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Neck injuries and headaches.
- I still have neck pain and headaches more than a year after my rear end collision. My adjuster says it is from stress and not doing enough exercise. Is there any way out of this cycle of pain and depression?
- Many doctors traditionally thought that the small subgroup of their patients who developed chronic, long-term pain following a whiplash injury did so for psychological reasons or because they did not exercise enough. In the mid-1990s, scientists in Australia produced evidence that strongly challenged these theories. They discovered that the source of pain in over half of patients with chronic neck pain following whiplash injuries is damaged facet joints. These small joints down the back of the spine allow the spine to move. They combine with the disc space to create a three-joint complex at every vertebral level. Each facet joint consists of two opposing bone surfaces with cartilage between them. A nerve ending in each facet joint transmits pain signals to the brain.
Damaged facet joints are often aggravated by certain exercises or by a person maintaining certain body positions (such as leaning over, reading or working on the computer) for an extended period.
In the Australian studies, injections of local anaesthetic (called facet joint blocks) relieved the neck pain in over half the subjects and relieved headaches in about one-quarter of them. If anaesthetic is applied to a damaged facet joint, a patient's pain may drop from, say, 8 out of 10 (severe) to 1 or 2 out of 10 within a very short period of time.
Another study showed that patients' psychological states improved rapidly after their facet joint pain dramatically improved. This is strong evidence that physically-based pain had caused the patients' depression and anxiety, and that the depression and anxiety had not caused the pain, as has been frequently claimed.
These facet joint blocks serve a second function over and above the prime function of significantly relieving pain. The results of the blocks are very powerful evidence in a legal case—evidence that can lead to fair compensation for the long-term pain a person has suffered following a whiplash injury.
ICBC's adjuster and, if the case goes to trial, a judge or jury, will all likely be very impressed by the evidence of a medical specialist who pinpoints and explains, using a large, clear medical diagram, the exact facet joint or joints which he has proven to be the source of the injured patient's pain. This is much more powerful evidence of why the injured person did not get better than is a vague explanation by a doctor that some people simply don't get better after a whiplash injury. The latter approach is unlikely to impress the average ICBC adjuster, judge or juror, who may be suspicious that the claimant has either a psychological problem or a so-called minor "soft tissue" injury, or that the claimant is exaggerating his or her pain and disability. They may suspect that the claimant will feel much better once the stress of the court case is finished.
A much tighter diagnosis implicating specific joints, ligaments or nerves in the neck with supporting diagrams is much preferred to the "soft" diagnosis of "soft tissue injury. " Settlements and court awards do not magically heal damaged joints or ligaments in the neck, and it is vitally important that your ICBC settlement or court award account for all future expenses and loss of earnings anticipated as a result of your injury.
Unfortunately, only a few medical specialists in British Columbia perform facet joint "diagnostic blocks" and the treatment is usually not funded by the Medical Services Plan without a lengthy wait. Don't let this deter you. Certain physiotherapists and medical specialists are adept at screening patients whose chronic neck pain or headaches are likely as a result of a damaged facet joint of the neck. Certain physiotherapists can initially treat such injuries to see if the injury will significantly improve without the necessity of diagnostic blocks.
Speak to a lawyer experienced in handling severe neck injuries about how to find a medical person who can do the screening and initial treatment. The lawyer should also be able to help you access a specialist who does the facet joint block treatments if your medical practitioners think it is appropriate treatment for you.
Click here to read about a recent Supreme Court of B. C. jury verdict of $953,000 obtained by Chris Temple, senior counsel at TNT Lawyers, for a woman whose specialist established that her whiplash was a permanent injury because she damaged facet joints in her neck in her rear end car accident.