Back Injuries from Car Accidents…What Are They Worth?
In our practice we have handled thousands of car accident cases over the last 22 years. The most common injuries we see from these cases are back injuries. Back injuries can range from minor strains and sprains to life altering fractures resulting in paralysis. The purpose of this blog is to discuss the different types of back injuries we encounter, how they are most commonly treated medically and how the type and severity of these injuries affect the settlement value of a client’s case.
The “Back” Story
When we talk about our backs we are really talking about the area from the base of our skull all the way down to our pelvis. In that area we have bone, discs, muscles, tendons and ligaments. The primary boney structure in this area is our spine. Our spine is a series of vertebrae extending from the skull to the small of the back, enclosing the spinal cord and providing support for the thorax and abdomen. Between each vertebra is a shock-absorbing disc that prevents the bones from rubbing together. The spine is our body's central support structure. It keeps us upright and connects the different parts of our skeleton to each other: our head, chest, pelvis, shoulders, arms and legs. Injuring your spine is a big deal. We also have muscles, tendons and ligaments that play an integral role in the function of our backs. The two main muscle groups that affect the spine are extensors and flexors. The extensor muscles allow us to stand up and lift objects. The flexor muscles are in the front and include our abdominal muscles. Ligaments are strong fibrous bands that hold the vertebrae together, stabilize the spine, and protect the discs. Tendons vary in size and are somewhat elastic and attach bones to muscles. In a car accident these bones, ligaments, tendons, muscles and discs in our back are all vulnerable to injury.
Types of Back Injuries
Back Strains & Back Sprains
The difference between a sprain and a strain is that a sprain injures the bands of tissue that connect two bones together (ligaments), while a strain involves an injury to a muscle or to the band of tissue that attaches a muscle to a bone (tendons). When either tissue is stretched beyond its normal limits injury occurs. Pain and range of motion issues are common with these types of injuries and can linger long after the accident itself. We can suffer a strain or sprain at any level in our back but the most common area we see injured involve neck and lower back sprains and strains. We are all familiar with the term “whiplash”, which is a type of sprain/strain we see frequently in car accident cases.
Trauma from a car accident can cause the inner portion of our discs to protrude through the outer ring. This is known as a slipped or herniated disc. This can cause pain and discomfort. If the disc compresses one of our spinal nerves, we may experience numbness and pain along the affected nerve, which is called radiating pain. We have had many clients who experienced numbness and tingling in their arms, fingers and legs because of a disc injury. Radiating pain can be very debilitating and is a serious concern.
There are several types of fractures we have seen in our practice over the years. Below is a brief description of each.
A burst fracture is most commonly seen in the middle to lower part of the spine and it is a very serious injury. It appears on an x-ray as if the vertebra has literally exploded. The bone is compressed and splintered. It is a horrible injury that often causes severe pain and bleeding, leaving the client unable to walk immediately after the accident. Immediate neurosurgery is most often required.
With a crush fracture the vertebra just collapses, as if crushed from pressure. Despite its menacing name, crush fractures are usually stable fractures unlikely to undergo more changes that could lead to a greater injury.
A wedge fracture is a very common type of compression fracture. It reduces the height of the front of the vertebra and ends up looking like a wedge, thus the name. Treatment for these types of fractures depend on the loss of height of the vertebra. A 10-30% loss in height– the treatment is bed rest along with hyperextension for about a week followed by bracing and then physical therapy; a loss in height between 30-50%, traction is typically recommended, followed by bracing and then physical therapy; a loss of height over 50%, and surgery is often required.
Treatment of Back Injuries
The type of injury a client sustains to their back often determines the type of treatment they receive. For this reason, it is very important for car accident victims to be aggressive addressing their symptoms so that a proper and early diagnosis can be made, and appropriate treatment begun.
Most “soft tissue” injuries, (strains and sprains) are treated conservatively with rest, physical therapy (or chiropractic care) and pain medications if needed. These types of injuries tend to be quite painful at the outset, but often heal completely after 6-8 weeks, depending on the client’s age and pre-accident health. We have had clients with soft tissue injuries however who had longer periods of rehabilitation.
Frequently a client who is initially diagnosed with a soft tissue injury continues to have pain despite conservative treatment. Their pain level may increase over time, or may have migrated into their arms or legs, depending on the level of their spine injured in the car accident. It is at this point that we see doctors order MRI’s or CT scans to get a better understanding of the problem. One thing to remember is that these diagnostic imaging tests are expensive, and our medical system does not encourage doctors to move quickly toward expensive tests before less expensive conservative treatment has failed. Therefore, many of our clients endure weeks or months of physical therapy and pain before they get an accurate diagnosis. It is often months after the accident that we learn a client has a herniated disc injury. Therefore, we tell clients to be vocal and assertive with their doctors about their symptoms and their progress (or lack of) with conservative treatment. If you suspect there is more going on than a mere sprain or strain, possibly a disc problem, you want to get imaging done as soon as you can and telling your doctor that’s what you want is perfectly appropriate.
Treatment for back injuries involving disc herniations and bulges also range from very conservative (rest, medication, and physical therapy) to major surgical intervention. It all depends on the severity of the symptoms that the disc derangement causes. If the disc is impinging on a nerve to the point that pain or mobility restrictions are severe, surgery is often required. A less invasive treatment for moderate disc injuries is epidural steroid injections (ESI). An ESI is a minimally invasive procedure that can help relieve neck, arm, back, and leg pain caused by inflamed spinal nerves due to a disc herniation. Medicines are delivered to the epidural space, which is a fat-filled area between the bone and the protective sac of the spinal nerves. Pain relief may last for several days or even years. The goal is to reduce pain.
How the Type of Back Injury Affects the Value of a Car Accident Case
The type of back injury you sustained, the treatment you received and the recovery you made will all have a major impact on the value of your case. Someone who has a minor strain or sprain and makes a full recovery after 4 to 6 weeks of physical therapy often finds the settlement value of their case to be lower than they expected. We often suggest to prospective clients who fall into this category that they consider trying to settle their claim without a lawyer’s involvement, so they can maximize their recovery. We will give them guidance and review any offer they get so they don’t accept an unreasonably low settlement offer. In our experience these types of cases have low settlement values, and if they involve minor property damage to the cars, are vigorously defended by the insurance companies.
If a client is unfortunate enough to have sustained a disc injury or a fracture involving nerve impingement their outcomes are usually less than total recovery and therefore their cases warrant considerably more in settlement. These cases are also more likely to result in surgery for treatment. These types of cases make up most of the car accident cases we accept. They require careful preparation to adequately resolve for fair value and are the type where having a lawyer truly adds value for the client. When we get involved we follow our clients’ treatment closely and ensure that all medical questions that need to be addressed are addressed on a timely basis. For example, if there are any lingering questions as to whether the car accident caused the client’s disc injury or simply aggravated a preexisting problem, we will communicate with medical experts and get their expert opinion that we can then use to argue our client’s case. Also, if we need an opinion on whether the client’s limitations or symptoms are permanent we will make sure we retain the necessary experts to support our position. Although most cases we accept do settle, not all do and cases in this category are the ones most likely to end up being litigated in court. The reason for this is because the cases have much higher value and insurance companies aren’t known for paying fair value unless and until they know they are forced to; which is what bringing a lawsuit often achieves.
Cases in this latter category can have values that range from tens of thousands of dollars to millions of dollars depending on the lasting impact on the client. A disc problem that aggravates a preexisting back injury that resolves after one ESI and some physical therapy will obviously have a much lower value than a fracture that results in permanent paralysis.
It's important to remember if you are entitled to compensation such compensation might include lost income, past and future medical expenses, past and future pain and suffering and scarring from surgeries. It is our job as injury attorneys to pay very close attention to how your injuries affect your daily life and to persuasively advocate to the insurance company and possibly a jury just how your life has been altered. Back injuries can be debilitating and life altering and need to be handled by competent injury attorneys because you only have one chance to make sure your legal rights are protected. Once your case is settled or tried in court, you will never be able to come back and argue you weren’t fully compensated.
Knowledge is Power After an Accident.
If you want to know what we think your case is worth, call us or text us at 617-889-5000. It cost you nothing to discuss your situation with us. We believe the best thing you can do if you suffered a back injury in a Boston car accident and want to be fairly compensated is to understand your legal rights before you make any decisions. Before you speak to an insurance company adjuster, sign or submit any paperwork or hire a lawyer, you owe it to yourself to get as much information as you can, so you can make a smart decision on what you need to do next. At Spada Law Group, we offer free consumer guides and videos that answer many of the questions car accident victims have. Take a look, download our free information or contact us for a free consultation. Learn what Spada Law Group is all about and how we might be the right car accident lawyers for you.