Back pain is the number one medical issue we see with car accident victims. Understanding the anatomy and causes can be helpful in understanding why it occurs, and why the doctors are prescribing physicals therapy or surgery.
The spinal anatomy is a remarkable combination of strong bones, flexible ligaments and tendons, large muscles and highly sensitive nerves. It is designed to be incredibly strong, protecting the highly sensitive nerve roots, yet highly flexible, providing for mobility on many different planes. Most of us take our health for granted, until it’s gone. Back pain (speaking from having it before) can limit daily activates where it’s even hard to walk.
Your spine and connecting muscles are vulnerable to injury in a car accident. After the accident, you may experience pain in the upper, middle and lower back. Back injuries can be aggravating, debilitating, painful and long-lasting.
The lower back is the most prone to injury as it is highly flexible and already subject to stress due to being the primary load-bearer of your torso. The bones and ligaments of the spine can be damaged, as can the muscles and tendons which support your back. The nerves at the base of the spine can also be harmed, as can internal organs.
Injuries suffered by car accident victims
Many different structures in the spine can cause back pain. The most common causes we see:
- When the back or neck muscles are strained.
- The nerves are irritated in the legs and arms. If you have radiating or burning pain in your hip, the pain is caused by nerve irritation (or a pinched nerve).
- Broken bone or torn ligaments
- Ruptured discs in the back.
Your doctor will review of your spinal anatomy with you to help you understand the causes your back pain, neck pain and sciatica (leg pain), and evaluate treatment options.
Disc Injuries
The impact from a car accident can damage a disc, causing it to break or deform, thereby destroying its ability to cushion the bones of the spine. A damaged disc may also put pressure directly on nearby nerves, which can cause pain, numbness and weakness in any part of the body that the affected nerve travels to.
Spinal cord injury
Spinal cord trauma is damage to the spinal cord. It may result from direct injury to the cord. Direct damage can also occur if the spinal cord is pulled, pressed sideways, or compressed. This may occur if the head, neck, or back are twisted abnormally during an accident. Spinal cord injuries impair the brain’s ability to communicate with the rest of the body. This results in partial-paralysis, or complete paralysis, and lack of sensation/feeling in all or part of the body. A spinal cord injury may be “complete,” meaning that there is total numbness and paralysis in the affected part of the body, or it may be “incomplete.” Incomplete paralysis results in some amount of sensation and/or movement loss.
Injuries at and below the first lumbar vertebra do not cause spinal cord injury. However, they may cause “cauda equina syndrome”-injury to the nerve roots in this area. This type of spinal cord injury is a medical emergency and needs immediate surgery.
Injuries at any level can cause:
- Increased muscle tone (spasticity)
- Loss of normal bowel and bladder control (may include constipation, incontinence, bladder spasms)
- Numbness
- Sensory changes
- Pain
- Weakness, paralysis
Lumbar strain
A muscle strain in the lower back is by far the most common cause of lumbar pain. Picking up luggage off of the floor at the airport, or straining to reach some dropped car keys can cause the muscle fibers to abnormally stretch or tear causing the ligaments to tear from their attachments.
The soft tissue areas of the neck and back are particularly susceptible to injury in low speed car accidents. The property damage to the vehicle might be minor, but the sudden jerking causes about 1/3 of people to sustain a soft tissue injury. The injuries can be quick to recover (only sore the next day), take months, or even be permanent. Strains and sprains are often untreated because the patient assumes that they will get better, and end up not going to the doctor. Sometimes the symptoms are not immediate like someone would see with a broken bone. If someone is stiff, sore, bruised, or is experiencing numbness or tingling after a car wreck, that person likely has some type of soft tissue injury. So, it’s always a good idea to get evaluated by a doctor, as soon as possible after the wreck.
Diagnosis
If you’ve been in a car accident, seek medical treatment immediately if your body doesn’t feel like it usually does. Early diagnosis of a back injury can potentially help you recover faster, and an insurance company is going to want the injury well documented to pay anything on the claim.
You’ve likely seen on TV where the EMSA personnel immediately put someone in a neck brace or on a stretcher after a car wreck. The TV writers likely got that idea from real life. Paramedics are trained to watch out for spinal and back injuries and proper bracing (immobilizing) can help prevent increased harm or paralysis.
X-rays are useful in pinpointing broken bones or other skeletal defects. To analyze soft-tissue damage such as disk herniation, magnetic resonance imaging (MRI) scans may be required. A CT scan can be performed, for those who cannot have an MRI. To determine possible nerve or muscle damage, an electromyogram (EMG) can be performed.
Treatment
The treatment for back injuries depends on the type and severity of the back injury. Back injury treatment goals are pain relief and restored movement. The basic treatment for relieving back pain from strain or minor injury is rest. An ice pack can be helpful, as can Aspirin or other nonsteroidal anti-inflammatory drug (NSAID) to reduce pain and inflammation. After the inflammation subsides, applying heat can soothe muscles and connective tissues.
Once the pain resolves, physical therapy should be started as soon as possible. Back stretching and strengthening exercises can reduce pain and speed up recovery. Severe injuries may require surgery to repair damaged tissue. Most mild back injuries resolve within 1-2 weeks, while moderate to severe injuries may take months to heal.
A severe back injury may require surgery, such as:
- Laminectomy
- Vertebroplasty
- Spinal fusion
- Disk surgery
Damages
If you’ve been in a car accident (and you weren’t at fault), you should make a claim to include medical bills, pain & suffering, lost income, and anything that has been affected in your life by the wreck.
Make sure to tell your doctor of any health affects from the wreck, however minor, and go to all of your appointments.