In most personal injury cases involving back and neck pain, the pain will be caused by damage to the soft tissues around the spinal column (muscles and tendons), and not due to herniated discs or fractured vertebrae. These soft tissue cases will be the ones most likely to involve a physical therapists and chiropractors, as medical doctors will most often only be able to treat them with anti-inflammatory and narcotic pain medications. Because long-term use of narcotic pain medication has too many downsides to list, many people seek alternative treatments — such as chiropractic care.
The problem with most soft tissue cases is that insurance companies do not value them very highly. While the pain you feel from your soft tissue injury can be intense, and sometimes permanent, there are no sophisticated tests, like MRIs or CT scans, that can show the damage, much less the degree, of a soft tissue injury (like a broken bone). Without the objective evidence provided by these types of scans to back up your claim, your subjective complaints will often be the only proof of how badly you are hurt.
Subjective complaints by a plaintiff without hard medical evidence are usually not well received by insurance adjusters or juries. A broken bone is easy to see on an X-ray, but strained muscles/ligaments are a different battle.
The Balancing Act of the Chiropractor in Soft Tissue Cases
When you have a soft tissue injury case, you must pay special attention to how much you will owe your medical providers (and health insurance to the extent that it has paid for accident-related injuries) when it is over. You must pay particular attention to chiropractic care, mainly because the costs add up rather quickly. Most chiropractors will want to treat you several times per week. This will likely go on for several months before you have recovered or when the doctor is ready to say whether you are at maximum medical improvement, or MMI. It is important for you have recovered or to be at MMI before settling your case.
Knowing that you may need treatment for several months before your case is in a position to potentially settle, you have to ask yourself if you need as many treatments as your chiropractor is suggesting (i.e., could you go 1 or 2 times per week instead of 4?).
Honestly evaluate whether the treatment is making you feel better. Discuss with the chiropractor how many treatments he or she expects you to need, and do the math on how much that will cost. Above all, your medical rehab and health are the number one priority! Some doctors fail to consistently monitor patient progress. If you are not improving week to week, make sure your doctor knows. Likewise, if you feel like you’re close to back to normal, let your doctor know that you are improving. Insurance companies love to tout “excessive treatment” a year later even though they weren’t in the treating room. This honest documented conversation with your doctor can improve your treatment, and oftentimes your legal case result.
Consistency of treatment is important to a soft tissue injury plaintiff. You don’t want to go for any extended period of time without receiving any treatment at all. Insurance companies are quick to claim that, “if you’re not treating, you’re not hurt.” But, in real life, sensible people do not look forward to going to the doctor.
However, overtreating is almost as much a risk to your case as undertreating. If you accumulate more medical bills than your case is worth, you could wind up walking away with no money in your pocket, or worse — still owing money to your medical providers. Just like all professions, there are good chiropractors, and bad ones. There’s an oft-repeated joke on Chiros:
“How many chiropractors does it take to change a light build?”
- Just one, but it takes 10 visits.
Paying attention to your treatment and progress (or lack of progress) is important, and it’s important that your doctor knows how you are feeling.
Ultimately, you must balance the cost of your chiropractic care against the benefit it provides to your health and your lawsuit. Ask your lawyer to keep an eye on your medical bills (their office will be routinely requesting them anyway) and let you know if he or she thinks you’re overtreating. Let them know that you’re not asking for medical advice. You just want to know when he or she thinks that the cost of your medical care will exceed the fair value for your case.
A Kind Word About Chiropractors
I’ve been kind of rough on chiropractors in this article, so I will try to finish on a positive note. In my experience, more often than not, chiropractors benefit the lawsuits of soft tissue plaintiffs. They seem to take soft tissue claims more seriously than medical doctors, which makes them more vocal advocates for plaintiffs. What they may lack in credibility with insurance adjusters, they can often make up for helping their patients get better – they seem to be true believers in their patient’s pain. They can often give the jury a scientific reason for showing that the soft tissue “whiplash” injury is both real (because it is) and permanent. Even if the insurance company is skeptical of all “soft tissue” injuries and chiropractors, they will be more likely to believe your subjective complaints of pain with a chiropractor backing you up than if you were to go to trial with no medical expert at all.
So, should you see a chiropractor? If you have a soft tissue injury case and you see a medical doctor first, sure. Try it out. If the chiropractor makes you feel better, continue to see him or her.