Texas is a big State with hundreds of thousands of miles of roadways. It is no mystery, then, that thousands of auto accidents happen every day across our state. Thankfully, most of these accidents are minor fender benders and many of these do not cause any injuries whatsoever. I will discuss major accidents, involving death or serious injury, at another date. Today, I want to focus on the most common injuries – those that do not result in broken bones but are painful none-the-less. These usually involve sprains, strains, stiffness and soreness and are referred to as soft tissue injuries.
In this article you will learn
- What is meant by the term soft tissue
- How car wrecks cause soft tissue injuries
- How soft tissue injuries affect your body
- Diagnostics commonly given to patients with soft tissue injuries
- Common medical treatment for soft tissue injuries
- Why soft tissue injuries are hard to prove
- Ways your attorney can help you if you have suffered a soft tissue injury
What is soft tissue? When we refer to the body’s soft tissue, we are usually speaking of muscles, ligaments, tendons, and fascia – the connective tissue that surrounds and holds the muscles, tendons, ligaments, blood vessels, and organs. Soft tissue cannot be seen on an x-ray.
How do soft tissue injuries occur in a car wreck? In almost any type of car wreck, the occupant’s body is whipsawed back and forth at a very fast rate. As this is happening, the body’s soft tissue can be stretched beyond its capacity and can result in microscopic tears which cause pain, stiffness, and disability. Within a day or two after a wreck, you can expect to also have some swelling in the affected areas. If you’re lucky, and especially if you are young, all your symptoms will go away within a week or two. For the average adult, however, medical intervention will probably be necessary. (For more detailed information on treatment of these injuries, please refer to my article on Whiplash Injuries.)
How is your body affected by a soft tissue injury? Typically, people in car wrecks complain of pain to their necks and backs. Sometimes, people will complain of pain to their knees, shoulders, ankles, or feet. The pain usually also involves swelling and stiffness. With the stiffness comes restrictions on your ability to move. Because of the pain and stiffness, it may be difficult for you to perform your acts of daily living, such as getting dressed, cooking, cleaning, bathing, caring for your children, and doing other chores around the house. If your work involves prolonged sitting you may not be able to work, at least not without a lot of breaks for stretching and moving around. If your work involves physical labor, you may not be able to work at all, or you may have to get help from a co-worker with anything that involves bending, lifting or climbing.
What are some common diagnostic tests in soft tissue injuries? Even though soft tissue injuries cannot be seen on x-ray, doctors will none-the-less order x-rays in order to rule out broken bones. If symptoms persist for more than a month or so, doctors will typically order an MRI if the pain is to the back or a joint such as a knee or shoulder. If it is the neck that is symptomatic, the preferred diagnostic is a CT scan. If the symptoms involve a wrist, hand, or elbow an electromyography (EMG) and nerve conduction study will be ordered to determine whether and where nerves are being impinged.
What kinds of medical treatment is typical for soft tissue injuries? Immediately after a car wreck, treatment usually consists of over-the-counter medications like Tylenol or Advil, and applied heat and ice to the affected areas. As symptoms persist, treatment will include prescription medications such as muscle relaxers, anti-inflammatories, and pain relievers. Chiropractic or physical therapy treatment is almost always a part of the treatment regimen, and will usually consist of electrical stimulation, massage, heat packs, cold packs, and stretching exercises. In persistent back pain cases, doctors may also perform injections into the spine called epidural spinal injections (ESI’s). Severe neck or back injuries may require surgery. Surgery may also be necessary in cases involving knees, shoulders, elbows, wrists, hands and fingers.
Why are soft tissue injury cases hard to prove? For purposes of this discussion, I am excluding herniated discs, which of course can be identified through MRI’s or CT scans. I am also excluding nerve impingements and tears to tendons, ligaments and muscles. These can be identified through EMG’s/nerve conduction studies and MRI’s. When it comes to other soft tissue injuries, there is no scientific test to prove them. There are no diagnostics that can confirm the presence of pain, swelling, and stiffness. In fact, it would be fairly easy for someone to falsify symptoms of pain, swelling, and stiffness. It is also not lost on the adjuster that a car wreck victim has a financial incentive to over-state or even completely lie about his pain and stiffness. The only evidence of his injury will be his testimony and, through his medical records, the complaints of pain and stiffness he made to his doctors. This evidence will be much more credible if the car wreck resulted in heavy damage to the vehicle. In cases where the car wreck has caused little property damage, it is almost impossible to prove soft tissue injuries. Ultimately, though, it will be up to a jury to determine whether a victim’s complaints of pain and suffering are credible after considering all of the evidence.
How an attorney can help you on a soft tissue injury case: There are, of course, obvious advantages the attorney has that you do not. The attorney knows the statutory law and latest case law. He is a professional who handles your type of case for a living. He knows the different insurance companies and adjusters as well as their tendencies. He has in his arsenal tried and true tactics for getting maximum value out of each case. He knows what will improve the value of your case and what will diminish it. He knows how to read medical records and how to pick out the most important information out of them. He knows the best doctors for each injury. He has a good idea, based on experience and jury reports, how a jury will value your case. And he knows how to try a lawsuit if the case cannot settle.
The attorney who practices personal injury law reads hundreds of pages of medical records every week. If you have ever read your own medical records, x-ray reports, or MRI reports, you know how hard it is to make sense out of them, mostly because you do not know what those medical terms mean. The attorney, however, has studied those terms, has discussed them with doctors, and knows exactly what they describe.
Aside from relying on his knowledge and expertise, a good attorney can start laying the groundwork early on so that your pain and disability will be properly documented. He will make sure your treatment will make sense to the adjuster and make sure there are no long gaps in treatment, which the adjuster will interpret as you not being in pain. He will keep a close eye on the medical records to spot the need for any medical experts or diagnostics that would not only help you heal faster, but document your pain and suffering better. He will have regular conversations with you about your symptoms and what the doctor is telling you and prescribing for you. He will document with photographic evidence any bruising or scarring, as well as the severity of damage to your vehicle to support the fact that the impact was severe enough to support your complaints of pain and suffering.
A good attorney will study the doctors’ records and diagnostic reports to see if the doctors may have missed something. This actually happens more than you think. As an example, one of my clients had broken glass removed from her forehead at the emergency room the day of the accident. A year later, she complained to me that she could still feel some knots on her forehead and that these knots were painful. I asked her to go back to her doctor and tell him what she had told me. When I checked with her afterward, she informed me that the doctor told her that the knots and pain was normal. I assured her it was NOT normal and referred her to a plastic surgeon who upon palpating her forehead confirmed that she still had pieces of glass under her skin. He removed them and I had one happy client whose case got even better because of the plastic surgeon’s report.
If you have been in a car wreck and have symptoms of soft tissue injury, give me a call and let me answer your questions and explain your options to you. I have handled thousands of cases just like yours.