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Neck and Back Pain

Neck and back pain has many causes. However, a handful of causes are commonly seen as the result of injury, such as in a car accident or serious fall. These include:

Back sprain/strain/spasms: A sprain is an injury where the ligaments are stretched beyond their normal capacity, and sometimes torn. A strain is an injury to a muscle in the same manner. Both conditions are painful, and often cause the involved and surrounding muscles to spasm so as to keep the spine still and prevent further injury. Muscle spasms can be so intense that they reverse the normal curvature of the spine (lordosis), as seen on x-rays and other imaging studies. This type of injury is often referred to as whiplash when it involves the neck, and is quite common in car crashes, particularly in rear-end collisions.

Unfortunately, insurance companies minimize back sprain/strains, referring to them as “soft tissue” injuries, and offering very little to settle. Indeed, they will hand-pick doctors to examined the injured person and testify that all soft tissue injuries heal within a matter of weeks. The truth of the matter is that healing time depends on many factors, including age, conditioning, underlying disease, body size, body type, sex, prior injuries, etc. Only an experienced personal injury attorney knows how to deal with these frivolous arguments.

Spinal fracture: Spinal fractures generally occur in one of four areas of the vertebra – the vertebral body (the part that holds the disks), the articular process, the transverse process, or the spinous process. Spinal fractures can be quite painful, but usually resolve with time. People with osteoporosis or osteopenia (reduced bone density) can experience multiple fractures in a single vertebra (“crushed vertebrae”), which can be more serious and cause complications. Spinal fractures generally occur in falling injuries or severe car crashes.

Insurance adjusters minimize spinal fractures, particularly those not involving the vertebral body. Moreover, of the fractures involving the vertebral body, most are compression fractures – essentially a crushing of the bone (think of a corn flake that has been stepped on). Underlying disease, such as osteoporosis, can make these fractures more likely, and more serious. However, the law protects folks with such underlying conditions, also known as prior infirm conditions. Experienced personal injury attorneys know how to apply the law to fully compensate their clients.

Herniated disk: Herniations occur when the tough, fibrous outer ring of an intervertebral disk tears, allowing the soft interior to bulge out. The interior of a disk is highly inflammatory to surrounding nerves and tissue, which can cause severe pain. Also, the herniation can be so severe that it physically pushes on the nerves exiting the spinal canal, causing the entire nerve to become aggravated, or presses on the spinal cord itself (spinal stenosis). This results in pain, numbness, and tingling in the nerve, including down the arms or legs, which is referred to as radiculopathy. This is commonly referred to as sciatica when involving the legs. Radiculopathy is often seen where persons over the age of 40 are injured, as the disks are more fragile with age. However, in high-impact injuries, such as car or truck crashes, younger persons can suffer a disk herniation. They sometimes resolve on their own, but often require surgery.

The value of a herniated disk depends on numerous factors, including the type of surgery performed, the number of disks involved, the prior condition of the disks, the ultimate outcome of treatment or surgery, and any permanent restrictions. Insurance companies often hire doctors to say that the injured person would have had the surgery at some point in their life anyway. Only an attorney specializing in the field of personal injury has the background to properly evaluate this type of injury and defend against such arguments.

Annular tear: This condition involves a tear in the outer layer of an intervertebral disk (like a herniated disk) but none of the soft interior bulges out (unlike a herniated disk). An annular tear can cause pain in two ways. First, similar to the herniated disk, the interior substance can irritate surrounding nerves and tissues. Second, because the outer layer has nerves just like your skin, the tear can cause pain on account of the torn nerves. Annular tears are less serious than a herniated disk, but can be extremely painful. Also, because the outer layer of the disk has been torn, it leaves the injured person susceptible to a future disk herniation.

Because annular tears (also called annular fissures) can occur naturally, it is often difficult to determine whether they are the result of injury. However, the keen eye of a good doctor can often determine if they were caused by an event, such as a car accident, based on water content on imaging studies, age of the person, and presentation of symptoms. These are often difficult injuries to prove because they can occur naturally, and because they can be difficult to pick up on imaging studies. A personal injury attorney will improve the probability of connecting this type of injury to the traumatic event.

Facet joint injury: The facet joints are sliding joints in the cervical spine, where the spinous processes of each vertebra attach to each other, and also where the ribs attach to the thoracic vertebra. Just as the vertebra connected to each other with a common disk, they are also connected by facet joints called the articular processes. Their purpose is to guide and limit movement of the spine. With trauma, the joints can become inflamed, restricting movement and causing pain. Anti-inflammatory medication can stop the swelling and pain. However, in severe cases, such as high-speed rear-end collisions, the facet joints become permanently injured, and more invasive procedures may become necessary.

Like annular tears, facet joint injuries can be difficult to prove, as they often look like arthritis on imaging studies. This gives the insurance company an excuse that many jurors might buy. Again, an experienced personal injury attorney can improve your chance of success.

Degenerative Disk Disease: Degeneration of the intervetrebral disk can cause severe pain and interference with one’s daily activities. Disk degeneration is a normal part of aging, and for most people does not cause a problem. As a result of disk degeneration, the disk becomes dehydrated, reducing its ability to act as a shock absorber, causes a reduction in the space between the vertebrae, and may also bulge outward. This causes people to become more susceptible to injury, thereby requiring less force to do the same damage to the spine than a younger person. This is known as a prior infirm condition. Unfortunately, disk degeneration also predisposes a person to disk herniation. Trauma, such as a simple car collision or fall, is the most common cause of the activation of symptoms caused by degenerative disk disease.

Insurance companies love degenerative disk disease, because it gives them an excuse to explain the pain. They argue that they shouldn’t have to pay to fix a condition that was already there. It is the pain, however, that is the key. If the traumatic event causes the pain to present or increase, even to the point that a surgery is necessary, the law says that you can recover for the surgery. Only experienced personal injury attorneys know how to defuse the insurance company’s bunk arguments.

Osteoarthritis: This condition is also known as degenerative joint disease, and is a natural consequence of aging or trauma. Osteoarthritis is a general term for the breakdown of the joints, including those in the spine (spondylosis). This breakdown makes the joints weaker and more susceptible to injury (prior infirm condition), and can result in chronic inflammation and pain once a triggering event, such as a fall or car crash, causes the symptoms to occur. This condition is often quite painful, but generally does not result in surgery.

Like degenerative disk disease, osteoarthritis can cause complications in a personal injury case. Again, the presentation of, or increase of, pain is the key. If the traumatic event causes the pain to present or get worse, the law says that you can recover for the increase. Only an experienced personal injury attorney knows how to defuse the insurance company’s arguments that are designed to confuse a jury.