doctor may decide to use a combination of treatments, including pain medication, muscle relaxants, and physical therapy. Mild and moderate whiplash cases should improve over six to twelve weeks.

More severe cases may require steroid injections. Some victims develop chronic whiplash that affects their ability to work, particularly if their job requires physical labor or sitting at a desk all day.

Back Injuries

Back pain after an accident can be excruciating and is typically caused by herniated discs, lumbar strains, and sciatica. Even low-speed rear-end impacts can cause injuries to your lower back.

Herniated discs cause pain when the gel-like center pushes through and presses on nearby nerves. Lumbar strains occur due to overstretched or torn muscles and ligaments in the lower back. A rear-end accident can also trigger sciatica, nerve pain that starts in your lower back and travels down your leg. Sciatica can feel like shooting pain, numbness, or tingling.

Most back injuries heal in two to three months with adequate rest, physical therapy, and medication. If the conservative approach doesn’t work, your doctor might recommend epidural steroid injections. In severe cases, involving weakness or loss of function, surgery may become necessary.

Watch out for any of these symptoms, which could indicate cauda equina syndrome, a medical emergency requiring immediate treatment:

• loss of bladder control
• numbness in the groin
• weakness in both legs.
• Severe pain that doesn’t improve with rest
• Fever combined with back pain

Head and Brain Injuries

When your car stops suddenly from a rear-end impact, your brain keeps moving inside your skull and slams against the inner surface. This can cause concussions and traumatic brain injuries even when your head never hit anything.

Immediate symptoms of a brain injury include headache, confusion, dizziness, and nausea. In addition to immediate effects, brain injuries can also present with delayed symptoms that may show up days or even weeks after your accident:

• Difficulty concentrating
• Memory and other cognitive problems
• Irritability
• Sleep disturbances
• Mood changes

Head injuries, such as traumatic brain injury (TBI), carry higher personal injury settlement values because they can have a profound impact on your work and home life. For example, they may prevent you from working, especially in jobs requiring concentration or decision-making. That’s why lost wages and reduced earning capacity often become major components of TBI claims.

Shoulder, Arm, Wrist, and Hand Injuries

If you glance in your rearview mirror and see the crash coming, you may instinctively grip the steering wheel tight. This transfers massive force through your arms and shoulders. The sudden jolt can tear rotator cuff muscles, sprain wrist ligaments, or fracture small bones in your hand. And the seatbelt holds your chest in place while the rest of your body moves forward, straining and injuring your shoulder joint.

Injuries of the shoulder, arm, wrist, and hand that are commonly seen in accidents include:

• Rotator cuff tears (shoulder)
• Labral tears (damaged cartilage)
• Wrist sprains and fractures
• Hand fractures

These injuries, while not catastrophic, can still affect your daily life and independence. For example, ordinary tasks, like getting dressed, cooking, or doing housework, become impossible without help.

Imaging scans may be crucial for your injury claim. Shoulder, arm, and wrist injuries typically require MRI scans or CT scans to show the full extent of damage, which insurers may require before they’ll consider paying your claim.

Chest Injuries and Rib Fractures

It’s true that seatbelts save countless lives, but they can also bruise or fracture ribs during a rear-end accident. And in severe impacts, they can even cause internal injuries to organs located under the ribs, such as your lungs, heart, liver, or spleen.

The same is true for airbags: they protect you from severe injuries. But when the airbag deploys, you could experience burns, abrasions, eye injuries, and broken facial bones.

Don’t ignore chest injuries after a rear-end crash, and make an appointment with your doctor as soon as possible. If you experience difficulty breathing, severe chest pain, coughing up blood, or signs of shock like rapid heartbeat and cold skin, call 911 immediately.

Knee, Ankle, and Lower-Extremity Injuries

In a rear-end accident, even with moderate impacts, your knees can slam into the dashboard or steering column and cause “dashboard knee.” Such injuries can involve kneecap fractures, torn ACL or MCL ligaments, meniscus tears, and ankle sprains (if your foot was on the brake pedal).

Dashboard knee and other lower extremities injuries might get completely missed on the day of the crash, because the pain may be overshadowed by neck or back injuries. You might not realize your knee is seriously injured until swelling and other symptoms develop a day or two later.

Depending on their severity, lower extremity injuries can severely affect your mobility. You might need crutches, a knee brace, or even knee replacement surgery, followed by months of physical therapy.

When a Rear-End Collision Causes Catastrophic Injury or Wrongful Death

Not all rear-end crashes are harmless fender benders. High-speed impacts on I-70 or accidents involving commercial trucks can cause life-altering or fatal injuries.

A catastrophic injury is a severe injury that typically causes permanent or long-term loss of function, such as:

• Spinal cord damage causing paralysis
• Severe traumatic brain injury with permanent cognitive impairment
• Multiple fractures requiring extensive surgery and rehabilitation
• Internal organ damage requiring long-term treatment.

These injuries change your life, as you might be unable to work or live independently again. And medical expenses can reach millions of dollars over a lifetime.

When a loved one dies in an accident due to the negligence of another party, Missouri law generally allows families to file wrongful death claims under Mo. Rev. Stat. § 537.080. These claims help families dealing with the financial impact of the loss. Compensation can include funeral expenses, medical bills incurred before death, lost financial support the deceased would have provided, and compensation for the loss of companionship.

Catastrophic injury and wrongful death cases require experienced and tenacious legal representation. Since such claims typically involve significant damages, insurance companies fight tooth and nail to reduce or deny fair payouts.

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What Strengthens Your St. Louis Rear-End Collision Injury Claim

Insurance companies often downplay rear-end collision injuries because many are soft tissue injuries with no visible damage, such as whiplash. They’ll argue you’re exaggerating pain or that your injuries weren’t even caused by the crash. This means you’ll need compelling evidence to strengthen your claim:

• Get medical attention immediately. Go to the emergency room or urgent care immediately, even if you feel fine. Insurance adjusters will try to exploit any longer gaps between the crash and your first doctor visit.
• Follow your treatment plan meticulously. Attend every doctor’s appointment and don’t skip any physical therapy sessions. Skipped appointments and treatments provide ammunition to insurers to argue your injuries aren’t as serious as you claim.
• Keep records of everything. Start a pain journal and take photos of your injuries. Save all medical bills, prescription receipts, and wage loss documentation.
• Get diagnostic imaging. MRI scans reveal soft tissue damage like herniated discs or torn ligaments that are typical in rear-end crashes. These injuries don’t show on X-rays, so MRIs can be crucial to back up your claim.

The stronger your documentation, the harder it becomes for insurance companies to deny or reduce your rear-end injury claim.

Who Is at Fault in a Missouri Rear-End Crash? (And When It’s Not the Rear Driver)

Most people assume the rear driver is always at fault in a rear-end collision. And Missouri law does create a presumption that the following driver caused the crash by failing to maintain a safe distance under Mo. Rev. Stat. § 304.017. But this doesn’t mean the driver in the back is always responsible.

Common Exceptions to the Rule

Several scenarios can shift some or all fault to the driver in front, including:

• Sudden unsafe lane changes
• Brake-checking (intentionally slamming on brakes).
• Non-functioning brake lights
• Multi-vehicle chain reactions

These rear-end crash fault exceptions in Missouri often surprise people who assume the rear driver always pays.

Evidence Checklist

Proving fault in a rear-end crash can be challenging, especially if you want to prove that the driver in front was responsible. Here’s the evidence to collect:

• Photos of the accident scene
• Missouri State police reports and St. Louis reports
• Dashcam or traffic camera footage
• Witness statements
• Event data recorder (EDR) data (your car’s “black box”)
• Cell phone records

Some of this evidence, such as St. Louis traffic camera footage and cellphone records (to prove a driver was texting), can be impossible to obtain on your own. Consider getting an attorney on your side when fault is disputed. Learn more about rear-end fault exceptions.

What Damages Can You Recover in Missouri?

Missouri’s pure comparative negligence system under Mo. Rev. Stat. § 537.765 allows you to recover compensation even if you share some fault for the accident. However, your compensation is typically reduced by your percentage of fault. Here’s a rundown of the damages you could recover in a St. Louis rear-end accident claim:

Medical Bills and Future Care

If another driver is mostly at fault for your rear-end crash, you can recover all reasonable medical expenses. This includes:

• Emergency room treatment
• Hospital stays
• Surgery
• Doctor visits
• Physical therapy
• Prescription medications
• Crutches, braces and other equipment
• Home health care if needed

And if your injuries require long-term treatment, you could also be entitled to future medical expenses. A life care plan prepared by medical experts can be crucial, as it’ll document what care you’ll need and how much it can cost over your lifetime.

Lost Wages and Reduced Earning Capacity

If your injuries prevent you from working, you can recover lost wages, including hourly pay, salary, bonuses, and lost benefits like health insurance. More serious injuries that permanently reduce your earning capacity allow you to recover the difference between what you used to earn and what you can earn now.

Pain and Suffering

Non-economic (pain and suffering) damages include physical pain, emotional distress, lost quality of life, and permanent disfigurement or disability. Missouri doesn’t cap these damages in most car accident cases, so if your injuries are severe or life-changing, your recovery could be substantial.

The more severe and long-lasting your injuries, the higher your pain and suffering damages. For example, if a TBI stops you from working, your chronic whiplash limits your daily activities, or you suffered herniated discs requiring surgery, your claim could include substantial pain and suffering damages.

Property Damage and Rental Car Issues

In Missouri, you can recover the cost to repair your vehicle or its fair market value if it’s totaled. And diminished value claims compensate you for the reduction of your car’s value after accident repairs.

You’re also entitled to rental car expenses while your vehicle is being repaired, but insurers often push back on these costs. If they deny or lowball your rental costs, consult an attorney who can help you recover reasonable rental expenses.

Talk to a St. Louis Car Accident Lawyer About Your Rear-End Injury

Insurance companies want you to settle fast and cheaply. They know you’re worried about medical bills and missing paychecks.

Don’t fall for it.

Most rear-end collision injuries don’t reveal their full extent for weeks or months. Once you sign that settlement release, you can’t ask for more money, even when you discover you’re far more injured than you thought.

Bradley Law Personal Injury Lawyers has recovered hundreds of millions of dollars for Missouri car accident victims. Our St. Louis rear-end accident lawyers know how to prove a claim’s full worth and shut down insurance company arguments. You pay nothing until we win.

What happens when you call us: We review your accident, tell you straight whether or not you have a case, and give you our honest assessment of what your claim is worth. The clock is ticking on your claim. Contact us now for a free, no-obligation case review.

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