Chapter Two Truck Crash Injuries Are Serious and Require Proper Medical Care
Truck crash injuries can be devastating and life-altering. If the wreck doesn’t kill the victim, it often leaves him or her with severe injuries that can persist for the rest of their lives. People have challenges in navigating the medical side of their crash – they may not have health insurance, may never have experience treating injuries like this, not know how much treatment to get with what kind of doctors, and may not know when to decide more treatment will not help and they should surrender to the chronic and permanent nature of their injury. Unfortunately, many truck accident victims will experience permanent pain and suffering and life-long medical conditions and disabilities that will continue long after their legal case is concluded. (But remember, the law is designed to accommodate that).
If you are acutely injured after a truck crash, ask to be taken by an ambulance to a medical provider. If you are hurt but do not think it is bad enough for an ambulance, tell the other driver and the police officer you are injured but do not want an ambulance. If this is an accident where you think you are fine, and you walk/drive away but have pain later, get immediate medical attention. Very often, we encounter people who deny or refuse medical attention at the scene of the accident, but hours later or the next morning they are in severe pain. If that occurs, do not worry that you did not get medical attention at the scene. Rather, go to an emergency room; call your primary care physician and get treatment; go to urgent care; or go to a local chiropractor versed in acute auto care.
Assess your level of pain and symptoms you are experiencing and make the best decision you can about seeking appropriate care. Very often your primary care physician knows you and can adequately handle your claim. Urgent care facilities now provide rapid, quality care and can quickly see you for an evaluation, x-rays, and prescriptions. If you are in acute pain or none of those options are available, go to an emergency room. Many times, physicians at all of these types of locations will order x-rays, prescribe an anti-inflammatory, and recommend follow up treatment if the symptoms persist. Sometimes they will prescribe a pain reliever or a muscle relaxer.
When you get medical care, provide a clear concise history of the accident: “I was rear-ended and thrown around in the vehicle,” “the other driver ran a red light and hit the side of my car” or “the truck swerved into my lane and hit the front passenger side of my car which made my truck spin.” Tell them the symptoms you had and when they started, i.e., right after the wreck. Make sure you advise the doctor of all your symptoms. The broken leg may be really hurting, but the sore neck and numbness in the arm is important too – and may be a more serious injury. Advise how the pain changed and how it may get worse and better with activity. Explain what you can and cannot do because of the injury.
Fill all prescriptions and get the necessary medication you need to get better. Then, after your first visit, follow up with additional medical care if you need it. If your primary care doctor or another physician orders you to go have physical therapy, do it. If they are unsure about recommending a physical therapist or a chiropractor, rest assured that chiropractic physicians are capable medical professionals and have many unique abilities to treat people after truck accident crashes – do not be afraid to use them. Continue to consult with your primary care physician about the course of your medical treatment. If your care is not being monitored by a primary care physician, or an internist, consult with the chiropractor or physical therapist about what you should do next. If you are not getting relief from physical therapy, you may need to see an orthopedic, neurologist, or another specialist. If you are not getting relief from chiropractic care, you may need an MRI or other type of test to see if there are soft tissue problems.
Many times, trucking accidents cause injuries to the intervertebral discs between our spine vertebrae. This can occur in the neck, mid, or low back areas. MRI and CT scans detect these injuries well. Many times, orthopedic surgeons will follow up care and treat a person conservatively. They may order strengthening exercises and other things to try to ameliorate the symptoms from a soft tissue and/or herniated disc injury. Sometimes an injection or other intervention by a pain specialist is necessary to control the pain. Surgery is usually the last option when the pain is unbearable or life activities need to be resumed. Many people get permanent relief from constant pain with surgery. This can be life-changing and can enable folks to go back to work and enjoy life again. Most people need to work and take care of their families, and unfortunately, sometimes surgeries are only a last resort to assist in their return to normalcy.
Remember, do not minimize your injuries to your doctor. Tell the nurse and doctor everything that is wrong with you and try to be consistent in describing your pain and physical problems. Do not think you are too tough to go to additional specialists or have further diagnostic treatment. This is your one and only chance to recover from the negligence of what the other driver inflicted on you, and you want to ensure that you know the full extent of your injuries and the medical treatment necessary to remedy them. Males can tend to want to be tough and not express the extent of their pain, while women sometimes do not want to be a bother and want to take care of others so they downplay their injuries.
One of the most prevalent injuries I see my truck crash clients suffer from is back and neck injuries. These injuries can range from minor neck pain to dislocated spinal discs. Neck and back injuries often keep victims out of work and result in lost wages.
Anatomy of Neck and Back
Our necks and backs consist of bones, nerves, muscles, ligaments, and tendons. Our spine spans from the length of our neck to our lower back and is broken down into sections: the cervical spine, thoracic spine, lumbar spine, sacrum (or sacral region), and the coccyx (or tailbone). The spinal cord is the highway that allows our message center (the brain) to communicate and control the rest of the body. Any interference or irritation wreaks havoc on our ability to function normally and can be a significant source of pain.
- Cervical Spine
- The cervical spine consists of the cervical vertebrae with cervical discs in between. It supports the head and provides the flexibility you need to turn your neck from side to side and to rock it from front to back. The cervical discs, composed of collagen and ligaments, carry the bulk of the workload by acting as shock absorbers between the cervical vertebrae, holding the vertebrae together and allowing for the movement of the neck. This area of the spine also provides the path for blood flow to the brain. When you hear about C1, C2, C3, C4, C5, C6, and C7, you are hearing about the area known as the cervical spine.
Trauma to the cervical spine and nerves can result in pain, numbness, tingling, or the functional loss of the diaphragm, shoulders, biceps, arms, wrists, hands, and fingers.
- Thoracic Spine
- The thoracic spine consists of twelve vertebrae that hold the body upright and, combined with our rib cages, protects the vital organs located in the chest. The thoracic discs are thinner in the thoracic spine, causing this area of the spine to have limited flexibility. The spinal canal is at its smallest in this area of the back, making the spinal cord more vulnerable to damage if the thoracic spine is injured. The vertebrae T1, T2, T3, T4, T5, T6, T7, T8, T9, T10, T11, and T12 are positioned in this area of the spine.
Trauma to the thoracic spine can cause upper back pain and nerve injuries that affect the shoulders. Other muscles compensate for injuries to this area of the spine, causing pain to resonate throughout the upper body.
- Lumbar Spine
- The lumbar spine consists of five intervertebral segments in the lower back and provides the power and flexibility necessary to lift, twist, and bend. The vertebrae in the lumbar spine are connected to the back of the spine by facet joints. These joints allow for flexibility in the lower back. Nerve roots branch out and continue down all the way to the feet after the spinal column ends between the thoracic and lumbar spine. Because this section of the spine bears the most weight and provides the most flexibility, it is more vulnerable to injury. The vertebrae L1, L2, L3, L4, and L5 are located in this area of the spine. Trauma to the lumbar spine can cause pain, tingling, and loss of range of motion in the lower back, legs, ankles, feet, and toes. This area of the spine is also most prone to disc herniation and spondylolisthesis. A herniated disc occurs when the gel-like inner core of the intervertebral disc leaks out and puts direct pressure on the nerves that run through the spine, also referred to as nerve impingement. Spondylolisthesis occurs when a vertebra slips over the one below it causing compression on the nerve root.
- The sacrum consists of five segments of fused bone and is located between the lumbar spine and the tailbone. This region supports the back of the pelvis and forms the sacroiliac joints at the hip bone. The sacral nerves and blood vessels run through this area of the spine. Since it is fairly stable, most pain that arises from trauma to this region occurs where the lumbar spine connects to the sacral region.
- The coccyx or tailbone consists of four fused vertebrae and is located at the base of the spine at the bottom of the sacrum. This part of the spine serves as the shock absorber for your back when you are in a sitting position.
- Treatment Options
- Most physicians, chiropractors, and physiatrists like to initially recommend conservative treatment when an injury occurs to the neck or back. Most injuries get better within six weeks and typically require conservative measures like physical therapy and anti-inflammatory medications.
Epidural steroid injections are considered a more aggressive form of treatment. Steroids do not heal the back but provide enough relief from inflammation to allow the back to heal.
If neck and back pain is not relieved with conservative measures, your doctor may refer you to an orthopedic spine surgeon or neuro spine surgeon for an evaluation of surgical options. Common neck and back surgeries include fusion surgery, vertebroplasty, laminectomy, and microdiscectomy. Surgical options can be minimally invasive, but some surgeries are more extensive and require more of the surgical site to be exposed. The decision to move forward with surgery is entirely elective because of the invasive nature of the treatment and the inability to guarantee results. Some people who undergo a surgical procedure may require additional surgeries in the future. Discuss the success rates of your recommended procedure with your doctor.
Head injuries are also common among my truck crash clients. Head trauma can result in an injury to the brain, such as a concussion. Concussions can manifest in symptoms such as nausea, confusion, vision problems and cognitive issues such as slow word recall. Brain injuries are not always obvious at first and can occur even without direct trauma to the head from whiplash or rapid acceleration or deceleration. Unfortunately, head injuries can be tragic and some people never fully recover from them.
Some other common injuries I see my clients suffer from include fractures and broken bones, internal damage to organs, lacerations, and cuts, seatbelt injuries such as whiplash and burns, spinal cord injuries and paralysis. Regardless of the injury, it is important that a truck crash victim receive proper medical attention.