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Catastrophic and Unusual Injuries

Many injuries are deemed soft tissue cases where there is a sprain or strain of the neck and back. These may involve stretching or tearing of ligaments or tendons in the injured areas. Often these type of injuries do heal well with appropriate treatment. Hot packs, cold pack, electrical stimulation, massages, manipulations, stretching exercises, aq1au therapy are some of the modalities often used. However not all persons are alike. We all heal different and respond to different modalities of treatment. There simply is no one size fits all in terms of a treatment regimen. For example, women are more likely to be less muscular in the neck area as men. An accident involving a slight woman could be more serious for a tiny woman than it might be for a man. Similarly, age can be a complicating factor in the way people heal from traumatic injuries. A person’s prior medical history and whether there had been previous trauma to the same body parts could affect the healing process. There just are no two anatomies that are exact. It is a myth created by the insurance companies that there is one short course of therapy that should be given and no more.

In very serious or catastrophic injuries, physical therapy modalities could far exceed what might occur from a less serious accident. The nervous system for each person is very complicated and the slightest trauma could upset the delicate balance. An injury to an extremity, for example, could le3ad to a condition called reflex sympathetic dystrophy. This is an insidious traumatically induced disease that causes misfire in the central nervous system and can cause significant, debilitation body pain. If reflex sympathetic dystrophy comes on in full force, the injured party has virtually no relief and it becomes virtually full body pain. It is important for the treating doctor to be alert to the symptoms of this type of injury so that it is diagnosed early and the symptoms can be treated aggressively before the develop into a catastrophic injury. For example, in our office we had a case where a dock worker had a hand cart fall on his toe. It caused unbelievable pain. He went to a doctor immediately. The doctor apparently did not consider reflex sympathetic dystrophy as part of the differential diagnosis and did not treat him for that possibility. The client developed reflex sympathetic dystrophy. That case settled for a significant amount of money but the client would much rather have had his health then the residuals caused by this fierce disease process.

What might appear as a routine back injury can develop into a significant disc issue in the future. Physicians tell us that the supporting structures surrounding the spine weaken over time as a result of injury. Consequently a disc can herniate long after an accident and cause a very debilitating condition. Indeed, there is a term in medicine call a failed back syndrome. If one contract this injury, there is little that can be done for it. Even surgery with instrumentation does not cure the problem. That person has a lifetime of pain in front of him or her.

The brain is a very delicate, complicate organ. Any type of trauma can affect various parts of the brain. What appears to be a slight headache can turn into a serious concussion and in some cases brain damage. It may be important to send a client to a neurologist if lack of brain function becomes an issue. Having a baseline cognitive function test can be essential to protecting the client’s claims. A specialist will be far better to describe the symptoms to a jury than a primary care physician. There are many cases where brain injuries seem to be ignored to the client’s peril. If a client has nausea at the scene of an accident, vomits, becomes dizzy or unsteady a concussion must be part of a differential diagnosis to rule out. There really is not much therapy that can be performed on the brain so early detection, medication and other proper treatment modalities become very important. Any time the brain is involved in an accident, it must be treated as a serious injury until determined otherwise. If not, the consequences can be devastating for the client.

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