SOFT TISSUE INJURIES AFTER A CAR ACCIDENT

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Until recently, the term-of-art used to describe soft-tissue injury received in rear-end car accidents was “whiplash.” This term is now considered extremely controversial in medical and legal circles. The term is not of medical origin; nor is it yet considered a proper medical diagnosis. Those who condemn use of the term “whiplash” believe that the average layperson believes that when it is used a physician has overtreated, a client is feigning, and allegations of pain and severity of injury are exaggerated, when in fact there is a real injury and a real claim. The term “hyperextension/hyperflexion injury” can be used to accurately describe the injury received in a rear-end collision.

A hyperextension/hyperflexion injury from a car accident may produce musculoligamentary limitation which locally produces pain but which usually disappears in weeks or months. If “operant mechanisms” are in play, the complaints of pain may persist without local, objective findings of pathology.

A patient’s prior conditioning (the sum of his or her life experience) sets the stage for the subconscious to generate impulses to fulfill psychological needs. The same trauma may produce a ruptured disc whose presence may cause pressure on nerve roots, which in turn will cause pain until the disc is surgically removed.  A proper demonstration of the mechanisms of the hyperextension/hyperflexion injury establishes a strong foundation for claims of injury to muscles, ligaments, nerves, and vertebral bodies in the neck.

Serious consequences can flow from soft-tissue injuries. Cerebral concussion, fracture of part of the bony structure or cartilage in the cervical area, protrusions or herniations of intervertebral discs, and aggravation of pre-existing degenerative condition in the vertebral structures are common examples. Medical research now recognizes that soft-tissue injuries can be very disabling—even when the rear-end impact is minimal.

Soft-tissue injuries can result in permanent problems. In one study, 45% of the patients who had traditional medical care, including a referral to a specialist, continued to have symptoms two years after their cases had been legally resolved. In another study, 12% of the patients having had hyperextension/hyperflexion trauma continued to be significantly disabled several years after the injury. There is radiographic evidence indicating that a whiplash victim is about 6½ times more likely than the general population to develop degenerative disc disease in the seven-year period following injury.

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