-By Andrew Cash, M.D.
According to the National Safety Council, 4.6 million people were seriously injured in car accidents in 2016. While some injuries can be minor and heal relatively quickly, other injuries, even following minor auto accidents, can cause severe injuries. Injuries can occur as prevalent in slow speed accidents as they do in high speed accidents.
Regardless of the injuries and the number of affected body parts, symptoms are not necessarily felt immediately following the accident. With that said, it’s important ALL symptoms are addressed-whether minor or severe. It is important to understand the common injuries associated with auto accidents and the recommended treatment.
The most common injuries following car accidents are in the neck and back regions. Neck and back injuries tend to result from damage to muscles, tendons, ligaments, discs, joints and bones.
Some symptoms can include:
• Pain in the neck, back, head, shoulders;
• Radiating pain, numbness, and tingling;
• Pain that worsens with activity;
• Difficulty focusing, migraines, headaches and dizziness;
• Numbness, prickling, burning, tingling;
• Restricted range of motion;
• Inability to lift something or difficulty walking, sitting, reaching;
• Bump or deformity near injury; and/or
• Redness, bruising, inflammation or swelling.
Most commonly in rear-end collisions are whiplash related injuries. Whiplash occurs when the head and neck are thrown forward and back (or side to side) with force. This can cause damage to the muscles, ligaments and tendons of the neck.
Whiplash symptoms can include:
• Neck pain and stiffness;
• Worsening of pain with neck movement;
• Loss of range of motion in the neck;
• Headaches, most often starting at the base of the skull;
• Tenderness or pain in the shoulder, upper back or arms;
• Tingling or numbness in the arms;
• Blurred vision;
• Ringing in the ears (tinnitus);
• Sleep disturbances;
• Difficulty concentrating;
• Memory problems;
• Depression; and/or
Your doctor will ask questions about what happened, frequency of pain, severity of the pain and what makes your symptoms better or worse. Your doctor may also ask about how your symptoms are affecting your daily life.
A typical exam may include:
• Your doctor moving your head and neck, to check for range of motion in your neck and shoulders;
• Examining which motion causes pain or an increase in pain;
• Targeting any tenderness in the neck, shoulders or back; and
• Checking your reflexes, strength and the sensation in your limbs.
Imaging may be used to show or rule out some conditions. You can anticipate your doctor requesting one or more of the following imaging tests:
• X-rays: Particularly of the neck;
• CT: This special type of X-ray can produce cross-sectional images of bone and show possible bone damage; and/or
• MRI: This imaging test uses radio waves and a magnetic field to produce detailed 3-D images. In addition to bone injuries, MRI scans can detect some soft tissue injuries, such as damage to the spinal cord, disks or ligaments.
In some instances, the force of an accident can lead to broken bones. A common spinal fracture is known as a compression fracture. A compression fracture is a crack in the vertebrae that can lead to a collapse of the vertebrae. Spinal fracture can be extremely painful, cause numbness, muscle weakness and pain when sitting or walking. Depending on the severity of the fracture, the treatment may vary from rest and minimal movement to surgery.
Common symptoms of vertebral fractures typically include one or a combination of symptoms:
• Sudden onset of back pain;
• Standing or walking will usually make the pain worse;
• Lying on one’s back makes the pain less intense;
• Limited spinal mobility;
• Height loss; and/or
• Deformity and disability.
Questions your doctor may ask during an exam to diagnose a spinal fracture are:
• When did the pain start?
• Was it sudden or gradual?
• Where is the pain?
• What is the intensity of the pain?
• What activities or positions tend to make the pain feel better or worse?
• Does the pain radiate down the leg or arm or to other parts of the body?
Treatment for Spinal Fractures
Treatment for a spinal fracture may include conservative care such as rest, pain medication, use of heat or ice for local pain, and limitation of activities until the pain subsides. Braces help maintain spinal alignment and immobilize the spine during healing.
They also help control pain by limiting movement. Some fractures may only need a brace, such as a rigid collar for the neck or a lumbar brace for the lower back. A brace is usually used for 8 to 12 weeks. Some neck fractures or dislocations may require traction for the spine to return to its correct position.
Surgery may also be a recommended option. The two most common types of surgery for a compression fracture are vertebroplasty and kyphoplasty. Both can help relieve pain and help the fracture heal.
Vertebroplasty is a minimally invasive treatment designed to help reduce or eliminate pain caused by a fractured vertebra and stabilize the bone. A low viscosity polymer is injected directly into the collapsed vertebral body under high pressure, with the goal of stabilizing the fracture and relieving the associated back pain.
Kyphoplasty is similar to vertebroplasty. Kyphoplasty is a minimally invasive procedure designed to reduce or stop the pain caused by a spinal fracture, to stabilize the bone, and to restore some or all of the lost vertebral body height that can result from the fracture.
Torn, slipped, ruptured, herniated and bulging discs can press against nearby spinal nerves. Discs cushion the vertebrae in the spine. In an accident, discs can sustain injuries because of the force exerted on them. A herniated disc happens when the soft, gelatinous center of a spinal disc pushes the fibrous outside casing of the disc. The force of an accident can also cause the discs to shift. This can be described as a bulging, herniated, protruded, or extruded disc. These injuries can result in nerve compression resulting in pain, numbness and/or weakness in the neck, arms, legs or back.
Disc Injuries are diagnosed with imaging and many are usually treated conservatively. Doctors often address pain relief and physical and/or chiropractic therapy will be incorporated. A combination of conservative treatment options can be used to ease discomfort and pain. Therapy, exercise and gentle stretching can help relieve pressure on the nerve root. Ice and heat therapy are common for pain relief as are chiropractic adjustments. These conservative therapies are generally used through at least the first 6 weeks. In some cases, surgery may be used to treat the injury if the disc injury is severe and is causing related symptoms of numbness, weakness or interfering with normal activities.
In many cases, the surgeon removes only the protruding portion of the disk. Usually making a small hole and using a microscope for the discectomy. Another option might be an artificial disc replacement. A third common option is a fusion which grows two or more bones together while being rigidly held with screws and rods.
Vertebra can slip or move abnormally relative to the vertebra beside it. If the vertebra slips too far, it may press on nerves and cause severe back pain or nerve crowding that produces leg pain or numbness. Initial treatment may include rest and medication. Severe spondylolisthesis may require surgery.
Some symptoms include:
• persistent lower back pain;
• stiffness in your back and legs;
• lower back tenderness; and
• leg pain, numbness, weakness.
The treatment for spondylolisthesis depends on the severity of pain and vertebra slippage.
Common nonsurgical treatment methods include:
• wearing a back brace;
• doing exercises;
• taking over-the-counter or prescription anti-inflammatory drugs (such as ibuprofen) to reduce pain; and
• using epidural steroid injections.
Surgical correction of the misplaced vertebra is required when the patient doesn’t respond to nonsurgical therapies. Surgery might be required if the bones of your spine are pressing on your nerves. To ensure that your back or neck injury heals as quickly as possible, early diagnosis and treatment preferred.