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Serious car accidents can cause a variety of injuries in both pedestrians and occupants of motor vehicles. Trauma to the neck, or cervical spine, is extremely common and can vary in severity and type. Cervical injuries can result in mild temporary injuries to life-altering or even fatal injuries. Depending on the impact load or pressure on the neck, injuries can be in the form of vertebral fractures and displacement, sprained neck ligaments, injuries to the intervertebral discs and soft tissue/muscle injury. A herniated disc or vertebral dislocation in the neck can irritate your spinal nerve roots or spinal cord, causing severe nerve symptoms.
Suffering from severe neck pain after a car accident can cause a variety of negative consequences, both financially and physically. Financially, you could lose income due to missed work, experience high costs of medical care and transportation, require extra caregiver services at a cost, and easily slip into debt without the right financial stability. Depending on the specific type of neck injury you suffer from, you could be facing years of ongoing medical treatment, chronic pain, and even in the worst cases, paralysis.
Anatomically, your neck has seven vertebral bodies, that are medically numbered C1 to C7. C1 to C7 starts at that base of your skull, and down towards your back. In addition to the 7 cervical vertebrae, your neck area has 8 pairs of nerves, (called cervical nerves) that are medically numbered C1 to C8. Each pair of these cervical nerves emerge from your spinal cord on top of each corresponding vertebra, except for the C8 nerve, which exits inferiorly to the C7 vertebra. In between your cervical vertebrae are intervertebral discs that act as cushions. The discs are cartilaginous structures that are made up of three components: an inner nucleus pulposus, outer annulus fibrosus, and endplates that anchor the discs to adjacent vertebrae.
The following neck injuries are the more common causes of neck issues after a car accident, which can lead to a range of pain levels from moderate to severe:
Whiplash occurs when the neck undergoes a rapid and forceful back-and-forth motion, usually caused by a sudden jolt, and is most common in rear-end car accidents as the force comes from behind. This sudden movement can cause damage to the muscles, tissues, and ligaments in the neck. While many cases of whiplash generally produce minor injuries and victims can recover successfully naturally, in other cases whiplash can lead to traumatic brain injury, severe concussion, or ongoing chronic pain.
A herniated cervical disc occurs when a disc in the spine has been ruptured due to an unexpected force. The spinal fluid leaks from the disc which may result in impingement of these traversing nerves as they exit the neural foramen (holes in the vertebrae) or directly compress your spinal cord contained within the spinal canal. The cervical section of the spine (located in the neck) includes seven discs that are responsible for holding up the head, as well as sending messages down the spine to the rest of the body through the central nervous system. When a disc in the neck is herniated or ruptured, the spinal fluid leaks out and causes a chemical irritation with the nerves in the surrounding area. This can result in severe pain, stiffness, and muscle weakness in the neck, shoulders, and/or arms.
What areas are affected by disc herniations?
Disc herniations can have devastating and painful symptims. Typical symptoms of compression by a herniated disc in the cervical spine are:
C2 Nerve – eye or ear pain, headache;
C3, C4 Nerve – neck, and trapezial tenderness and muscle spasms;
C5 Nerve – neck, shoulder, and scapula pain. Pins, needles and tingling may also happen in the lateral part of your arm. Certain motions in the shoulder and elbow can also be affected. Victims may also observe weakness with certain shoulder and forarm movements, as well as bicep flexion issues;
C6 Nerve – neck, shoulder, and scapula pain. Numbness and tingling in the forearm, hand, and outside fingers. Primary motions affected include elbow flexion and wrist extension. You can also suffer from shoulder abduction and forarm movement issues;
C7 Nerve – neck and shoulder pain. Numbness and tingling of the posterior forearm and third digit. Elbow, wrist and tricep motions can be affected;
C8 Nerve – neck and shoulder pain. Numbness and tingling of the forearm, medial hand, and middle two digits. Weakness with finger flexion, handgrip, and thumb extension;
T1 Nerve – Neck and shoulder pain. Numbness and tingling of the medial forearm. A weakness of finger abduction and adduction.
Cervical spinal stenosis occurs when a nerve root has been compressed or pinched. Cervical stenosis may occur at a very slow or very fast rate. These changes cause narrowing of the spinal canal and can pinch the spinal cord and nerve roots. Spinal cord or nerve function may be affected and impaired, causing symptoms of cervical radiculopathy (damage or irritation of nerve roots that exit the spine). It is commonly seen at C4-5, C5-6, and C6-7 vertebral levels. When the compression occurs in the neck, the spinal canal narrows and impedes on the space where the nerves leave the spinal cord and travel down the body. As a result, victims with cervical spinal stenosis may experience severe pain, stiffness, numbness, muscle weakness in the neck, limbs, and back, as well as loss of control over bladder and bowel movements.
There are numerous ways for spinal stenosis to develop – such as with advanced osteroarthritis, or ligament changes. Accident related factors which can cause the narrowing of the spinal canal is with a disc herniation – normally caused by trauma related forces or by disc degeneration. With disc degeneration, the discs between your vertabrae begin to lose their water content, becoming flatter and more frangible. In time, the disc’s outside fibrous makeup can develop microscopic tears, causing the jelly-like inside in the disk’s center to exude out. As mentioned above, the herniated disk then pushes on the surrounding nerves, causing pain in your arms and legs. Sometimes you may also have numbness, tingling or weakness in the buttock, leg or foot on the affected side.
An traumatic SCI is damage to the spinal cord from trauma or an accident. Traumatic SCI might occur because of a car, truck, or motorcycle crash, a fall, an act of violence such as gunshot or stab wound or a sports injury.
The higher on the spinal cord your injury occurs, the greater the effect on movement, sensation, and other body functions. A spinal cord injury can result in paraplegia, tetraplegia and/or quadriplegia. Tetraplegia (formerly called quadriplegia) refers to an injury to the cervical (neck) section of the spinal cord. It can involve either partial or complete loss of movement and/or feeling in the head, neck, shoulders, upper chest, arms, and legs. Paraplegia refers to an injury in the thoracic, lumbar, or sacral sections of the spinal cord. It can involve either partial or complete loss of movement or feeling in the chest, stomach, hips, legs, and feet. Tetraplegia is slightly more common than paraplegia. In addition to being described according to the level of injury, SCI is described according to the severity of the injury. A complete injury is one that results in no voluntary movement and no measurable feeling below the level of injury. An incomplete injury is one in which there is some measurable feeling and/or voluntary movement below the level of the injury. A doctor or health care professional who specializes in treating people with SCI can help you determine if your injury is complete or incomplete.
Cervical spinal cord injuries (injuries to the spinal cord at the C1 to C8 level in the neck) are life-changing and can result in catastrophic damage to the victim. The spinal discs in the cervical spine are much smaller than those in the lumbar area, and are therefore more vulnerable during forceful impact such as that of a car accident. When the cervical spine is damaged, messages are unable to travel from the brain to the rest of the body, which can result in life-changing consequences, including paralysis or tetraplegia.
Most cases of neck pain after a car accident will typically resolve in two to four weeks without any type of intervention. If your pain does not resolve, your doctor will most likely refer you for cervical imaging if he or she is suspicious of potentially serious pathology or some type of neurological compromise.
Imaging will normally be in the form of xray, CT Scan, MRI or Electromyography. In approximately one-third of victims, cervical pain symptoms will remain persistent despite non-operative intervention. If symptoms last longer than six weeks, it becomes less likely that symptoms will improve without the need for pain block or surgical intervention  such as steroid injections, nerve block injections, epidural injection or surgery.
Since 2003, Hamilton Personal Injury Lawhyer Matt Lalande and his team have assisted car accident victims throughout Ontario who have suffered serious life changing injuries. The firm has represented countless accident victims who have suffered serious neck and spinal cord injuries and have recovered millions for individual and families to help put them back in the place they were before they were hurt. Our firm offers free consultations and if we decide to work together, we never ask our clients for money upftont. Call us province wide at 1-844-LALANDE or local in the Hamilton – Toronto area at 905-333-8888 for more information and to get your case started today.
 Eubanks JD. Cervical radiculopathy: nonoperative management of neck pain and radicular symptoms. Am Fam Physician. 2010 Jan 01;81(1):33-40
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