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Column September 27, 2025

Why Aftereffects Appear Late

Hyo-seop Kim
Hyo-seop Kim
Chief Director

How adrenaline masks pain

When a traffic accident occurs, the body triggers an immediate stress response. The adrenal glands release large amounts of adrenaline (epinephrine) and cortisol, raising heart rate, increasing muscle tension, and at the same time temporarily suppressing pain perception. This is why many people feel they are not really hurt right after an accident. Korean medicine describes this as stagnation of qi mechanism (Gigi-uljeol, 氣機鬱結) — a state in which the flow of qi is temporarily frozen by the shock.

Delayed presentation of soft-tissue micro-injuries

Micro-tears in muscles, ligaments, and fascia may not even show on imaging right after the accident. Over time, the inflammatory response spreads, swelling accumulates, and the pain finally becomes perceptible. Typically, 24–72 hours after the accident, the adrenaline effect wears off and the inflammation from micro-injuries reaches its peak — this is when pain begins suddenly.

Why 48–72 hours of observation matter

  • Within 24 hours: Adrenaline still active, pain perception dulled
  • 24–48 hours: Cortisol levels fall, inflammatory mediators begin accumulating at micro-injury sites
  • 48–72 hours: Swelling peaks, muscle stiffness intensifies, full-blown pain emerges
  • 1–2 weeks: Without treatment, fibrosis (scar tissue) begins → chronic pain becomes fixed

Early Korean medicine response

Even if symptoms are mild, starting treatment on the day of the accident allows preemptive removal of blood stasis through resolving stasis and activating blood (Geo-eo Hwalhyeol, 祛瘀活血) before it becomes fixed. Formulas containing Persicae Semen (peach kernel, doin, 桃仁), Carthami Flos (safflower, honghwa, 紅花), and Ligustici Rhizoma (cheongung, 川芎) given from the start suppress the spread of inflammation and shorten recovery time. Acupuncture immediately stimulates qi and blood circulation and accelerates natural healing of micro-injury sites.

Even if you feel fine, please monitor yourself for 48 hours, and visit the clinic immediately if any pain — even mild — appears.

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Hyo-seop Kim

Hyo-seop Kim Chief Director

Hello, I am Director Hyo-seop Kim, Chief Director of Geummaek Korean Medical Clinic. I look beyond visible symptoms to find the root causes. Through over 15 years of clinical experience and research, I provide the most helpful treatment for each individual patient. Please feel free to share your concerns. Together, we will find the answers.

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