Tuesday, March 22, 2011

On Car Crashes and Chronic Pain

A new study in the March 21st issue of the journal, Arthritis Care & Research found that people in car wrecks have an 84% increased risk of developing new onset chronic pain.

The study was done at the University of Aberdeen in Scotland, UK. The researchers reviewed over 2,000 patients who suffered from chronic pain. Out of these, 241 patients had new onset of chronic widespread pain after certain events such as trauma, hospitalization, surgery, etc.

What the study found was that those who said they had been in a car wreck had an 84 % increased chance of developing chronic pain--that is they didn't have chronic pain before the car wreck.

Unfortunately, the authors seem a little confounded. Many doctors will attribute this finding to a pre-existing physical or mental predisposition. Often, these poor patients will be dismissed as trying to game the system and trying to get a large insurance settlement from personal injury tort lawsuits.

However, I see these patients all the time. Most commonly, they have undiagnosed fractures. They have a fracture that is mistaken as a normal variant, just because it doesn't 'light up' on MRI. They have all of the other obvious clinical features, such as midline and/or radiating pain, pain worse with standing or lifting, and tenderness to palpation of the spinous process at the involved vertebrae.

What's more is these patients are often on narcotics. The doctors they have seen before have said that there is nothing that can be done. I hear that from patients so many times that it makes me angry. I just don't understand why other doctors insist on ignoring these clinically obvious fractures and choose to sentence their patients to a lifetime of narcotics which don't help. Often, this choice to do nothing leads to unnecessary loss of productivity and income, but also robs the patients of enjoying life.

Years ago, there was nothing that could be done for fractures. I understand why people have been suffering for years from a car wreck 20 years ago. However, now there are effective, non-operative, solutions for fractures that are effective in up to 95% of patients with back pain.

So, if your doctor has told you or a loved one that there is nothing that can be done, especially if you've been in a car wreck, please--get a second opinion. As an expert, board-certified radiologist, I am available to review films and do this for patients outside of Oklahoma.

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