A rear-end collision can look minor at the scene and still change the course of someone’s life. For one of our clients, an ordinary drive ended when an inattentive driver struck her from behind. The other driver was cited for careless operation and later admitted under oath that she alone caused the crash.
What started as a diagnosis of neck strain grew into shoulder surgery, multiple rounds of imaging, spinal injections, and a series of procedures aimed at the nerves in her neck and shoulder. The Townsley Law Firm resolved her case with a settlement of over $675,000.
Her experience shows how the true extent of a car crash injury often surfaces weeks or months later, and why following through on medical care matters so much.
The emergency room diagnosed only a neck strain
The day after the crash, our client went to the hospital with headaches, neck pain, low back pain, and abdominal tenderness. Doctors performed a CT scan and diagnosed her with acute cervical paraspinal muscular strain. The force of the impact strained the muscles running along the sides of her neck. The hospital prescribed Cataflam, an anti-inflammatory medication, and Flexeril, a muscle relaxer, and referred her to an orthopedic surgeon.
Many people leave the emergency room with a similar diagnosis and assume the soreness will fade on its own. Our client kept the referral. That decision uncovered injuries the first visit never identified.
The orthopedic surgeon diagnosed a complete rotator cuff tear in her left shoulder and ordered MRIs of her left shoulder, lower back, and neck. The rotator cuff is a group of muscles and tendons that hold the upper arm bone in the shoulder socket and allow the arm to lift and rotate. A complete tear means the tendon has torn all the way through, which typically requires surgery to repair.
Our client first tried a non-surgical option, an injection meant to help the tendon heal. It gave her no relief. She then underwent rotator cuff repair surgery. During the same operation, the surgeon performed three additional procedures on the shoulder:
- Distal clavicle excision. The surgeon removes a small piece from the end of the collarbone to relieve painful pressure where it meets the shoulder blade.
- Subacromial decompression. The surgeon creates more room beneath the top of the shoulder blade so the tendons can move without rubbing against bone.
- Biceps tenodesis. The surgeon reattaches the biceps tendon to a new location to relieve pain caused by a damaged tendon.
After surgery, she completed months of physical therapy to rebuild strength and motion in her shoulder.
Imaging revealed lasting damage in both the shoulder and the neck
Her shoulder MRI showed high-grade tearing of the supraspinatus and infraspinatus tendons. The supraspinatus and infraspinatus are two of the four rotator cuff muscles that power shoulder movement. That MRI also showed partial tearing and tendinosis, mild atrophy of the supraspinatus and infraspinatus muscles, and thickening of the inferior glenohumeral ligament.
Tendinosis is a breakdown of tendon tissue that causes pain and stiffness. Atrophy means the muscles had begun to shrink, and the supraspinatus and infraspinatus are two of the four rotator cuff muscles that power shoulder movement. The inferior glenohumeral ligament helps stabilize the shoulder joint, and thickening of that ligament can limit motion. Testing also showed her shoulder was positive for impingement, meaning tendons were being pinched as she raised her arm.
The MRI of her neck showed degenerative changes at multiple levels of the spine along with facet joint hypertrophy that narrowed the openings where nerves exit the spine. Facet joints are the small joints that connect each vertebra to the next and guide how the neck bends and turns. Hypertrophy means those joints had enlarged, which can narrow the space around nearby nerves.
Specialized motion x-rays later showed instability and ligament injury in both her neck and lower back. Doctors concluded the crash aggravated a slipped vertebra condition in her lower back.
Insurance companies often seize on words like “degenerative” to argue that pain comes from age rather than a crash. A person can live for years with changes in the spine that never cause a problem until a collision triggers symptoms.
Pain management targeted the nerves behind her symptoms
To control her ongoing pain, our client was referred to a pain management specialist. Her doctors diagnosed her with radiculopathy in both her lower back and her neck, along with cervicalgia. Radiculopathy occurs when a nerve root near the spine becomes irritated or compressed, sending pain, numbness, or weakness into the arms or legs. Cervicalgia is the medical term for neck pain.
She first tried medications, including pain medicine, anti-inflammatories, and muscle relaxers. She then underwent three nerve-focused procedures:
- Cervical dorsal medial branch block. A doctor injects numbing medication near the small nerves that carry pain signals from the facet joints in the neck. Relief from the block helps confirm where the pain is coming from.
- Bilateral cervical radiofrequency ablation. A doctor uses heat generated by radio waves to disrupt those same pain-carrying nerves on both sides of the neck, aiming for longer-lasting relief.
- Left suprascapular nerve block. A doctor numbs the nerve that supplies much of the feeling in the shoulder to reduce persistent shoulder pain.
Because her symptoms persisted, a spine surgeon recommended a two-level fusion in her neck and a three-level laminectomy in her lower back if non-surgical care continued to fail.
The crash also affected her work and emotional health
Her injuries forced her to stop working within weeks of the crash. She also developed trauma-related symptoms, including avoidance of driving, along with worsened anxiety and depression, and began counseling and medication to manage them.
At the hospital the day after the crash, the only diagnosis was neck muscle strain. By the end of her treatment, the record showed a surgically repaired shoulder, nerve-related pain in her neck and back, multiple specialized procedures, and recommended spine surgeries. Each diagnosis, scan, and procedure documented how the collision affected her body.
