No car accident is too small to cause pain and suffering. Sometimes even a fender bender can cause pain, depending on the level of impact, which is why the absence of visible injuries is no excuse for not getting checked after an accident. You need to certify that you don’t have to worry about any common injuries associated with car accidents. What are some of these pain-causing injuries?

There are sprains, strains of the neck, the back, and many shoulder injuries. You could also have spine pain which can travel to your hands, legs, and even your toes. When you start to feel numbness and tingling in your hands or feet, there could be an injury to the nerves. No thanks to muscular spasms or injuries from trauma during the car accident. The injuries can be worse. You can also experience bladder incontinence or inability to hold your bowels after a car accident. 

The plan is not to neglect the injury impact of an accident. Granted, sometimes you may not feel sore after an accident and do not see the need to see a physician. But there are asymptomatic issues that could be going on, but you wouldn’t know if you don’t go to the physician to get checked out. Also, seeing the physician will provide a documentary trail of your injuries for a potential personal injury case. The physician will determine which injuries are preexisting and acute or caused by the car accident.  

You don’t want a situation where you’re involved in a car accident but skip going to the physician only to endure pain and suffering down the line without proper compensation. You can avoid that fate by knowing what can go wrong in your body after an accident and what you can do about it. 

Learn more in this episode of the David vs. Goliath podcast with elite personal injury lawyer Matt Dolman and his guest, Dr. Ian Rainey. They discuss neck and back injuries you could sustain after an accident, how they can make you feel or not, treatment options, and when to see a surgeon. 

In this episode: 

• [00:48] Matt Dolman welcomes his guest, Dr. Ian Rainey, and introduces the topic of the day: common injuries from automobile accidents that can affect your neck and back
• [01:12] What is radiculopathy, and any correlation to the numbness and tingling in your hands or feet after an accident? 
• [03:17] How physicians diagnose and alleviate radiculopathy
• [04:21] When does a nerve injury require you to see a surgeon? 
• [06:25] Why it is pertinent to get an MRI after an auto accident 
• [07:39] The role of the physician in your injury case 
• [09:13] Acute versus pre-existing injuries, how does the chiropractor differentiate? 
• [10:20] When surgery becomes inevitable 
• [11:36] What is the maximum medical improvement?
• [12:51] Other common car accident injuries
• [13:54] The difference between radiculopathy and neuropathy
• [15:02] How car accident victims ruin their injury case 

Transcript

Welcome to the latest Dolman Law Group Podcast. I’m Matthew Dolman, principal owner of the Dolman Law Group here at Dr. Ian Rainey of Rainey Chiropractic and Injury Center. Say hello Ian.

Hello everyone.

Well today we’re going to discuss common injuries from automobile accidents that are related to the back and neck and more specifically, neuropathy and radiculopathy. Kind of take the viewers and listeners through what radiculopathy and neuropathy are.

So radiculopathy is going to be what we call pathology of the nerves, that’s going to radiate specifically from the spine. So if you’ve got pain due to an injury in the spinal cord, that pain, it may radiate down to the extremities. So that could go into your arms, to your legs, to your feet, to your toes. And when we start to see that, that’s an indicator that there’s something serious going on and it needs to be evaluated.

So rather than a back injury or a neck injury that’s in a specific area, you’re feeling it actually correlate to numbness and tingling in your hands or your feet. What are those specifically related to?

They’re going to be related to injuries to the nerves, either specifically in the spinal cord or maybe compression of the nerves, anywhere along the way, due to maybe muscular spasms or injuries from trauma during the automobile accident, from the airbag or from the seatbelt or something like that.

When does it arise to being very serious to the nature that you have to see somebody?

Say that again?

What does the injury arise to the point where it’s so serious that you need to see somebody?

Oh, now if we see somebody who’s having bladder incontinence or they’re unable to hold their bowels, then we know that’s a medical and an emergency, you’ve got to see a medical doctor, a surgeon-

That’s cauda equina, right?

Cauda equina, correct, yeah. And if I see somebody who has motor weakness or maybe they don’t feel certain areas of the skin, we’ve got these things called dermatomes and we’re looking at different areas of the skin. And if the person has numbness or tingling in those regions, we know that there can be a correlation between certain spinal segments. So there could be an injury along the spinal cord that we need to evaluate.

So in other words, you have corresponding areas that… Well, I better state it, it corresponds with the location of your injury. So for instance, if you have a neck injury at C1/2 in your spinal column, it’s going to relate to specific digits in your fingers.

Correct. Yeah. So when we’re doing certain tests, we may do orthopedic or neurological testing that will indicate that there is an injury that could be due to a bulging disc or a herniation or a protrusion along one segment of the cervical spine or the lumbar spine.

Okay. What could be done to alleviate it?

To alleviate, what we like to do is we like to do conservative therapy first. So, first of all, you may want the doctor may prescribe you some anti-inflammatory medication that may take down the swelling, which may take the pressure off of the nerves, or we may do ice obviously is a great thing to do to reduce swelling. And then we start to look at things like massage or chiropractic, where you can actually align the segments and take the pressure off the nerve.

What is the injury in terms of a nerve injury so seriously, you have to see a surgeon? What is it to the point where you can’t do anything further with conservative care?

Well if I’ve given the patient a couple of treatments and I don’t see improvement after four or five visits, maybe the sixth at the most, if the patient is not getting better, then I definitely am going to refer them to a surgeon or an orthopedic specialist or somebody who is going to be able to do a little bit further investigation and be able to treat that injury.

So is that just for localized pain or is that when there’s neuropathy or radiculopathy?

Particularly when there’s neuropathy and if there’s localized pain, it’s kind of hard to describe a particular situation, but when you see it after you’ve had enough experience, you look at something, you go, “All right, this is not getting better. This is something that I’m not comfortable with. And I know that this is something that a surgeon would have to see.” But when I see a patient who comes in, I expect to see results pretty quickly. And if that’s not happening, then I know that I’ve got a team of professionals that I work with, and I know that they’re going to do a better job, so that’s when I refer out.

So muscular injuries, muscular ligamentous injuries respond better to conservative care?

Absolutely.

Where disc injuries could, it depends, it’s pretty tricky.

Yeah. If somebody has a swollen disc, it kind of depends on the complexity of the condition. But if the disc is just swollen and inflamed, the patient may have some mild symptoms. They may have a little bit of muscle weakness, but if that goes on for very long, I don’t want that pressure to be on the nerve for too long, because that can cause permanent damage. So, if the patient continued to approve, then we know that we’re making progress and we should be able to get that patient back to pre-injury status.

I know physicians like yourself, you treat symptomatology, not pathology. What does the MRI do for you? And how important is the MRI result, when I know for instance, I have three or four blown discs in my neck, I’ve had two auto accidents. They’re asymptomatic, I don’t feel it every day. In fact, generally I never have an issue with my neck. What is the importance of the MRI and how far does that go, and when do you need to correlate that with the actual symptoms?

The MRI is extremely helpful because I could have a patient who, they have some symptoms, but when we see that there is an issue in their cervical spine, say that they’ve got a protrusion into the spinal canal, then we know that there is pressure on the spinal cord, and that does verify the symptoms that we’re finding. So when I see that, I also know where the issue is, and that’s also going to give me good ammunition to know exactly where to adjust, what segments to focus on when we’re providing ice, electrical stimulation, and then when we’re actually doing the adjustment, because if the person is just standing there, they get the MRI or they get an x-ray done, you’re not going to see a bulging disc or a protrusion on an x-ray.

But on that MRI, you’re going to see all the soft tissue, the damage that’s been done. And you can also see the structure of the spine. So if they’ve got a military neck, we call it, a straight neck, we know that there’s going to be more protrusion of that bulging disc back into the spinal canal. But if we can start to restore that curve…

Lordosis.

Yeah. It’ll take a little pressure off of the disc and allow it to heal a little bit faster.

I understand, well in particular, the spine injury cases, your job is also to document the case for an attorney.

Yes.

Because there’s a personal injury perspective to the case. When you’re documenting case, how do you determine what’s acute versus what’s preexisting? So acute as in related to the actual trauma, versus what may be preexisting and been lightened for years and could have been laying dormant or may have been symptomatic beforehand, but is not actually acutely related to the accident. Adjusters make a big deal about this. I didn’t mean to cut you off, but they’ll often say, “Matt, those injuries were there for years. It’s very obvious it was degenerative disc disease.” And let’s get into that. What is degenerative disc disease? What’s the importance of acute versus preexisting and how do we show it?

Okay. So first of all, looking at the patient and determining whether or not there was a preexisting condition, I want to make sure that I get a very thorough history from the patient. I want to make sure that I’ve got all the information, if there were previous injuries or auto accidents, I want to make sure that I’m aware of that. But then also that’s why we utilize imaging. The radiologist is able to tell whether or not there was a preexisting injury or whether or not that that was more of an acute condition. And then also when we’re looking at disc degeneration, there’s a lot of testing that I’ll do, and you can kind of tell whether or not the patient has had more of a preexisting issue. But that information is just really good to have. It’s good for the case. It’s important for the attorney. And then I just like to make sure that we have all that.

So you mentioned testing. What kind of testing can be done to determine acute versus preexisting?

Let’s see, if a patient comes in and and they’ll say that they’ve had… Well, I guess a good example would be one patient who had, on the MRI, we could tell that he had basically compression in the lumbar spine. And he was also in a previous accident. And so you kind of take a little bit of the history, plus also the imaging. And then I guess a little bit of communication with the patient to kind of determine that. If the patient said, “I never had this pain before, this just happened right after the car accident.” And then you do some orthopedic testing and you find out that the patient is unable to hold his legs up without recreating low back pain, then we know this is definitely an acute condition here.

I know that your job is to avoid surgery at all costs. When does it get to the point where surgery is necessary? What’s the role of injection therapy? When has a client basically, or I should say patient in your ,they’re clients for me. When have they exhausted all forms of conservative care in injection therapy, where there is no alleviation of the pain and we need to proceed?

Typically, if I’m working with someone and they’re continuing to get better and better and better, I do want to work with other individuals, to make sure that they’re getting the best possible treatment available. Maybe my extent of what treatment I can provide is limited here, but say that I have a person who has a very bad shoulder injury and I’m getting some improvement, but I know to myself, I don’t have prescriptive rights, so I want to get the inflammation reduced so that we can get this shoulder better. Then I may refer to the orthopedist or someone else who can do injections and take that inflammation down.

Next thing you know, now I can get that shoulder to move so much better and we can get in there and break up the scar tissue that’s forming, break up the adhesions and restore full mobility. And that may be a good example of someplace where I would be limited on my own. And that’s nice to have those other resources available. If we reached a point where the patient is not getting better, after a week or two, if the patient has completely stabilized, then I know that’s going to be no longer a situation for me to treat that patient, and that’s where I need to refer out to another specialist.

Fair enough. There’s a term in our industry called maximum medical improvement, MMI. What does that mean?

So that means basically that the patient has reached the point that we feel that they’ve reached their maximum medical improvement. So the patient is about as good as we feel we can get them or where I feel like I can get that patient.

Is that specific to what you do? Is there chiropractic MMI and then maybe there’s MMI for a physiatrist or MMI for a spine surgeon? Is it just specific to your industry or is it specific to just the patient as a whole that can never get any better than they are now?

That would be specific to an industry. So if I feel that I’ve reached the point where I can’t get the patient any better, then it’s time for another specialist to take a look at that. Because, the way that I was trained is completely different than a medical doctor was trained. I don’t want to say completely different, but, we have different approaches. They’re going to be like a medical doctor or an emergency room physician is going to be trained a little bit differently than chiropractor. So they may have some other tools in their toolbox that may be able to help where I can’t or maybe they may be great at treating somebody who has had cuts and abrasions and things like that, whereas I can treat musculoskeletal issues very well.

Okay. What are some other common injuries you see?

I see a lot of sprains, strains of the neck, the back, a lot of shoulder injuries. Right now, I’ve got one patient who the right shoulder’s damaged because when they got into the car accident, the strap on the shoulder belt came across and covered half the body, but not the other half. And then the other person who was in the car, the other shoulder’s damaged. So, you’ve got a lot of shoulder injuries, a lot of patients who get broken ribs, a lot of patients who just have strains of the muscles, the intercostal muscles that feel like they’ve broken ribs, but it just hurts every time they laugh or breathe or try to move. Yeah, those are pretty bad. But it’s good to tell them, “You know what, you’re going to get better.” And that at least provides some comfort to them knowing that they’re going to get better. So other injuries, definitely a lot of disc injuries. And then there’s of course the radiculopathy, we get some people that have numbness and tingling, things like that.

Is there a difference between radiculopathy and neuropathy?

Yeah. Well, radiculopathy, I would say is more radiating pain. So say if I told you had lumbar radiculopathy, that means you’ve got pain radiating down the nerves from the lumbar spine into the extremities. So into the feet or maybe into the legs, but neuropathy could just be nerve pain. So, there’s a lot of different things that can cause neuropathy. It may not be compression of the spinal cord. It could be just nerve damage or maybe for one example, you got hit by the seatbelt and that caused some damage to the nerves around the pelvis, and that can cause some weird symptoms.

So they’re mutually exclusive. You could have both?

Correct, yeah.

You could have one or the other?

Correct, yeah.

Okay. Fair enough. Anything else you want to cover in terms of back and neck injuries you commonly see at your practice?

Let’s see. Not that I can think of off the top of my head.

You look at your patients, what’s your biggest hangups in terms of what can a person do to ruin their case or ruin their medical treatment?

Oh boy. I could give you a good example.

Please do.

I have one patient who said, “I have to exercise. I have to exercise. You don’t understand. If I don’t exercise, I’m going to drink alcohol.” And I said, “That’s not good.” But the person like that, when I say you cannot exercise, if you want to get better, that’s a challenge because the doctor says what needs to be done for the person to get better, but the person feels like they want to go do exercise or do things. One of the hardest things really, is telling people, “All right, this is a period in time where you need to let your body heal, and that way you can enjoy your life later.” I guess that’s one of the challenges, so I don’t want people going out there and exercising or posting certain things that they should not [inaudible 00:15:48].

Oh yeah, social media just kills cases.

Yeah.

So an era of instant gratification, and it’s very tough for individual to stay patient and see the case through or see the treatment through, okay.

Yeah. And I had one patient who actually went running in a boot. He had to run, he was that adamant about running, but it was because he had a little foot surgery, unrelated to the accident.

Not smart though.

No.

Absolutely not. I think we covered everything related to neck and back injuries, at least what we could do from a non-academic perspective, without boring in the listeners. appreciate your time today, Dr. Rainey.

Hey, thank you for having me.

That’s Ian Rainey from Rainey Chiropractic. How do individuals get ahold of you?

They can call the office, phone number is 727-314-2663, or you can look us up on the web, raineychiropractic.com.

Thanks again.

All right.

I appreciate it. This concludes the Dolman Law Group Podcast.

Thank you.