Herniated Disc Back Injury Caused by Accident?
Medical Diagnosis is Insufficient
I believe that the source of confusion stems from the false belief that medical diagnosis alone connotes the seriousness of an injury, and hence its value. Actually, depending on the doctor making the diagnosis, each of these three terms – slipped, bulging or herniated disc – can mean the same thing (source: Medline Plus, a service of the National Library of Medicine and National Institutes of Health). The terms do not have a single, universally accepted meaning in the medical community.
Medical Background
Between each of the bones in our spine is a type of cushion called a disc which acts as a shock absorber, the function of which is to prevent injury to the spine and the spinal nerves. The disc is made of a gelatinous like substance which can be likened to jelly in a doughnut. The disc is surrounded on all sides by something called the annulus, or rings of fibers, which can be likened to the cake portion of a jelly doughnut. In a normal disc, the “jelly” is contained fully within the annulus/cake part of the doughnut, and can fulfill its shock absorber function. Sometimes however, the rings of the annulus weaken or tear and the inner gelatinous part of the disc slips/bulges/herniates out from its normal position.
Depending on the extent of the “leakage” the disc material can compress the exquisitely sensitive spinal nerves located just millimeters away. The result of this compression can be severe pain in the lower back running (“radiating”) down your leg, among other symptoms.
The important thing to keep in mind is that while the term slipped, bulging or herniated disc all refer to a deformity in the annulus, not all such deformities result in pain or disability. In fact, as people age (starting in their 30’s – 40’s), discs commonly begin to undergo changes that result in bulging, etc. Most often, these changes result in no symptoms at all. People are not even aware that they have an arthritic or “degenerated disc”. Sometimes however, following an accident, a person with an already bulging but unpainful disc, will become symptomatic and experience back pain either with or without radiation into the legs or arms.
Did the Accident Cause the Herniated Disk?
When a doctor is asked whether an accident “caused” the herniated bulging or slipped disc, most often the answer will be “no”. Does that mean that the individual is not injured? No. It means that the doctor was asked the wrong question.
The proper focus should be whether the accident caused the patient’s pain and disability, not whether it caused a particular diagnostic condition. To be sure, sometimes an accident can be so severe as to directly cause a spinal injury. Most often, however, what the accident causes, is pain and attendant disability where there had been none immediately before the accident.
Thus, the road to just, fair and reasonable compensation tracks the onset of pain rather than a particular medical term and its cause.
