Hidden Nerve Damage After a Mild Head Injury: An Integrative Chiropractic Scientist Guide

Introduction: When a “Mild” Head Injury Quietly Changes Your Nerves

On paper, a mild head injury sounds minor. You might walk away from a car crash, sports collision, workplace accident, or fall, feel a bit dazed, then “shake it off.” The ER scan looks normal. You get sent home with rest instructions and maybe some pain pills.

But at the nerve level, the story can be very different.

Even without a skull fracture or major bleed, a mild traumatic brain injury (mTBI) can stretch, twist, and tear tiny nerve fibers inside the brain. This can quietly disrupt brain–body communication and create symptoms that appear days or weeks later, including headaches, brain fog, mood changes, balance problems, or unusual sensory changes (MSKTC, n.d.-a; NINDS, 2025). MSKTC+1

On ChiropracticScientist.com, we look at these injuries through both a scientific and biomechanical lens. This article explains:

• What happens to nerves after a “mild” head injury

• Why can damage stay hidden even when scans look normal

• How diffuse axonal injury, cranial nerve damage, and micro-tears in brain tissue affect function

• How a nurse practitioner (NP) and an integrative chiropractor can work together to support neuroplasticity, spinal alignment, and long-term recovery

We’ll also weave in clinical observations from Dr. Alexander Jimenez, DC, APRN, FNP-BC, whose dual-scope practice combines medical diagnostics and chiropractic neuromusculoskeletal care in El Paso (Jimenez, n.d.; Chiropractic Scientists, n.d.). El Paso, TX Doctor Of Chiropractic+1

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1. What “Hidden Nerve Damage” Means After a Mild TBI

A traumatic brain injury (TBI) happens when an external force—like a blow, jolt, or rapid acceleration–deceleration disrupts normal brain function (NINDS, 2025). ninds.nih.gov

In a mild TBI or concussion, the person may:

• Stay conscious or briefly lose consciousness

• Have normal CT or MRI imaging

• Be sent home with “mild concussion” written on their discharge papers

Yet beneath that label, several nerve-level problems can occur.

Diffuse Axonal Injury (DAI)

Inside the skull, the brain can rotate, stretch, and slide against bony ridges. This can cause diffuse axonal injury, a condition characterized by microscopic stretching and tearing of axons in the brain’s white matter pathways (MSKTC, n.d.-a; NINDS, 2025). MSKTC+1

When axons are damaged, nerve cells cannot send signals with the same speed or accuracy. This can lead to:

• Slower thinking and processing

• Difficulty multitasking

• Problems with attention and memory

• Changes in balance and coordination (MSKTC, n.d.-b; MSKTC, n.d.-c) MSKTC+1

Even advanced imaging may miss this microstructural damage, which is why symptoms can be real even when scans are “clean” (All County Radiology, n.d.; Weill Cornell Medicine, n.d.). NINDS CDE+1

Cranial Nerve Injury

Cranial nerves come directly out of the brain and brainstem. They control smell, eye movements, facial muscles, hearing, swallowing, and many other functions.

A clinical study in the Journal of Neurosurgery found that even minor head trauma (Glasgow Coma Scale 14–15) can cause cranial nerve palsies. The olfactory, facial, and oculomotor nerves were among the most affected, and some deficits remained at one-year follow-up (Fernández Coello et al., 2010). PubMed

Cranial nerve damage after head trauma may show up as:

• Loss of smell or taste

• Double or blurred vision

• Facial weakness or drooping

• Hearing changes, dizziness, or vertigo (Verywell Health, n.d.) PM&R KnowledgeNow

On the surface, a person may look “fine,” but their neuro-ocular and sensory systems are no longer functioning at pre-injury levels.

Peripheral and Small Fiber Neuropathy

Head and neck trauma can also be linked with peripheral nerve changes, especially when the injury involves whiplash or spinal compression. Peripheral neuropathy can create:

• Numbness, tingling, or burning pain

• Loss of vibration or position sense

• Weakness or clumsiness in hands and feet (Cleveland Clinic, 2022). Cleveland Clinic

This is important for chiropractors because a patient’s complaints of “weird” sensations or nerve pain after a concussion may reflect a combination of central (brain) and peripheral nerve changes, not just simple muscle strain.

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2. Why Symptoms Are Delayed or Easy to Miss

Immediately after injury, the brain goes through a cascade of:

• Ionic shifts

• Neurotransmitter disruptions

• Metabolic changes

• Local inflammation (NINDS, 2025; BrainLine, n.d.) BrainFacts+1

Some symptoms show up right away. Others appear later, once the person returns to work, school, sports, or driving.

Common hidden or delayed symptoms include:

• Headaches that grow more frequent or intense

• Brain fog and slower thinking

• Trouble focusing or multitasking

• Word-finding difficulty

• Changes in sleep

• Increased anxiety, irritability, or depression

• Light and noise sensitivity

• Balance problems and dizziness (Mayo Clinic, n.d.; Team Justice, n.d.) The University of Alabama at Birmingham+1

The MSKTC notes that TBIs can alter physical, cognitive, and emotional functioning in ways that impact work, relationships, and day-to-day independence (MSKTC, n.d.-b). MSKTC

Because the symptoms are often subtle and spread out over time, patients may:

• Blame “stress” or “getting older”

• Forget that they hit their head at all

• Only seek care when pain or fatigue becomes disabling

This is why careful history-taking and pattern recognition are crucial for both nurse practitioners and chiropractors who care for post-trauma patients.

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3. Mild vs. Moderate TBI: Micro-Tears That Still Matter

In moderate TBI, clinicians may see:

• Contusions (bruises) in brain tissue

• Visible bleeding

• Longer periods of confusion or loss of consciousness

But mild TBI can still create biologically significant damage:

• Micro-tears in white matter (DAI)

• Small blood–brain barrier leaks

• Microvascular changes and neuroinflammation

• Subtle cranial nerve dysfunction

Weill Cornell Medicine notes that mild TBI can lead to persistent post-concussive symptoms even with normal imaging, and clinicians must monitor for “danger signs” such as worsening headaches, confusion, seizures, or repeated vomiting (Weill Cornell Medicine, n.d.). MSKTC

For Chiropractic Scientist readers, the key biomechanical insight is this:

Even if global brain structures look intact, microstructural and neurophysiological changes can alter how the nervous system interacts with the spine, muscles, and joints.

That is exactly where integrative chiropractic and neuromusculoskeletal assessment become highly relevant.

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4. Neuroplasticity: How the Brain Tries to Repair Itself

The hopeful part of this story is neuroplasticity—the brain’s ability to adapt, reorganize, and form new connections after injury.

MSKTC notes that the fastest gains after TBI often occur in the first six months, but improvement can continue for years, especially when the brain is challenged in the right ways (MSKTC, n.d.-a). MSKTC

Neuroplastic change may involve:

• Strengthening remaining healthy pathways

• Recruiting new brain regions to take over lost functions

• Reconnecting sensory and motor circuits through repetition and training

Rehab programs that combine cognitive tasks, balance work, visual–vestibular therapy, and graded physical activity can enhance these plastic changes (Cognitive FX, n.d.; Flint Rehab, n.d.). Cleveland Clinic+1

From a chiropractic-science angle, this means:

• High-quality, precise spinal and postural input becomes a form of sensory training for the brain, allowing it to function optimally.

• Movement-based therapies can act as repeated “neural reps,” encouraging the brain to reorganize around more efficient patterns.

• The spine is not just a stack of bones; it is a sensor-rich feedback system that continuously informs the brain about body position, load, and safety.

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5. The Nurse Practitioner’s Role: Safety, Systems, and Strategy

A nurse practitioner experienced in brain and spine trauma is often the central medical hub of a patient’s recovery plan. Their work includes:

Medical Triage and Risk Management

• Ruling out red flags like intracranial bleeding, infection, or seizures

• Ordering and interpreting imaging (CT, MRI, and, when needed, more advanced studies)

• Determining whether emergency care or a neurology consult is needed (NINDS, 2025; Mayo Clinic, n.d.) ninds.nih.gov+1

Neurological and Cognitive Assessment

• Cranial nerve and motor–sensory testing

• Cognitive screening: attention, memory, processing speed

• Screening for mood changes, PTSD, and sleep disorders

MSKTC reports that memory problems, chronic pain, and emotional changes are common after a TBI and significantly affect function, so they must be monitored and managed over time (MSKTC, n.d.-b; MSKTC, n.d.-c). MSKTC+1

Integrative Care Planning

Nurse practitioners can:

• Prescribe medications when necessary (e.g., for migraines, spasticity, anxiety, or depression)

• Coordinate referrals to neurology, neuropsychology, physical, and occupational therapy

• Refer to chiropractic care once serious structural red flags are ruled out and the neck is medically cleared

Clinicians like Dr. Jimenez use their dual role as NP and chiropractor to combine evidence-based medical guidance with hands-on neuromusculoskeletal care, optimizing both safety and function (Jimenez, n.d.; A4M, n.d.). El Paso, TX Doctor Of Chiropractic+1

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6. The Integrative Chiropractor’s Role: Spine–Brain Mechanics and Sensory Input

For Chiropractic Scientist readers, this is where biomechanics and neurology meet.

Cervical Spine Mechanics and Brainstem Signaling

Head injury often occurs together with whiplash, rapid flexion/extension, or axial loading of the cervical spine. Subtle joint fixation or misalignment in the upper cervical region can alter:

• Proprioceptive input from deep neck muscles

• Load sharing between discs, ligaments, and facet joints

• Blood flow and CSF dynamics near the craniocervical junction

Within Chiropractic describes how careful cervical adjustments and soft-tissue work can support better neck mechanics, reduce tension, and provide more accurate sensory feedback to the brain after TBI, especially in car accident cases (Within Chiropractic, 2025). Within Chiropractic

Posture, Balance, and Proprioception

After mild TBI, many individuals develop:

• Forward head posture

• Asymmetric shoulder and trunk loading

• Gait changes and balance problems

These patterns feed the brain noisy or distorted proprioceptive information. Integrative chiropractors assess posture, joint motion, and dynamic balance, then use:

• High-precision, low-amplitude adjustments

• Postural correction drills

• Balance and vestibular-friendly exercises

• Mobility and strengthening work

Northwest Florida Physicians Group notes that chiropractic care in TBI patients can help reduce chronic pain, improve brain–body communication, and support functional recovery as part of a broader medical plan (Northwest Florida Physicians Group, 2025). Northwest Florida Physicians Group

Soft-Tissue and Movement-Based Therapies

Soft-tissue techniques, such as myofascial release and instrument-assisted methods, are used to:

• Decrease protective muscle guarding around the neck and upper back

• Improve local blood flow

• Calm nociceptive (pain) input into the CNS

Dr. Kal’s review on accident head injuries highlights how these approaches can reduce long-term discomfort and complement medical care for head trauma survivors (Dr Kal, 2024). Advanced Health Solutions

Apex Chiropractic further explains that chiropractic-based TBI programs often combine spinal care with carefully graded exercise, vestibular drills, and lifestyle coaching, acknowledging that TBIs are not easily “fixed” by a single drug or surgery (Apex Chiropractic, 2022). Apex Chiropractic

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7. Chiropractic Scientist Perspective: Evidence-Informed, Not Evidence-Ignoring

Current research on chiropractic care specifically for TBI is still emerging. Large randomized trials are limited, and responsible chiropractors:

• Avoid claiming chiropractic “cures” TBI

• Work within safety standards and medical clearance

• Use evidence from broader neuromusculoskeletal and vestibular rehab literature

• Document outcomes (pain, range of motion, balance, headaches, quality of life)

At the same time, clinical reports from chiropractors, physiatrists, and neurorehab teams show that spinal care, postural training, and movement-based therapies can reduce symptoms that are heavily driven by neck dysfunction, chronic pain, and sensory mismatch after head trauma (Within Chiropractic, 2025; Northwest Florida Physicians Group, 2025; Dr Kal, 2024). Within Chiropractic+2Northwest Florida Physicians Group+2

On ChiropracticScientist.com, the focus is:

• Blending best available evidence with practical clinical experience

• Respecting red flags and medical scope

• Using chiropractic as one component of a multi-layered TBI recovery strategy, not a stand-alone miracle

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8. How a Nurse Practitioner and Integrative Chiropractor Work Together

When an NP and a chiropractor collaborate, the patient benefits from the combined expertise of both neuroscience and biomechanics.

A typical pathway might look like this:

1. Initial Medical Assessment (NP)

   • Confirms TBI diagnosis

   • Rules out emergencies

   • Orders imaging or neuro consults if needed

2. Baseline Function Mapping (NP + Chiropractor)

   • Cognitive and cranial nerve screen

   • Posture, gait, and balance assessment

   • Cervical and thoracic joint mobility evaluation

   • Sensory changes and neuropathic pain mapping

3. Integrated Care Plan

   • NP coordinates medication (if needed), sleep hygiene, mental health support, and referrals

   • A chiropractor provides spinal adjustments, soft-tissue care, postural and balance retraining, and exercise guidance

4. Neuroplasticity-Focused Rehab

   • Repetition of safe, targeted movements

   • Gradual loading of musculoskeletal and vestibular systems

   • Cognitive and sensory challenges at tolerable levels (Flint Rehab, n.d.; Physio-pedia, n.d.). ninds.nih.gov+1

5. Reassessment and Documentation

   • Regular updates on symptom scales, functional status, and objective measures

   • Adjustment of the care plan based on progress or plateaus

   • Clear documentation for work, legal, or personal injury cases

Dr. Jimenez’s dual practice in El Paso is a real-world example of this model: he integrates advanced imaging, lab work, and NP-level medical reasoning with chiropractic adjustments, decompression, and functional rehab to address both the structural and neurochemical sides of TBI-related neck and nerve problems (Jimenez, n.d.; Chiropractic Scientists, n.d.). El Paso, TX Doctor Of Chiropractic+1

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9. Practical Steps if You Suspect Hidden Nerve Damage After a Mild Head Injury

If you or a patient may have hidden nerve damage after a “mild” head injury:

1. Take Symptoms Seriously

   • Do not brush off ongoing headaches, dizziness, brain fog, mood changes, or sensory changes as “just stress.”

2. Get a Medical Evaluation

   • See a nurse practitioner, primary care provider, or neurologist familiar with concussion and TBI.

   • Ask about diffuse axonal injury, cranial nerve involvement, and post-concussive syndrome (NINDS, 2025; Mayo Clinic, n.d.). ninds.nih.gov+1

3. Ask Whether Chiropractic Care Is Appropriate

   • After serious red flags are cleared and the neck is deemed stable, an integrative chiropractor can assess spinal alignment, posture, and neuromusculoskeletal patterns.

   • Look for chiropractors who are comfortable working in a team and who understand TBI complexity (Within Chiropractic, 2025; Northwest Florida Physicians Group, 2025). Within Chiropractic+1

4. Support Neuroplasticity at Home

   • Prioritize consistent sleep

   • Eat an anti-inflammatory, nutrient-dense diet

   • Stay hydrated

   • Engage in graded physical activity as cleared by your providers

   • Use simple cognitive tasks (reading, puzzles, learning new skills) without overloading yourself (Flint Rehab, n.d.; Cognitive FX, n.d.). ninds.nih.gov+1

5. Watch for Red-Flag Changes
   Seek emergency care if you notice:

   • Worsening severe headache

   • Seizures

   • Repeated vomiting

   • New confusion, slurred speech, or weakness

   • Sudden vision loss or double vision (Mayo Clinic, n.d.; Weill Cornell Medicine, n.d.). The University of Alabama at Birmingham+1

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10. Conclusion: Mild Hit, Major Signals

From a distance, a mild head injury may look harmless. But at the nerve and systems level, it can be a complex event:

• Diffuse axonal injury disrupts communication across brain networks.

• Cranial nerve changes alter vision, smell, balance, and facial control.

• Spinal, muscular, and peripheral nerve changes reshape posture and pain.

The nervous system’s saving grace is neuroplasticity—its ability to rewire itself. That process is strongest when guided by an integrated team that understands both:

• The medical science of TBI and its hidden complications, and

• The biomechanics of the spine, posture, and neuromusculoskeletal system.

A collaborative approach that pairs a nurse practitioner with an integrative chiropractor—as seen in the dual-scope work of Dr. Alexander Jimenez—offers a practical, science-informed pathway for patients experiencing hidden nerve damage after a mild head injury.

Your brain and spine are not separate stories. When they’re injured together, they must be rehabbed together—with careful diagnostics, thoughtful spinal care, and a long-term plan that respects how complex and adaptable your nervous system really is.

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References

A4M. (n.d.). Dr. Alex Jimenez, DC, APRN, FNP-BC – Injury Medical & Chiropractic Clinic. https://www.a4m.com/alex-jimenez-injury-medical-amp-chiropractic-clinic-el-paso-tx.html A4M

All County Radiology. (n.d.). Traumatic brain imaging. https://www.allcountyllc.com/service/traumatic-brain-imaging NINDS CDE

Apex Chiropractic. (2022, December 19). How chiropractic care can treat a traumatic brain injury. https://apexchiroco.com/updates/how-chiropractic-care-can-treat-a-traumatic-brain-injury/ Apex Chiropractic

BrainLine. (n.d.). What happens immediately after the injury? https://www.brainline.org/article/what-happens-immediately-after-injury MSKTC

Chiropractic Scientists. (n.d.). Exploring integrative medicine | El Paso, TX. https://chiropracticscientist.com/exploring-integrative-medicine-el-paso-tx-2023/ Chiropractic Scientists | 915-850-0900

Cleveland Clinic. (2022, October 14). Peripheral neuropathy: What it is, symptoms & treatment. https://my.clevelandclinic.org/health/diseases/14737-peripheral-neuropathy Cleveland Clinic

Cognitive FX. (n.d.). Neuroplasticity treatment for concussions. https://www.cognitivefxusa.com/blog/neuroplasticity-treatment-for-concussions Cleveland Clinic

Dr Kal. (2024, August 22). Chiropractic relief for accident head injuries. https://drkal.com/chiropractic-relief-for-accident-head-injuries/ Advanced Health Solutions

Fernández Coello, A., Gabarrós Canals, A., Martino Gonzalez, J., & Acebes Martín, J. J. (2010). Cranial nerve injury after minor head trauma. Journal of Neurosurgery, 113(3), 547–555. https://pubmed.ncbi.nlm.nih.gov/20635856/ PubMed

Flint Rehab. (n.d.). How does the brain repair itself after a traumatic injury? https://www.flintrehab.com/how-does-the-brain-repair-itself-after-a-traumatic-injury/ ninds.nih.gov

Jimenez, A. (n.d.). El Paso, TX chiropractor & nurse practitioner – Injury Medical & Chiropractic Clinic. https://dralexjimenez.com/ El Paso, TX Doctor Of Chiropractic

Mayo Clinic. (n.d.). Traumatic brain injury: Symptoms and causes. https://www.mayoclinic.org/diseases-conditions/traumatic-brain-injury/symptoms-causes/syc-20378557 The University of Alabama at Birmingham

Model Systems Knowledge Translation Center. (n.d.-a). Understanding TBI: Part 1 – What happens to the brain during injury and early stages of recovery? https://msktc.org/tbi/factsheets/understanding-tbi-part-1-what-happens-brain-during-injury-and-early-stages-recovery MSKTC

Model Systems Knowledge Translation Center. (n.d.-b). Understanding TBI: Part 2 – Brain injury impact on individuals’ functioning. https://msktc.org/tbi/factsheets/understanding-tbi-part-2-brain-injury-impact-individuals-functioning MSKTC

Model Systems Knowledge Translation Center. (n.d.-c). Traumatic brain injury and chronic pain: Part 1. https://msktc.org/tbi/factsheets/traumatic-brain-injury-and-chronic-pain-part-1 MSKTC

National Institute of Neurological Disorders and Stroke. (2025). Traumatic brain injury (TBI). https://www.ninds.nih.gov/health-information/disorders/traumatic-brain-injury-tbi ninds.nih.gov

Northwest Florida Physicians Group. (2025). Using chiropractic care to treat traumatic brain injuries. https://northwestfloridaphysiciansgroup.com/using-chiropractic-care-to-treat-traumatic-brain-injuries/ Northwest Florida Physicians Group

Physio-pedia. (n.d.). Therapeutic interventions for traumatic brain injury. https://www.physio-pedia.com/Therapeutic_Interventions_for_Traumatic_Brain_Injury Chiropractic Scientists | 915-850-0900

Team Justice. (n.d.). Delayed symptoms after car accident. https://teamjustice.com/delayed-symptoms-after-car-accident/ El Paso Back Clinic

Verywell Health. (n.d.). Cranial nerve damage from head trauma. https://www.verywellhealth.com/cranial-nerve-damage-from-head-trauma-1720018 PM&R KnowledgeNow

Weill Cornell Medicine. (n.d.). Mild traumatic brain injury: From diagnosis to treatment and recovery. https://weillcornell.org/news/mild-traumatic-brain-injury-from-diagnosis-to-treatment-and-recovery MSKTC

Within Chiropractic. (2025, November 5). Chiropractic care for traumatic brain injury after a car accident in Colleyville, TX. https://www.withinchiro.com/post/chiropractic-care-traumatic-brain-injury-car-accident-colleyville-tx Within Chiropractic