The Lack of Relationship Between Degenerative Changes in the Cervical Spine and Pain/Disability
By Richard H. Adler
September 13, 2003
Insurers and their medical examiners often attempt to link pre traumatic spinal degeneration and patient symptoms after a traumatic injury as a way to deflect their responsibility for the injuries following an automobile, bicycle, trip and fall or pedestrian trauma. Recently, however, a study published in Spine, “A Cross-Sectional Study Correlating Degeneration of the Cervical Spine with Disability and Pain in United Kingdom Patients,”1 refuted that connection. The focus of this study, as described by the authors:
“…… was designed to investigate the relation between degenerative changes in all joints of the cervical spine as well as pain and disability. The link between pain and disability levels and impending litigation was also studied.”
Radiographic and questionnaire data from 180 consecutive patients with neck pain was collected. The questionnaires asked about chronicity, etiology and any litigation associated with the injury causing incident.. The radiographs were evaluated for the number of levels of degeneration and the severity of degeneration in the disc as well as the uncovertebral and facet articulations.
In this study, 71 patients or 40.57% reported neck pain as a result of traumatic injury. However, only 5.1% of them had associated litigation. The authors found there was no statistically significant differences in pain severity or disability levels between the patients with and without pre traumatic injury cervical degeneration. Additionally, according to the findings, the number of cervical levels with degeneration and the severity of degeneration in the discs, facets and uncovertebral joints were not related to the levels of pain and disability.
The authors summarize and discuss their study by stating:
“Patients with neck pain resulting from trauma report significantly more pain and disability then patients with neck pain who have no trauma history. However, trauma patient do not have more degeneration in their cervical spines. Because so few patients in this studies were involved in litigation related to the trauma episodes, impending litigation was not a factor in the higher pain and disability levels. The increased symptoms most likely reflect soft-tissue injury. The presence of degenerative changes in the cervical spine of trauma patients should not be regarded as causing or contributing to the levels of pain and disability reported.”
All too often in the personal injury claim context, insurance companies and their medical examiners will point to any degenerative changes in the spine as the actual pain generators for the injured party’s symptoms. This study provides an important resource for care providers and personal injury attorneys to use in refuting the assertion of a link between spinal degeneration and post trauma patient symptoms arises.
It is important in these situations that the injured person consult with, and if necessary obtain representation by experienced personal injury attorneys like those at Adler Giersch ps to ensure they receive full and fair recovery. Free consultations are available throughout Washington State with Adler Giersch ps attorneys by telephone or our offices in Seattle, Bellevue, Everett and Kent.
1Peterson, et al, Spine 2003. Volume 28 pages 129-133