Back muscle injury after car long to heal?
December 27, 2013 7:44 AM   Subscribe

Hello all, I know YANMD, but I am curious about how to go about addressing my muscle gripes with a doctor.

I was rear-ended by an inattentive driver a month or so ago which somehow injured my back and neck. I went to the ER that day to have x-rays and no bones were damaged (supposedly) but I am worried something else might be up. At first I couldn't really sit for long periods of time without my back and neck "burning" intensely and feeling very weak, almost as if I couldn't hold myself up. The doctor at the ER gave me muscle relaxants and Advil and told me I would be fine in a week. They didn't give me any indication that I had any sort of muscle or nerve damage or even whiplash. I used to run regularly (and I was in peak physical shape at the time of the accident) so I decided to stop for a while to heal properly and eventually the daily burning and what not did fade away. After a month of no exercise, I decided to start running again last night and the burning flared up, albeit, not AS bad as it once was. Still, the fact that it is still bothering me is giving me pause. The doctor at the ER stated that I wouldn't injure myself further by running but that I might make myself "uncomfortable" which I suppose describes how I am feeling this morning. I can't QUITE even describe what this feels like other than a tingly, burning sensation and like my upper back is weak. Nothing sharp or debilitating, just "man this sucks." It also seems to be super tender around where my bra fastens...

I suppose my question is, if and when I do go to a doctor, how is a muscle injury diagnosed if not through x-rays? And how does it heal if it is diagnosed if not through decreased activity? Can I just slap some Icy Hot on it after a run and be done with it? I don't really trust doctors and I feel like the fellow in the ER just told me whatever and kicked me out the door once he saw my x-rays and realize my spine wasn't broken. I've never had this sort of injury, so I have no idea how to communicate my concerns with my doctor. Thanks for any input!
posted by Young Kullervo to Health & Fitness (7 answers total)
It's your neck and back, so yes, go to a doctor and describe your symptoms. You might want a neuro work-up and the doc might recommend and MRI if your symptoms warrant it. Or they might send you for physical therapy and/or give you some more drugs to help.

If it were me, I would go to a doctor and say, "I think I might have whiplash. What do you think?" And ask if there is any permanent damage, is it safe to exercise, signs to look for, and how long it could take to recover (a month is a short period of time if it is whiplash).

IANAD but I have had whiplash from a car accident before. Go see one.
posted by Marie Mon Dieu at 8:05 AM on December 27, 2013

Most muscle injuries are diagnosed anecdotally, and it's nearly impossible to diagnose for several weeks to determine whether the damage is longer-term. Why don't you go see a regular doctor and tell him your back hurts and how and see about getting some physical therapy?

Icy Hot is not a treatment. Ice is, along with targeted exercises/stretching and some PTs like electrostimulation. Therapeutic massage might be useful.

Try not to be so hard on the ER doctor, whiplash and soft tissue damage are not really their specialties. Your GP probably isn't a specialist either, but can refer you to someone who is.

After I was rear-ended, I was only insured for a few (not very good) PT appointments and it was about 7 years before I recovered from the resulting sciatica that set in about 6 weeks later. So definitely try to find someone before you just start running with back pain. Maybe you just need to ramp back up, but maybe you need treatment or bracing first.
posted by Lyn Never at 8:09 AM on December 27, 2013 [4 favorites]

I think it is called Soft Tissue Damage.

When this happened to me, I had about 6 months of massage, physical therapy, and acupuncture because I was a professional chef at the time and treatment was really really important.

This is an insurance claim. You (ideally) should get an accident attorney to negotiate with the other driver's insurance company especially if you signed any releases. Your treatment (and any pain/suffering/medical expenses/loss of income from missed work) is covered by the other guy's insurance. The attorney works on contingency upfront, and then takes a small percentage of the final settlement.

When this happened to me, the BEST advice I followed was to get an "ambulance chaser" type lawyer.

The system is rigged against you and you NEED regular medical care from the accident. The attorney makes sure you get therapies as long as you need them.

I had a slight tinge in my shoulder for a year or two after the accident once in a blue blue moon, and eventually it totally passed. If I had not gotten PT, massage, and acupuncture for about 6 months after the accident, I'd probably have regular chronic pain flare-ups.

If you have regular health insurance with low co-pays, you may want to pay for this that way, but ideally, this is what auto insurance is for.

Good luck.
posted by jbenben at 8:49 AM on December 27, 2013 [2 favorites]

After I was rear-ended, I was in pain, and went to PT and all that jazz. One day I was exercising and I felt/heard a 'pop' and suddenly OW! Turns out I had bulging disks, that ruptured. Then one of the pieces of the disk came to rest on my sciatic nerve. DOUBLE OW!

The point of this is to get you to a doctor and to have an MRI. An MRI will show if there is any disk damage. Disks can cause pain pretty predictibly.

Your doctor is supposing muscle injury, but without an MRI, it's a guess. Get an MRI and get a lawyer. A scary, one, with imposing letterhead. Because this could get serious and you need to be compensated.

Save all of your medical stuff so far, settlements are typically your medical bills * 5, based on how serious the injury is.

The shitty thing about back injuries, is that you think you're going to be okay and things can get worse.

Treat this seriously.
posted by Ruthless Bunny at 9:02 AM on December 27, 2013 [3 favorites]

You really need to be seen by your own physician. ER physicians are there to stabalize; you really must follow up with your own doctor.

In late June I was rear-ended from a complete stop. I sustained injuries that had me in PT for about 10 weeks. Even though it didn't "look bad" at the beginning, I'm really glad I was evaluated. I can not imagine going on for as long as you have with your symptoms.

As for your questions: you can feel a muscle spasm through the skin, a lot of times. Other times a diagnosis of a muscle-based pain (spasm) is made through signs and symptoms. You may have a MRI ordered, depending on your symptoms, if the doctor feels it will show something or distinguish one injury from another type of injury.

Healing from a muscle sprain or tendonitis, like in my case, took time and physical therapy. I went 2x week for about 8 weeks and then once a week for 1x week. Besides exercises and stretches, I also got heat therapy and massage. My PT also did some type of hands-on "reprogramming" of my muscle that sounded weird, but completely worked. I also did exercises at home, and still have to do them in order to get back to normal. I have a residual IT band tightness problem from this accident; I never had that before, and it requires stretching every few days.

At the time of my accident, I was getting back into dancing and walking long distances, so I was delighted when I was told I could still do those activities--but I did take it easy. You should too. You've been through a lot; dedicate yourself to feel better. It takes time, especially as we grow older, to get back to normal. Please follow up with your GP today for an appointment. I hope you feel better!
posted by FergieBelle at 10:45 AM on December 27, 2013

I think I need to clarify:

The at-fault driver's insurance is already taking care of everything. I have a claim open with them for both my car repairs (complete, for now) and my injuries. I haven't signed anything in terms of a settlement, and the claim is still open regarding my injuries since they are fully aware that shit may not be resolved there. Since their client admitted fault immediately they have been taking care of me without push back, which has been nice. So getting this paid for on my terms is not the issue really. I don't feel the need to lawyer up yet.

I suppose what IS weird is that after I went to the ER the pain went away within in a few days. At least I didn't notice anything untoward, so I haven't been spending an entire month in pain (I...don't think I would have allowed that to happen). I was certain I was on the mend because I WAS able to engage in heavy activity (sex, going out for a night of heavy dancing) without any pain flaring up. It wasn't until the day before yesterday that the pain is back, after I ran a mile in 30 degree weather. I admit, I probably pushed myself too hard, as I also had hand weights. That being said, it alerted me that whatever is wrong with me has not healed. So yes, I will be seeing a doctor ASAP, and he may recommend an MRI or what not. I just really needed to know what might be wrong to better communicate with him. So yes "whiplash" and "soft tissue damage". I suppose some sort of issue with my "disks" would have been seen through an x-ray?
posted by Young Kullervo at 10:57 AM on December 28, 2013

I suppose some sort of issue with my "disks" would have been seen through an x-ray?

Nope. You need an MRI to get a true picture if there is disk or nerve involvement. Here's the thing, the first pain you felt was muscular, then you felt better, then your body re-settled and if disks were injured, it would be after a few days/weeks that they might start to really act up. What you are describing is pretty textbook.

What you need from a doctor is a "rating of disability". You get this after you do everything possible to mend. So PT, surgical procedures, etc.

Also, if the insurance company starts acting weird to you after you start to make claims for injury, lawyer up. A Personal-Injury Attorney/Ambulance Chaser, typically gets 1/3 of the settlement. An attorney can get you MORE settlement, and handle all the hassles associated with dealing with your insurance company.

Also, any settlement you get is not taxible, so that's a nice bonus.

Feel better!
posted by Ruthless Bunny at 5:53 AM on December 31, 2013

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