A segment of my practice deals with treating acutely injury patients suffering from whiplash, concussions, headaches, neck pain and back pain. I often see these types of injuries resulting from auto accidents (properly referred to as motor vehicle collisions) in Baltimore.
Many people think that if they are injured in a non-fault car accident that the adverse (other person’s) insurance company will deal with them fairly and give them access to needed chiropractic and medical care. Often, it is a real fight for injured clients to get the care they need. One tactic that insurance companies and claims adjustors use is the “pre-existing condition” arugment. They state that the pain that a patient has is due to a condition that they already had before their car accident, and that as such, the insurance company should not have to pay for care.
A pre-existing condition can be “active” in that the patient was already having a complaint which was worsened as a result of the car accident (i.e. lower back pain that was present 2x/week at a 3/10 which is now daily at a 7/10) or it can be “inactive” such as a prior resolved lower back injury resulting from a car accident three years ago.
When taking a history of patients involved in a car accident in Baltimore I attempt to “tease out” old injuries from new and so that I can properly apportion any pre-existing complaints. Many doctors do not take the time to do this, as they rush to see patients. What patient’s often do not realize is that if a proper honest history isn’t in a doctor’s report that it WILL BE USED AGAINST YOU!
Most claims adjustors and insurance companies read through your medical records with a fine toothed comb looking for anything they can claim might be a reason why you were a) not injured in this car accident or b) if you were injured, you were already injured from a pre-existing condition or c) you were injured unrelated to this car accident.
Dr. Art Croft in his book “Whiplash and Mild Traumatic Brain Injuries: A Guide for Patients and Practitioners” sheds some light on the pre-existing condition tactics used by insurance companies (page 102):
“Disc disease and spondylosis (spinal degeneration) are part of the normal aging process, like wrinkles, sagging flesh, gray hair, and age lines. About 50% of all people will have radiologically demonstrable spondylosis by their mid-30s and about 85% will have them by the time they are in their 50s. This condition is quite common, being found at autopsy in more than 80% of persons by the age of 50 years. Since it can not be said that 80% of persons over the age of 50 have chronic spinal pain, it provides no valid probative evidence of pre-existing symptoms in a forensic setting. Most people with moderate degenerative disease, in fact, do not have spinal pain.”
What Dr. Croft is saying is that while it is true that spinal degeneration becomes more likely as we age, most people with this condition do not have pain. Therefore, it is safe to conclude that pre-existing spinal degeneration (spondylosis) is NOT the cause of spinal pain following a car accident. This is an extremely important statement and one that needs to be understood by treating Chiropractors and other professionals involved in the rehabilitation of spinal injuries following car accidents in Baltimore.
My best advice to patients involved in a car accident in Baltimore is be honest. If you are injured, say so. If you are not, say so. If you have prior injuries from other car accidents, say so. Insurance companies know more about you than you know about yourself. The more honest you are with your care providers the more likely you will be treated fairly by the adverse insurance company.
This question has plagued all of us, including researchers for a long time! Could it be because we’re all inherently lazy and don’t exercise enough? Or maybe it’s because we have a job that’s too demanding on our back? To properly address this question, here are some interesting facts:
1. The prevalence of low back pain (LBP) is common, as 70-85% of ALL PEOPLE have back pain that requires treatment of some sort at some time in life.
2. On a yearly basis, the annual prevalence of back pain averages 30% and once you have back pain, the likelihood of recurrence is high.
3. Back pain is the most common cause of activity limitation in people less than 45 years of age.
4. Back pain is the 2nd most frequent reason for physician visits, the 5th ranking reason for hospital admissions, and is the 3rd most common cause for surgical procedures.
5. About 2% of the US workforce receives compensation for back injuries annually.
6. Similar statistics exist for other countries, including the UK and Sweden.
So, what are the common links as to why back pain is so common? One reason has to do with the biomechanics of the bipedal being – that is, the two legged animal. When compared to the 4-legged species, the vertically loaded spine carries more weight in the low back, shows disk and joint deterioration and/or arthritis much sooner, and we overload the back more frequently because, well, we can! We have 2 free arms to lift and carry items that often weigh way too much for our back to be able to safely handle. We also lift and carry using poor technique. Another reason is anatomical as the blood supply to our disks is poor at best, and becomes virtually non-existent after age 30. That makes healing of disk tears or cracks nearly impossible. Risk factors for increased back injury include heavy manual lifting requirements, poor or low control of the work environment, and prior incidence of low back pain.
Other risk factors include psychosocial issues such as fear of injury, beliefs that pain means one should not work, beliefs that treatment or time will not help resolve a back episode, the inability to control the condition, high anxiety and/or depression levels, and more. Because there are so many reasons back problems exist, since the early 1990’s, it has been strongly encouraged that we as health care providers utilize a “biopsychosocial model” of managing those suffering with low back pain, which requires not only treatment but proper patient education putting to rest unnecessary fears about back pain.
As a Baltimore Chiropractor I routinely treat patients with back pain, both acute and chronic. If you, or someone you know, is experiencing back pain as a result of an auto accident, slip and fall, worker’s compensation injury, or just “waking up stiff”, please do not hesitate to contact Mid-Atlantic Spinal Rehab & Chiropractic or call us at (443) 842-5500. We would be glad to help!
The preceding was reproduced with the consent of Dr. Ben Altadonna and “The Practice Building Alliance.”
BY: Mid-Atlantic Spinal Rehab
COMMENTS: No Comments
For more information or to schedule an appointment with our offices, contact us today!