What is sciatica?
Sciatica is pain that runs down the back of the leg. It is named after the sciatic nerve, a nerve that originates in the lower lumbar spine and then travels down the back of both legs. Sciatica pain is felt all along this nerve, from the lower back, to the pelvis, hips, and buttock, and to the thighs.
What causes sciatica?
Car accidents commonly cause nerve damage because the sudden stop or change in direction causes injuries to the spine. These injuries are often minor enough that they don’t immediately seem problematic, but they may result in nerve pain that can last for months or years in severe cases.
Herniated DiscsA disc herniation, also known as a slipped disc or bulging disc, is a common car accident injury.
What is a herniated disc?
The spine is a column of bones called vertebrae. These bones provide structural support and protect the spinal cord. Spinal nerves branch out from the spinal cord, providing sensation and function to the rest of the body. In between the vertebrae are spinal discs, also known as intervertebral discs.
Degenerative Disc Disease and Spinal StenosisAs we age, our spines suffer some wear and tear. Car accidents can cause deterioration due to the wear and tear of age to suddenly worsen and cause symptoms that were not there before. Lawyers call this aggravation of a preexisting condition. Degenerative disc disease is the term used to describe the effect that aging has on the spinal discs. Over time, the discs both dry out and crack, weakening their ability to cushion the spine against everyday movements and traumatic events like car crashes, potentially resulting in a herniated disc. Another symptom of degenerative disc disease and aging is spinal stenosis. Stenosis is the narrowing of the spinal canal, the hollow part of the vertebrae that houses the spinal cord. How does this happen? As the spinal discs weaken, the body attempts to strengthen and stabilize the spine by growing tough ligaments. These thickened ligaments in turn grow bone spurs. Both the thick ligaments and the new bony growths protrude into the space in the spinal canal, potentially putting pressure on spinal nerves and causing symptoms like sciatica.
Spondylolysis and SpondylolisthesisSpondylolysis is a term used to describe a stress fracture in one of the vertebrae of the lower back. Specifically, this term refers to a stress fracture in the pars interarticularis, the weakest part of the vertebrae. When the stress fracture causes the vertebra to slip out of place, this condition and its symptoms are called spondylolisthesis. The further the vertebra slips forward, the worse pain the person will generally feel, and the worse the damage will probably be to the nerves. While herniated discs can occur even in low-speed car accidents, fractures typically happen in more forceful, higher speed car accidents.
How is sciatica treated?
Most of the conditions described above that cause sciatica can be treated conservatively in mild cases. This means that the symptoms can be greatly reduced or cured with a combination of physical therapy, medications, and epidural injections.
What else might be causing my pelvic and leg pain?
Sciatica is caused by the pinching of the spinal nerves. Some other conditions feel similar to sciatica but have a different origin.
Recent sciatica medical studiesSurgery versus Conservative Care for Persistent Sciatica Lasting 4 to 12 Months by Chris Bailey et al., New England Journal of Medicine, March 2020. Some sciatica is acute—it begins when the back injury occurs and stops soon after. Other sciatica lasts for multiple months. Researchers in this study wanted to know what treatment works best in patients with chronic pain. They screened 790 patients with a lumbar disc herniation and sciatica lasting 4-12 months. They found that surgery, specifically a microdiscectomy, was the most effective treatment. Lumbar high-intensity zones on MRI: imaging biomarkers for severe, prolonged low back pain and sciatica in a population-based cohort by Masatoshi Teraguchi et al., The Spine Journal, March 2020. MRI is a type of imaging that is used to locate the source of sciatica and guide how it can be treated. High-intensity zones show up as bright white on the scan, and their significance is debated. The researchers in this study found that high-intensity zones on MRIs are linked to longer-lasting sciatica pain. Diagnosis and treatment of sciatica by Rikke Jensen et al., BMJ, Nov. 2019. This is an overview of practice guidelines for the diagnosis and treatment of sciatica from top researchers in the field. The main points are, first, that sciatica is a symptom of several conditions. It is characterized by pain radiating down one leg. Surgery is not necessary for most patients, for whom physical therapy, exercise, and pain management helps with symptoms until the condition improves. To diagnose sciatica, imaging is only needed if the patient asks for it, if the symptoms persist for longer than 12 weeks, or if they worsen. Urinary retention and decreased anal sphincter tone are signs of cauda equina, an emergency situation. Surgery can be used to speed up recovery in patients who not improve after 6-8 weeks.
Sciatica-Related Verdicts and Settlements
YEAR / STATE
CASE / INJURY SUMMARY
2020 – Massachusetts
A man’s vehicle was rear-ended at a red light. He suffered right-sided sciatica, a right hip tear, lower back pain, a right sacroiliac joint arthropathy, and walking difficulties. The man alleged that the other driver’s negligence caused the collision and his injuries. He claimed that the other driver failed to keep an appropriate distance, failed to control his vehicle, and excessively sped. The other driver disputed the relationship between the collision and the man’s claimed injuries. A jury ruled in the plaintiff’s favor and awarded $65,000, which the court reduced to $63,000. However, prejudgment interest increased the man’s net award to $79,893.
$79,893 – Verdict
2020 – Maryland
A motorist hit a woman’s vehicle and fled the scene. The woman suffered sciatica, spinal strains, and post-traumatic stress disorder. She underwent chiropractic and physical therapy. The woman sued her insurer for failing to pay her uninsured motorist benefits. The insurer contested the woman’s claims, arguing that she only suffered soft-tissue injuries and the aggravation of her pre-existing mental health issues. A Baltimore City jury awarded $145,000.
$145,000 – Verdict
2019 – Florida
A municipal-owned sanitation truck hit a 28-year-old woman’s westbound vehicle at an intersection. The woman suffered sciatica, disc herniations and bulges, right knee derangement, and post-traumatic headaches. She underwent facet injections and radiofrequency ablation to her lumbar spine. Despite undergoing these treatments, she claimed permanent injuries. The woman testified that before the collision; she had no prior neck or back issues. She also alleged the sanitation truck driver’s negligence made the City of St. Petersburg vicariously liable. The city disputed the causes of the woman’s injuries, arguing that her conditions were degenerative and unrelated to the collision. A jury ruled in the woman’s favor and awarded a $655,693 verdict.
$655,693 – Verdict
2019 – Washington
A 64-year-old man suffered a bulging lumbar disc with sciatica, cervical facet syndrome, and the aggravation of a right knee injury after being involved in a chain-reaction collision. He underwent epidural injections for his bulging disc and radiofrequency neurotomy for his cervical facet syndrome. Despite undergoing treatment, the man claimed seven percent bodily impairment. He alleged that the tortfeasor’s failure to safely operate his vehicle caused the collision and his injuries. A jury returned a $107,000 verdict.
$107,000 – Verdict
2019 – California
A vehicle backed out of a parking spot and struck a female pedestrian in a strip mall parking lot. The woman suffered right leg pain with sciatica, neck pain, back pain, hip pain, a torn right meniscus, muscle spasms, headaches, and vertigo. She underwent back surgery for treatment. The woman alleged that the motorist’s negligent driving caused the collision and her permanent injuries. This case settled for $650,000.
2019 – Connecticut
A man and his female passenger suffered neck injuries after their vehicle was struck head-on. The man suffered sciatica and finger and toe tingling, while the woman suffered a neck strain. They alleged that the other driver’s inattentive driving caused the collision and their injuries. The jury awarded a $90,000 verdict.
$90,000 – Verdict