A rear-end collision can change a person’s life for years. Neck pain, back pain, and headaches often grow worse in the days and weeks after a crash, and some injuries only reveal their full extent after advanced testing and months of treatment.
Our client was driving on an interstate bridge when the at-fault driver crashed into the rear of his vehicle. The impact was severe enough that his car was declared a total loss. Rear-end crashes at highway speeds put sudden, violent force on the body. The head and neck snap forward and back, and the lower back absorbs much of the impact through the seat. Even with a seatbelt on, the spine can take a beating.
After the crash, he experienced pain in his neck (the cervical spine), pain in his lower back (the lumbar spine), and headaches. Our client suffered due to this crash and his injuries, and the Townsley Law Firm recovered a settlement of over $375,000 to help him recover. His story shows how serious a rear-end crash can be, and why careful medical documentation matters when it is time to hold the at-fault driver accountable.
An orthopedic exam revealed nerve involvement in the neck
He first sought chiropractic care for his lower back pain and headaches, and his chiropractor ordered an MRI of his lumbar spine. He was then evaluated by an orthopedic physician, whose impression was a cervical strain with radiculopathy and numbness in his left arm. The physician ordered an MRI of his cervical spine and reviewed the lumbar MRI, which led to treatment for lower back pain with radiculopathy as well.
Radiculopathy means a nerve root in the spine is irritated or compressed. That irritation can send pain, tingling, numbness, or weakness down the arm or leg, well beyond the site of the original injury.
His doctors started with conservative care. He was prescribed physical therapy, chiropractic care, and medication for pain and muscle spasms. As his treatment continued, his lower back pain began radiating into both hips. Further evaluation led to a diagnosis of bilateral sacroiliac joint pain, meaning pain in both of the joints that connect the lower spine to the pelvis.
The sacroiliac (SI) joints sit where the base of the spine meets the pelvis. They carry the weight of the upper body and absorb shock when a person walks, stands, or climbs stairs. When a crash injures these joints, people often feel pain in the lower back, buttocks, hips, or legs. Sitting for long periods, getting out of a car, or rolling over in bed can all become painful. For our client, sitting and lying down made his sharp hip pain worse.
Pain management moved from therapy to medical procedures
To manage his pain, he underwent bilateral SI joint injections through his orthopedic practice. Joint injections deliver medication directly into the injured joint to calm inflammation and help pinpoint the source of the pain. The injections gave him only about three days of relief before the pain returned.
Because the injections did not provide lasting relief, he was referred to a pain management physician for a bilateral SI joint radiofrequency ablation (RFA). Radiofrequency ablation goes a step further. A doctor uses heat generated by radio waves to disrupt the small nerves that carry pain signals from the joint to the brain. Two weeks after the procedure, he still rated his overall pain at 7 out of 10.
These are not minor treatments. Doctors generally turn to them when therapy and medication alone do not control a patient’s pain.
A neurologist diagnosed post-traumatic headaches and nerve root irritation
His orthopedic physician also referred him to a neurologist for his headaches and the numbness and tingling in his left arm. The neurologist diagnosed him with post-traumatic headaches and with nerve root irritation in both the neck and the lower back. He was prescribed Amitriptyline, a medication often used to treat nerve pain and prevent chronic headaches, and his dose was later increased. He was also given Fioricet to take as needed for headaches.
As part of his evaluation, he underwent an EMG and nerve conduction study, which measures how well nerves and muscles respond to electrical signals, and an EEG, which records the brain’s electrical activity. These tests helped his neurologist rule out other causes and guide his treatment, and his headaches gradually improved under the neurologist’s care.
Post-traumatic headaches can begin after a jolt to the head and can last for months or longer. They interfere with concentration, sleep, and the ability to work. Nerve root irritation in two separate regions of the spine also meant his symptoms reached well beyond a single area of his body.
Continued joint pain led to a recommendation for fusion surgery
Even after injections and ablation, his sacroiliac joint pain continued. Looking ahead, his orthopedic physician recommended a right SI joint fusion, which permanently joins bones together to stop painful motion at a damaged joint. The surgery brings hospital costs, anesthesia, recovery time, and rehabilitation, and it can limit a person’s range of motion for life.
Future medical care is one of the most important parts of an injury claim, and one of the most overlooked. A settlement can only account for what the records support. When a doctor recommends a future surgery, that recommendation must be documented and presented clearly to the insurance company. Without that proof, an injured person may end up paying for the surgery out of pocket years later.
