A recent clinical trial suggests that a new kind of treatment for post-traumatic stress disorder (PTSD) called written exposure therapy (WET) may deliver the same results in less time than traditional therapies. WET involves writing about traumatic experiences. Continue reading
CBT is a useful treatment option for patients with non-cancer pain, according to new research. The authors discuss a growing evidence base that includes studies, reviews & randomized trials of CBT in the treatment of chronic pain. Continue reading
In a study published in August 2017, researchers measured the association between low back pain (LBP) & muscle-strengthening activity (MSA) in adults. They found that engaging in MSA at least 2 times per week was associated with having lower odds of having LBP. However, they found that this association did not hold in male smokers. Continue reading
In a new albeit small study, scientists measured the effects of intense training in short spurts versus moderate training over a longer period. They found that the former, called “High Intensity Interval Training” (HIT), improved migraine symptoms more than the latter, called “Moderate Continuous Exercise” (MCT). Continue reading
A radio-frequency rhizotomy (or denervation) is a procedure many medical specialists in the field of pain management use to treat patients with chronic back or neck pain caused by proven damage to one or more of their facet joints. These very small joints serve to stabilize between & behind adjacent vertebrae & they can be damaged in vehicle accidents.
Clinical trials with 681 patients with chronic low back pain showed….. Continue reading
Yoga can be as likely to be effective as physical therapy in relieving moderate & persistent low back pain according to a recent study of 320 people published in the Annals of Internal Medicine. Researchers assigned 320 people ages 18 to 64 to one of three groups. Each group did one of: Continue reading
Back in Motion is hosting a six-session chronic pain self-management course at four of its locations in the Lower Mainland. The course is designed to help people who live with chronic pain to manage their symptoms & improve the quality of their life. B in M is doing this in partnership with the University of Victoria & BC Health. Continue reading
Many injured people don’t discuss their use of over-the-counter (OTC) pain relievers, such as Tylenol & Advil, with their doctor. Often this is because they don’t consider them to really be medication since they are not prescribed.
Charles P. Vega, MD, explained the following safety factors he considers when he recommends an OTC pain reliever to a patient: Continue reading
Many people injured in car accidents have difficulty sleeping due to pain. New research suggests that even mildly insufficient sleep duration can have an adverse effect on people. Continue reading
Many injured people suffer a great deal of psychological stress after their accident. They are often on tight budgets because they are unable to work. Thus they may buy less fruits & vegetables to reduce their grocery bills.
A recent large study involving more than 60,000 Australian participants showed that injured people may unknowingly increase their risk of suffering from post-accident mental stress by eating less fruits & vegetables.
The study also found a surprising difference between men & women. Continue reading
Many people injured in vehicle accidents develop depression. Sometimes this is so severe that a physician or psychologist diagnoses the patient as having “clinical depression”. Often this is a result of people realising that their recovery will not be as rapid as they had hoped.
A recent study showed that if people follow a very healthy diet they may be able to:
- lower their risk of developing clinical depression or
- recover from their clinical depression more quickly.
People injured or insured in BC who suffer PTSD as a result of an mva are entitled to ICBC Accident Benefits. These include funding for psychological treatments & reimbursement for prescribed medications.
There are a few psychotherapy treatments & medications that are shown to be effective in the treatment of PTSD including:
- prolonged-exposure therapy,
- cognitive processing therapy,
- eye movement desensitization & reprocessing (EMDR) &
- a couple of selective serotonin re-uptake inhibitors (SSRI’s).
Many injured people who do not have a speedy recovery from their injuries are tempted to consider treatment by injections of Botox (Botulinum Toxin).
A pain management physician at the U. of Colorado Health Sciences Centre* wrote an article in Medcape on March 9, 2016 in which she referred to a review of botulinum toxin studies performed by the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology… Continue reading
In 2007 the American College of Physicians and the American Pain Society published an article entitled “Diagnosis and Treatment of Low Back Pain: A Joint Clinical Practice Guidline”.
Part of the guidelines dealt with the treatment of low back pain. The subcommittee wrote the following recommendations for each of acute (duration less than 4 weeks), subacute (duration 4 to 8 weeks) and chronic low back pain: Continue reading
Ms. Villing suffered from continuing low back pain at her trial 5 years after her accident. This caused her some difficulty handling her part-time job as a legal assistant. ICBC hired an orthopaedic surgeon to assess Ms. V. He stated that a procedure called a rhizotomy would improve her back pain but would need repeating over time.
In spite of the optimism of the surgeon ICBC hired, the trial judge awarded Ms. V. $100,000 for her loss of future earning capacity. ICBC appealed this award to the B.C. Court of Appeal. Three of its judges affirmed the trial judge’s award. Continue reading
The study randomly assigned participants to one of three groups, those in:
- weekly yoga classes over 12 weeks, which taught breathing exercises, postures and deep relaxation;
- weekly stretching classes which taught aerobic exercises, deep stretches & strengthening exercises focused on the lower body; &
- “self-care”. This was the control group. They only received a book with advice on back exercises & how to reduce pain.
A recent medical study shows the ineffectiveness of acetaminophen (Tylenol) in reducing pain & disability for patients with spinal pain or osteoarthritis. It also found that it may have harmful effects on the liver.
The findings from this study emphasize a shift away from pharmacological treatment to non-pharmacological ones. Continue reading
American & Canadian PTSD experts conducted a new study that revealed that treating post-traumatic stress disorder is more effective for “patients in committed relationships when their partners are deeply involved in the care”. Continue reading
Dr. Jha, a Toronto neurosurgeon, has launched a 24-hour toll-free hotline (1-855-899-5665) for anyone who has or thinks he/she may have sustained a concussion, including after a car accident, and has questions about his/her injury.
Dr. Jha says that, contrary to popular belief, a concussion can be caused by trauma other than a blow to the outside of the head. For example, during a car accident, it is possible to sustain a concussion from one’s brain getting bruised by impact with the inside of one’s skull. Continue reading
Mrs. Merko’s two accidents left her with chronic pain which severely impacted her quality of life. Her neurologist who treats her headaches & her GP recommended:
- an exercise program;
- Botox® injections for her headaches which got worse after her mva’s &
- Butrans® patches & other medications to manage her high level of pain.
A new study published in the Pediatrics medical journal shows that those who experienced a concussion and did not rest immediately afterwards took nearly twice as long to recover as those who rested immediately.
Mr. Moini experienced pain & depression that were worsened by his 3 car accidents. A few months after his first accident, he stopped taking his anti-depressant medication because he found that it made him dizzy, drowsy & unable to concentrate & work. Mr. M also stopped attending psychological counselling after a few sessions because he found it “completely unhelpful”.
At trial ICBC’s lawyer argued that:
- he failed to mitigate his losses by not attending counselling & taking anti-depressants;
Ms. Nijar was injured in two car accidents two years apart. Neither of them were her fault. She suffered from headaches & neck & back pain from both her accidents which had not resolved at the time of her trial.
- used Ms. N’s doctor’s records to show that he had told her a few times to go to the gym or to a rehab program to strengthen her back muscles,
- argued that she did not follow his advice & thus did not take all reasonable steps to mitigate (minimize) her damages and
- had her doctor agree in cross-examination that if she had done some weight training she would have had less back pain.
In a series of guidelines, medical agencies including the Centers for Disease Control and Prevention (“CDC”) in the USA are warning doctors about the dangers of prescribing opiates for chronic pain. They point to strong evidence suggesting that drug and opioid related deaths have sharply increased each year since 2000.
Ms. Litt was injured in two car accidents. After her second one she developed a pain disorder which was caused by physical and psychological factors. Her lawyer hired Ms. Berry, an occupational therapist who did an assessment in Ms. L’s home.
ICBC hired their own occupational therapist, Mr. Gander. He was critical of Ms. Berry’s report and suggested that her observations were not vigorous enough to prove that the claimant was incapable of ordinary functioning. ICBC’s lawyer argued that a reasonable award for her cost of future care should be $5,000 for an active rehabilitation program.
Ms. Castro was involved in an accident in 2010 and then a second one in 2012. Fault was admitted. The legal actions respecting each of these accidents were ordered by agreement to be heard together at one trial. This is the practice in our courts.
As a result of the first accident Ms. C received six fractured ribs, bruising to her arm, leg, and chest, and head injuries. The second accident made these injuries worse, particularly to her neck, shoulder, and spine. She went on to develop chronic pain. Her doctor diagnosed her with “major depressive disorder” in Feb, 2015 and prescribed her anti-depressant medication which she decided to discontinue.
After his accident, Mr. Derksen visited a number of treating people on his own accord for his injuries. No doctor had recommended them. He spent a total of $27,000 on massage therapy, physiotherapy, chiropractic and kinesiology. He went to trial to recover these expenses from ICBC.
ICBC’s lawyer argued that the treatments Mr. D took must have been recommended by his doctor before he is entitled to recover what he spent for them.
The claimant Ms. Lemyre was involved in a collision in 2010. As a result of the accident, the claimant had ongoing neck pain. Five years later at trial, she sought compensation for her injuries sustained in the accident. Part of her claim was for two expenses that she claimed were necessary to her recovery.
She sought compensation for a posture care mattress and a water pillow which she believed would reduce her level of pain.
The claimant, Mr. Chenier’s, car was struck by another vehicle. This left him with significant pain across the shoulders. These symptoms persisted until the date of his trial.
A doctor trained in sports medicine testified for the claimant at trial. He noticed that when the claimant walked slowly on a treadmill he experienced relief from his back pain. Mr. Chenier therefore claimed for the cost of a treadmill.
ICBC’s lawyer argued that the cost of a treadmill was unnecessary. Continue reading
Dr. Robinson is a senior neurologist in Vancouver who has a very well respected practice treating patients with headaches. He testified recently in the Supreme Court of B.C. in the case of Forder v. Linde.
He gave his insights into the treatment of headaches after a whiplash injury as well as his prediction of the future (prognosis). These would be valuable to anyone suffering from headaches after a whiplash injury.
Mr. Justice Crawford awarded the claimant a total of $835,600 for her damages.
He summarised Dr. Robinson’s report and testimony as follows: Continue reading
This is letter written by the president of Canadian Magnetic Imaging (CMI) , a private MRI clinic in Vancouver. While CMI benefits certainly benefits from injured people obtaining private MRI’s from them it is certainly worth considering what he has written:
“There has been much discussion about the use of MRI in litigation and, in particular, a focus on the role of the public system in recovering the cost of the scan. The reports attached to this newsletter demonstrate that, regardless of the recovery issues, the public system is not where you want your litigation clients scanned because it will likely not provide you with the information you require to obtain appropriate recovery for your clients.
Justice Greyell of the B.C. Supreme Court accepted the recommendations of the injured claimant’s medical specialist, Dr. Hershler, and awarded her $6,500 to fund a six months program of medical marijuana used by way of an ointment in order to control her pain so as to allow her to be able to work with a physiotherapist for 20 session in order to build up her core strength and increase her range of motion. Continue reading
After her accident, the plaintiff (claimant) in the Carreon-Rivera v. Zhang case got worse rather than better over time and developed chronic pain and depression as a result of her injuries.
Her one failing, which cost her at trial, was this: she chose to ignore the advice of her physicians to obtain psychological counseling and to take anti-depressant medication for her depression. Her physicians thought that this would have helped but not cured her chronic pain.
On March 27, 2014, Mr. Justice Verhoeven of the Supreme Court of B.C. gave his decision case of Hart v. Hansma. He concluded that Mr. Hart will need knee and possibly shoulder surgery due to his injuries in a car accident and that: “In general, the evidence is that the plaintiff finds relief and is better able to cope using therapies such as acupuncture, prolotherapy, and physiotherapy. His family doctor is in favour of at least some continued therapies.” and awarded him $20,000 for the cost of future treatment. Continue reading
On April 11, 2014 a judge awarded an injured person $15,000 for her future cost of Advil, a sleeping pill and the possibility of Botox treatments
People often suffer from myofascial pain syndrome after a car accident, particular after a whiplash type injury.
Myofascial pain syndrome is a chronic, painful condition associated with areas of increased muscle tone, which are clinically felt as tight bands punctuated by small areas that are very tender to pressure, often called trigger points. Continue reading