Back Injuries

Back injuries are the second most common complaint after car crashes and, because the back carries the body’s load in nearly every activity, among the most disabling. They range from muscle strains that resolve in weeks to disc herniations, facet injuries and compression fractures that change a person’s work and life. California’s rear-end and side-impact collisions produce all of them.

Types of back injury seen after collisions

• Lumbar and thoracic strains and sprains: stretched or torn muscles and ligaments, the most common and usually self-limiting.
• Disc herniations and bulges: the soft center of a spinal disc pushes through its outer ring, often pressing on a nerve root; symptoms include radiating leg pain (sciatica), numbness and weakness. See herniated discs.
• Facet joint injuries: the small joints connecting vertebrae can be sprained or damaged, producing localized pain worse with extension.
• Compression and burst fractures: vertebral body fractures from axial loading, more common in high-speed, rollover and head-on collisions and in older people with osteoporosis.
• Spondylolisthesis: forward slippage of one vertebra over another, sometimes aggravated by trauma.
• Sacroiliac joint injury: pain at the base of the spine and buttock from side-impact or bracing forces.

Diagnosis

Initial evaluation focuses on red flags—weakness, numbness, bowel or bladder changes—that signal nerve or spinal cord involvement requiring urgent imaging. Otherwise, X-rays identify fractures and alignment, and MRI is ordered when symptoms persist beyond several weeks or radiate into the legs. Electromyography (EMG) can confirm nerve root involvement. Back pain without imaging findings is common and real; the absence of a visible lesion does not mean the absence of injury.

Treatment

Most back strains are treated with early activity, physical therapy and anti-inflammatory medication. Herniations with radiculopathy may be treated with epidural steroid injections and, when conservative care fails or neurological deficits progress, microdiscectomy or fusion surgery. Compression fractures may be braced or treated with vertebroplasty or kyphoplasty. Chronic back pain after trauma is sometimes managed with facet injections, radiofrequency ablation or spinal cord stimulation.

The pre-existing degeneration argument

MRI scans of most adults over 30 show some disc degeneration whether or not they have pain. Insurers routinely argue that a post-crash herniation was “degenerative” and unrelated. California law addresses this directly: a defendant takes the plaintiff as they find them, and a crash that makes an asymptomatic condition symptomatic, or worsens a symptomatic one, is compensable for the aggravation. The decisive evidence is the before-and-after picture: medical records (or their absence) before the crash, the onset of symptoms immediately after, and a treating physician’s opinion on causation.

How back injury claims are valued

Beyond medical bills, back injury damages turn on function: lost work, reduced earning capacity in physical jobs, inability to lift, sit or stand for long periods, disturbed sleep and the loss of activities. A surgical recommendation changes the picture substantially, as does a permanent restriction. Future medical costs for chronic conditions should be included in any settlement, since the claim cannot be reopened.

Collisions that commonly cause back injury

Rear-end collisions load the lumbar spine as the seat pushes the pelvis forward. Side impacts produce lateral bending injuries. High-speed head-on and truck collisions cause the fractures. Our Corona rear-end collision page discusses back injury claims from freeway congestion crashes.

Common questions

My back pain started a week after the crash. Can it still be related?

Yes. Delayed onset is common with both soft tissue and disc injuries, particularly when early pain elsewhere masked it. Report the onset accurately; a plausible medical explanation documented by your provider carries weight.

The MRI shows degeneration. Does that end my claim?

No. Degeneration is nearly universal with age. The question is whether the crash caused new symptoms or worsened existing ones, which is answered by your history and a treating physician’s opinion.

My doctor recommends surgery but I do not want it. How does that affect the claim?

You are not required to undergo surgery. The recommendation itself is evidence of severity, and the cost of recommended future surgery can be claimed. If you later decide on surgery after settling, the settlement cannot be reopened, so timing matters.

Sources and official resources

• NINDS — Low back pain fact sheet

Links go to official government, court and public-health sources. Laws change; verify current text before relying on it.