Injured Back in a Maryland Car Accident

What causes low back pain in a car accident?

• A traumatic injury, such as from playing sports, car accidents, or a fall at work can injure tendons, ligaments or muscle resulting in low back pain. Traumatic injury may also cause the spine to become overly compressed, which in turn can cause an intervertebral disc to rupture or herniate, exerting pressure on any of the nerves rooted to the spinal cord.
• Sprains and strainsaccount for most acute back pain. Overstretching or tearing ligaments are sprains, and tears in tendon or muscle are strains. Both can occur from twisting or lifting something improperly, lifting something too heavy, or overstretching. Such movements may also trigger spasms in back muscles.
• Herniated or bulging discscan occur when the intervertebral discs become compressed and bulge outward (herniation) or rupture, causing low back pain.
• Radiculopathyis caused by compression, inflammation and/or injury to a spinal nerve root. Pressure on the nerve root results in pain, numbness, or a tingling sensation that travels or radiates to other areas of the body that are served by that nerve. Radiculopathy may occur when spinal stenosis or a herniated or ruptured disc compresses the nerve root.
• Sciatica is a form of radiculopathy caused by compression of the sciatic nerve, the large nerve that travels through the buttocks and extends down the back of the leg. This compression causes shock-like or burning low back pain combined with pain through the buttocks and down one leg, occasionally reaching the foot.

What is the treatment for back injuries caused by a car accident?

Treatment for back injuries depends on the diagnosis, level of pain, and whether there is loss of function or quality of life.

Conservative Treatment

• Cold Therapy reduces inflammation, edema, pain, and muscle spasms associated with acute back injury.
• Heat therapy is used to reduce pain and alleviate sore and stiff muscles.
• Activity: Bed rest should be limited. Individuals should begin stretching exercises and resume normal daily activities as soon as possible, while avoiding movements that aggravate pain.
• Strengthening exercises, Maintaining and building muscle strength is particularly important for persons with skeletal irregularities. Evidence supports short- and long-term benefits of yoga to ease chronic low back pain.
• Medication: Non-steroidal anti-inflammatory drugs) or acetaminophen can be taken to reduce mild to moderate pain associated with back injuries. If pain remains intolerable while taking over the counter, a stronger pain medication such as a narcotic or a muscle relaxant can be prescribed. The following are the main types of medications used for low back pain:
• Analgesic medications They include acetaminophen and aspirin, as well as prescription opioids such as codeine, oxycodone, hydrocodone, and morphine. Opioids should be used only for a short period of time and under a physician’s supervision.
• Nonsteroidal anti-inflammatory drugs(NSAIDS) relieve pain and inflammation and include OTC formulations (ibuprofen, and naproxen sodium).
• Anticonvulsants—drugs primarily used to treat seizures—may be useful in treating people with radiculopathy and radicular pain.
• Antidepressants such as tricyclics and serotonin and norepinephrine reuptake inhibitors have been commonly prescribed for chronic low back pain.
• Creams or sprays applied topically stimulate the nerves in the skin to provide feelings of warmth or cold in order to dull the sensation of pain.
• Therapy and alternative medicine: an active approach to recovery is recommended over bed rest for most cases of back injury.  Physical therapy can help reduce pain and regain strength and function.^[
• Spinal manipulation are approaches in which chiropractors use their hands to mobilize, adjust, massage, or stimulate the spine and the surrounding tissues. Evidence supporting their use for acute or subacute low back pain is generally of low quality. Neither technique is appropriate when a person has an underlying medical cause for the back pain such as osteoporosis, spinal cord compression, or arthritis.
• Biofeedback is used to treat many acute pain problems, most notably back pain and headache. The therapy involves the attachment of electrodes to the skin and the use of an electromyography machine that allows people to become aware of and self- regulate their breathing, muscle tension, heart rate, and skin temperature.
• Acupuncture is moderately effective for chronic low back pain. It involves the insertion of thin needles into precise points throughout the body.
• Traction involves the use of weights and pulleys to apply constant or intermittent force to gradually “pull” the skeletal structure into better alignment. Some people experience pain relief while in traction, but that relief is usually temporary.
• Injections: Spinal nerve blocks and epidural injections are options available to alleviate pain and neurological symptoms. Injections of anesthetics alleviate pain while steroid injections can be used to reduce the inflammation and swelling surrounding spinal nerves. Epidural steroid injections are a commonly used short-term option for treating low back pain and sciatica associated with inflammation. Nerve block therapies aim to relieve chronic pain by blocking nerve conduction from specific areas of the body.

Common arguments made by an insurance company when a claim is made for a back injury or back sprain or strain as a result of the accident.

All of the below arguments are tactics used by the insurance company to diminish the value of your claim. None of these arguments are usually accompanied by any medical testimony to back up their relevance. Your Maryland car accident lawyer will help you defend yourself from these frivolous defenses.

Back Pain Myths

1. Myth One: you did not have damage to your car, so how can you have back pain? This is likely the number one myth plaguing patients today. Bumpers on most of our cars these days were designed to tolerate some impacts without damage. Although your car does not look damaged, the force of the other car hitting yours is now deposited into your body. When an accident occurs, there is an energy transfer from one car to the next. That energy needs to be dissipated. Normally the act of a car crumbling uses up the energy. However, when the car does not crumble, the energy is still there and it now transfers into your body which unlike the bumper is not built to sustain such an energy transfer. Damage to your car or the lack thereof is not a predictor of whether you were injured.
2. Myth Two: No-one was injured in the other vehicle. Every person is different. Each person in each vehicle is likely to have a different experience depending upon the type of car, the impact to each etc.
3. Myth Three: Whiplash should clear up in a couple of days. Each person will heal at their own pace
4. Myth Four: The condition would have cleared up without treatment. Medical treatment will often speed up the recovery process and prevent the condition from becoming chronic.
5. Myth Five: You were the only person injured in your car. Each person is in a different position in the vehicle. I have handled car accidents where the front seat passenger was killed and the other passengers were uninjured.
6. Myth Six: You told the police you were not injured. Injuries can take several days before you notice any pain. Soft tissue injuries usually will appear within the first couple of days.
7. Myth Seven: You did not complain of any injuries at the scene. You may have felt some minor pain but did not want to make a big deal at the scene and figured it would go away in a couple of days.
8. Myth Eight: You had no symptoms until several days after the accident. Injuries can take several days before you notice any pain. Soft tissue injuries usually will appear within the first couple of days.
9. Myth Nine: You already had similar complaints before the accident. But now they are much worse. If the accident has aggravated an underlying condition, you are entitled to treat for and receive compensation for the aggravation of those injuries.
10. Myth Ten: You were offered an ambulance at the scene and refused. You may have felt some minor pain but did not want to make a big deal at the scene and figured it would go away in a couple of days. In addition, you did not want to leave your car at the scene. You felt well enough to drive yourself to the hospital.
11. Myth Eleven: You went to work directly from the scene. Injuries can take several days before you notice any pain. Soft tissue injuries usually will appear within the first couple of days. You have never missed time from work even when you were sick. You did not want to get fired.
12. Myth Twelve: You did not go to the hospital. You may have felt some minor pain but did not want to make a big deal at the scene and figured it would go away in a couple of days. Injuries can take several days before you notice any pain. Soft tissue injuries usually will appear within the first couple of days.
13. Myth Thirteen: The doctor charges too much. Medical expenses are high. Physical therapy, prescriptions and doctor visits are expensive whether related to an accident of otherwise.
14. Myth Fourteen: Treatment was too long. Insurance companies do not want to pay any money so they complain if the treatment is to long that you were exaggerating your injuries and if the treatment is short it is because you were not hurt.
15. Myth Fifteen: Treatment was too short. Treatment was too long. Insurance companies do not want to pay any money so they complain if the treatment is to long that you were exaggerating your injuries and if the treatment is short it is because you were not hurt.
16. Myth Sixteen: You left on a scheduled vacation. Unless vacation are strenuous why should this matter.
17. Myth Seventeen You did not keep your appointments with the doctor. If you missed your appointments you must have not been hurt. However maybe you had to work and could not afford to lose the time.
18. Myth Eighteen: Did not follow through on treatment plan. If you missed your appointments you must have not been hurt. However maybe you had to work and could not afford to lose the time.

What can a Baltimore car accident lawyer do to help me with my back injury?

1. Find a qualified doctor

Initially, if you have been injured and have not received medical treatment, an attorney can help you find the appropriate medical care. Often, specialists like orthopedic surgeons or neurologists have long waiting lists that cause patients to wait months before receiving care. Attorneys can help greatly with this lag time, as they are frequently able to get specialist appointments for their clients in a relatively short period of time, allowing for adequate medical treatment in a much timelier manner.

Individuals who are injured in automobile accidents often find, however, that doctors do not like to get involved in litigation because they do not like going to court.  In order to prove to an insurance company and/or a jury that you were in fact injured, a doctor must provide detailed reports connecting the injuries to the accident.  A lot of physicians refuse to dictate reports deemed acceptable by the insurance companies, thus it is important to select a doctor who is at least willing to dictate a report after each visit.  Each document provided by the medical facility is extremely important in your automobile accident case, as insurance companies base the amount of money that they are willing to offer you upon the documentation available.  Visiting a family physician who is unwilling to write a dictated medical report or who scribbles an illegible note on his office chart may result in a smaller settlement than would come from consulting a doctor who is willing to write a fully dictated report clearly outlining the injuries and necessary treatment. Therefore, how well the doctor documents your injuries can be extremely important, as inadequate documentation can lead to less money for the same injury.

2. Submit a convincing and complete demand package

After all of your medical treatment has been completed, an attorney can then submit a demand package to the insurance company. A demand package includes a favorable description of the client and summaries of the accident itself, the liability issues involved, the injuries involved, medical treatment incurred and total medical expenses or other losses. Finally, an evaluation of the claim is submitted to the insurance company along with a demand.  I have handled thousands of similar claims and I am extremely familiar with the values of these particular cases.  Most clients have no idea of what their case is worth, since they have never been involved in the process before, or if they have been in the process before have only limited experiences.

3. Determine what a case is worth.

            In evaluating the value of a claim, the attorney looks at many factors and considers many elements and questions surrounding the accident. Included in those factors is the type of injuries, such as whether fractures or any other physical signs of visible signs of injury exist versus complaints with no visible signs of injury. Questions and considerations include:

• Is there a permanent injury?
• Who is the client and what kind of witness will the client make?
• Where did the accident happen is important since some counties are known to give more generous verdicts than other counties?
• Whether there was significant damage to the vehicles involved since judges and juries are more likely to believe injuries in serious looking accidents than they are in minor property damage cases.
• What judge do you have?
• How long did the treatment last, which doctors performed the treatment, and were there any objective findings in the x-rays or MRI’s that would point to proof of injuries?
• Is there is any scarring and/or bruising
• What is the age and sex of the client?
• Whether the client has had any other accidents, as the courts look very closely at cases where a client has filed more than one claim and tend to give less credence to people who have filed many claims
• Is the fault clear or disputed?

Lawyers who have been practicing for a long period of time and have tried many cases know how to give weight to each one of these factors.  You can see that each case is different and there is no way for a lawyer to tell you the first day of an accident what the case is worth. The lawyer’s opinion of the value of the case can change as more information is gathered over a period of time and any lawyer who promises you that he knows the value of your case based upon your initial interview, will most likely not be able to deliver on any promise he makes.

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