Motor vehicle accidents can cause a wide variety of traumatic injuries. The possibilities are endless, from minor muscle aches to loss of limb. However, spine injuries in the back and neck are by far the most common cause of accident-related pain and suffering. These problems, and a few other common traumatic injuries, are discussed in more detail below.
At times, it is difficult to pinpoint exactly where, anatomically, you are injured or what, diagnostically, is wrong. Some injuries reveal a delayed impact. They cause pain long after the accident. The anatomical source of the pain is not always clear. Nevertheless, determining the type of injury caused by the accident is essential to your case. The nature of your injury has a major impact on the value of your claims. For example, in general, spinal injuries are worth more than arm, leg, or shoulder problems. Brain injuries are usually more valuable than neck and back injuries. Permanent nerve damage injuries like herniated discs in the spine typically bring larger settlements or judgments than broken bones that will eventually heal (even a fractured spine!) or soft tissue muscular injuries. Surgical injuries are worth far more than non-surgical harm.
Spine problems are commonplace in automobile accidents. They occur most frequently in the lower back, also known as the lumbar spine, and the neck, called the cervical spine. Less often accident related spine pain arises in middle back (thoracic spine) or the tailbone (sacral spine).
Traumatic injury symptoms typically originate from the following anatomic structures in and around the spine:
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It is often difficult to diagnose the exact location of the pain source because symptoms arising from different spinal tissues can feel extremely similar. Therefore, it is a challenge to differentiate the potential pain sources without using interventional diagnostic procedures. The problem that uncertain pain source diagnosis presents for injured accident victims is that the confusion clouds the issue of whether the accident or a preexisting condition caused your injuries. Determining the type of spine tissue causing your pain could help you prove your case against the other driver’s insurance company.
Spine pain can be constant or intermittent. It can be acute (lasting 12 weeks or less) or chronic (remaining more than 12 weeks). Sometimes it presents as a dull ache. Other times it is sharp, piercing, or burning. Neck and back symptoms can be radicular in nature, meaning that the pain may radiate into arms, legs, hands, and feet. It is often accompanied by numbness, tingling, and weakness. Spine pain can cause trouble sleeping, concentrating, and other major problems with daily living.
Below is a brief summary of common back injuries that result from motor vehicle accidents:
Low back pain, called lumbago by doctors, is both common and disabling. Indeed, back pain is the leading cause of disability worldwide. It is estimated that low back problems cause approximately 40% of all missed work days. Lumbago is a top five reason for visits to the doctor. Most adults experience some level of back pain during their lifetimes. However, back pain caused by car accident trauma generally proves far more painful and debilitating than the usual wear and tear back symptoms.
Back pain has numerous potential causes. Determining the source of your symptoms is important to your personal injury case. If possible, you need your doctor to diagnose the specific spinal tissue causing the pain. Whether the problem arises from the muscles, bones, intervertebral discs, nerves, or joints matters greatly in determining the value of your claims. Sometimes this can be determined without diagnostic imaging, but typically the use of diagnostics such as magnetic resonance imaging (MRI) is helpful if not downright necessary.
Neck injuries, like back injuries, commonly arise out of automobile accidents. “Whiplash” is a non-medical term used to describe a common neck injury that occurs in automobile accidents. Technically, whiplash is usually a cervical strain, which means that the muscles and tendons that support the neck are injured. When you are in an automobile accident, the force that is swiftly exerted upon your neck often causes whiplash. If you experience whiplash, you may also be experiencing neck sprain as opposed to neck strain. Neck injury symptoms include neck pain, stiffness, tightness, limited range of motion, headaches, dizziness, arm pain, and shoulder pain.
Between each of the bones in your back, there is a soft inner disc, the nucleus pulposus, which is surrounded by a harder outer wall, the anulus fibrosus. These flexible, rubbery jelly donut-shaped discs essentially act as a cushions between your back bones, called vertebrae. Intervertebral discs do not show up on x-rays the way bones do. Therefore, disc injuries are rarely diagnosed without the benefit of an MRI or other advanced imaging diagnostic device. Unfortunately, cervical and lumbar spine disc injuries do not heal like soft tissue injuries like muscle strains and sprains. They are typically permanent in nature, and they gradually worsen over time.
Sometimes, the hard outer ring tears and the soft material inside of each disc leaks or is pushed out, causing severe pain by affecting the surrounding nerves. When this happens, it is known as a herniated, ruptured, prolapsed, or slipped disc. (The use of the term “slipped disc” is not medically accurate because the spinal discs are firmly attached between the vertebrae and cannot “slip”.) Often, herniated lumbar discs cause spinal stenosis, a condition where the spinal canal narrows and compresses the spinal cord or surrounding nerves.
As similar but less severe injury called a bulging disc or protrusion occurs when the outermost layers of the anulus fibrosus are still intact but they bulge when the disc is under pressure, causing severe pain. In some instances, disc injuries can cause pain by releasing inflammatory chemicals even in the absence of nerve root compromise.
Disc injuries can be caused by trauma, such as a car accident, or age-related wear and tear called degenerative disc disease. Disc injury symptoms vary depending on the location and severity of the herniation, bulge, or irritation. In some instances, disc injuries can be asymptomatic, or pain free, for years. Indeed, many people do not even know they suffer from undiagnosed disc disease. Other, less fortunate disc injury sufferers, experience severe and unrelenting pain that radiates into the arms, legs, hands, and feet. Additional symptoms could include sensory changes like numbness, tingling, muscular weakness, paresthesia, paralysis, and impaired reflexes. Irritation of the nerves surrounding the spine is also common in disc injuries. Intervertebral disc problems are often associated with “pinched nerves” in the neck and back.
Because disc injuries do not heal like muscular injuries, sometimes surgery is required to treat the problem. However, in the majority of cases, spine surgery is not required. Initial treatment usually consists of conservative methods such as non-narcotic pain medications, exercises, physical therapy, and/or chiropractic treatment. If pain persists, injections are considered, such as epidural steroid injections, facet blocks, trigger point injections, etc. Next, minimally invasive surgeries such as radiofrequency ablation, or rhizotomy, are offered as a treatment option. Traditional invasive back surgeries such as discectomy, partial removal of the injured disc, or spinal fusion, a surgery that joins two or more vertebrae, are a last resort.
Radiculopathy, commonly known as a “pinched nerve,” is a condition where one or more nerves are not working properly. It involves neuropathy, damage affecting nerves that may impair sensation, movement, and other aspects of health. It is caused by a mechanical compression or inflammation of a nerve root. With cervical and lumbar radiculopathy, the location of the injury is at or near the root of nerves in the neck or back near its exit from the spinal cord. However, spine pain and symptoms radiate to other parts of the body served by the affected nerves, such as the arms, legs, shoulders, fingers, or toes. Radiculopathy is often called nerve root impingement.
To diagnose radiculopathy, doctors perform several specialized tests, such as the straight leg test, during physical examination. They also rely on diagnostics such as MRI, EMG (Electromyography), and NCS (Nerve Conduction Study).
A spine fracture is a medical condition involving a break in the continuity of a bone. A fractured vertebrae occurs whenever compression on the spine causes a bone to essentially break and collapse. Spinal fractures can cause severe pain that is intensified by standing or walking. Obviously, a broken back or neck is an extremely serious injury that can result in death or paralysis in the case of spinal cord injuries. Fortunately, such devastating injuries are extraordinarily uncommon in the context of auto accidents.
Doctors treat vertebral compression fractures with conservative methods such as medication and orthopedic braces. They also treat broken necks and back surgically with kyphoplasty and vertebroplasty procedures. While vertebral fractures can certainly be severe and debilitating, in many cases they heal faster and more completely than intervertebral disc injuries.
Sprain and Strain
A series of muscles, tendons, and ligaments in your back hold the bones in your lumbar spinal column in place. Insurance adjusters and personal injury lawyers call this portion of your anatomy “soft tissues” to distinguish them from the surrounding vertebrae and intervertebral discs. Doctors cannot objectively verify soft tissue injuries using diagnostic testing like MRI and x-ray the way they can with herniated discs and broken bones. Instead, sprains and strains are diagnosed based solely on medical history and physical examination.
While spinal strains and sprains are technically two different kinds of injuries, many of the symptoms are similar. Back or neck strain, also known as a “pulled muscle,” occurs when the muscles or tendons that support the spine are injured. More specifically, a spine strain results from the muscles stretching too far, causing tiny tears of the tissue and weakening the muscles to the point that they are not able to hold the bones of the spinal column in place correctly. This causes the spine to become less stable, resulting in low back pain, stiffness, limited mobility, and muscle spasms.
On the other hand, a back or neck sprain occurs when a ligament is injured by a stretch or a tear. Ligaments are the body parts that connect one bone to another and prevent excessive movement of the joint. Like a strain, a sprain causes instability in the spinal column that results in back or neck pain, stiffness, limited mobility, and muscle spasms.
Unlike disc injuries, sprains and strains usually heal fairly quickly. Most soft tissue injuries are resolved within a few months. Of course, everyone heals at their own pace, and some injuries last longer. Typical treatments for spine strains and sprains include rest, pain medication, anti-inflammatory medication, muscle relaxants, massage therapy, physical therapy, and chiropractic treatment.
Traumatic brain injuries (TBI), also known as intracranial injuries, are head injuries that can vary in severity from a mild concussion to severe brain damage. When the brain is jarred or shaken in a car wreck, the impact can cause bruising, swelling, or tearing of the brain tissue. TBI symptoms include unconsciousness, headaches, dizziness, sadness, anger, confusion, trouble concentrating, memory loss, nausea, vomiting, fatigue, drowsiness, and seizures. These problems can be temporary or permanent.
Doctors use a variety of methods to diagnose head injuries. They will begin by taking your medical history, asking questions designed to test your ability to pay attention, learn, remember, and solve problems. They will also physically examine you for physical indicators of TBI by checking your strength, balance, reflexes, coordination, and sensation. Finally, they may order advanced diagnostics such as MRI or CT scan testing.
Brain injuries cases can be incredibly valuable. However, they are extraordinarily difficult to diagnose and prove. Think about it: if you are suffering from memory loss and confusion symptoms, will you be able to tell your doctor about these problems? Considering the challenges inherent to TBI diagnosis, if you or someone who cares about you have noticed any head injury symptoms since your accident, please bring a loved one who knows you well with you to the doctor. Often a spouse, parent, or significant other will be able to report changes and symptoms you cannot notice or remember.
Doctors treat TBI with a variety of options, including (but not limited) to medicine; physical, occupational, and speech therapy; counseling; support groups; and even brain surgery.
Motor vehicle accidents sometimes cause bruises, breaks, or cuts to the face. Indeed, there is potential that you will break your nose, your jaw, your cheekbone or other bones. Swelling, bruising, pain, visible deformity, and bleeding in the area impacted could all be signs of a bone fracture or a broken bone. In the case of a broken nose, symptoms include swollen nose, tenderness, bruising around the eyes, nose bleed, audible noise when the nose is touched, and difficulty breathing through the nose. Cheekbone fracture results in asymmetry of your cheekbones, altered sensations on your face or particularly below the eye on the side of your potential injury, jaw pain, blood on the side of the eye, and vision problems such as blurriness. Dislocation or fracture of the jaw causes bruising or swelling on your jaw or near your ear, a feeling your teeth are misaligned, teeth actually missing, difficulty opening your mouth, jaw pain in general. If you have an eye socket fracture, you may notice a visibly sunken eye, pain when moving the eye, numbness of the eye, double vision, altered feeling beneath the eye that was injured. Finally, if the windshield or windows break as a result of the collision, severe lacerations and permanent facial scarring from broken glass are possible.
In additional to the traditional medical attention necessary to heal your facial injuries, you should consider whether cosmetic surgery is necessary. If it is, the other driver’s insurance company could be liable to cover these damages as well.
OTHER PHYSICAL INJURIES
Aside from the above mentioned injuries, you should keep a look out for other injuries that you may have experienced in your automobile accident. The following are some other common injuries that you should look for when you are involved in an automobile accident. Shoulder injuries, leg injuries, knee injuries, foot injuries, chest injuries, and abdominal injuries. These are generally characterized by pain in the area of where you believe your injury is located. Inability to use the body part or experiencing pain when using the particular body part you may have injured can be an indicator of injury as well. When you feel pain or a part of your body simply does not feel right after an automobile accident, it is better to check out the issue than to ignore it.