If you’ve felt chronic neck or back pain after what might seem like a “minor” collision because there wasn’t much damage to the cars, you might be inclined to dismiss the possibility that the crash caused serious injury. Insurance companies and defense attorneys certainly often assert that neck and back injury from a car crash without major car damage is impossible. One insurance training manual, for example, instructs claims adjustors to treat motor vehicle collisions with minimal damages as unlikely or unable to cause significant or permanent injury and to handle claims in such cases as a type of fraud.1
But medical evidence shows that the spine is far more vulnerable than a motor vehicle to the types of forces that can occur when cars collide even at low speeds. The neck, or cervical spine, is a weak part of the spine because it is supported by very little musculature. “[M]echanical forces associated with rapid acceleration and deceleration place excessive stress on the cervical spine.”2 This is the so-called “whiplash” injury that may occur when sudden, unexpected impact transmitted to the neck and upper back causes a traction force on the neck.
“The cervical spine initially develops an S-shape curvature and then progresses to a C-shape curvature during whiplash. The [lower cervical spine] is at risk for extension injury during both the S-shape and C-shape phases of whiplash [and] the potential for [upper cervical spine] extension injury exists at higher impact accelerations.”3 Thus, even at low speeds, force applied to the spine is quite capable of causing harm to a person even if the same force has a little apparent effect on metal, plastic, concrete, or other materials. In fact, a “substantial number of injuries are reported in crashes of severities that are unlikely to result in significant property damage.”4
Similarly, apparently minor injury to the spine’s facet joints can be a source of persistent neck and low back pain. The facet joints are the connections between the bones of the spine. They allow the spine to spend and twist and keep the back from slipping too far forward or twisting without limits.5 “Trauma to the facets, particularly when there are pre-existing degenerative changes, may [cause] many of the symptoms following hyperextension injury to the spine.”6 The “cervical facet joint is the most common source of chronic neck pain after a whiplash injury.”7
Unfortunately, “reliable diagnosis of facet joint pain [can be difficult], due to the inability of physical examination, clinical symptoms, radiologic evaluation, and nerve conduction studies to provide a reliable diagnosis.”8 A misdiagnosis of soft tissue injury based on the “minor” trauma of a low-speed collision that has actually caused a spine injury can leave a patient with significant discomfort and decreased ability even after lengthy physical therapy.
Thinking that serious injury cannot have happened simply because it doesn’t seem possible from the apparent degree of trauma is a mistake. If you or a loved one are facing such a situation, it’s a mistake that you shouldn’t make. Consult a doctor experienced in neck and back injuries. You may also wish to contact an experienced personal injury lawyer for an initial consultation at no cost to you.
1. Arthur C. Croft & Michael D. Freeman, Correlating Crash Severity with Injury Risk, Injury Severity, and Long-Term Symptoms in Low Velocity Motor Vehicle Collisions, 11 Med. Sci. Monitor 316, 317 (2005) [hereinafter Correlating Crash Severity].
2. Vert Mooney, MD, Understanding Whiplash Injury and Maximizing Recovery, 14 J. Musculoskeletal Med 71, 71 (1997).
3. M. Panjabi, et al., Cervical Spine Curvature During Simulated Whiplash, 19 J. Clin. Biomechanics 8 (2004).
4. Correlating Crash Severity, supra n.1, at 320 (2005).
5. Cedars-Sinai, Facet Joint Syndrome
6. Lawrence S. Nordhoff, Jr., Motor Vehicle Collision Injuries: Biomechanics, Diagnosis, and Management 175.
7. Jerome Schofferman, MD, Nikolai Bogduk, MD, & Paul Slosar, MD, Chronic-Whiplash and Whiplash-Associated Disorders: An Evidence-Based Approach, 15 J. Am. Academy of Orthopaedic Surgeons 596, 596 (2007).
8. Laxmaiah Manchikanti, MD, Influence of Psychological Variables on the Diagnosis of Facet Joint Involvement in Chronic Spinal Pain, 11 Pain Physician 145, 145 (2008).