Rose was involved in a road traffic accident when the vehicle in which she was a front seat passenger, was struck from behind at a pedestrian crossing. She experienced immediate pain on the right hand side of her neck and in her right shoulder. She was taken to the local hosptial where a diagnosis of “whiplash” was made. She had previously suffered from a frozen right shoulder, but following physiotherapy and osteopathy this problem had resolved.
She instructed the solicitors that contacted her through the driver’s insurance company. Six weeks after the accident, they obtained a medical report from a general practitioner which suggested she would make a full recovery within 6 to 9 months of the accident. The general practitioner recommended 6 sessions of physiotherapy. Her solicitor recommended that she use the physiotherapist appointed by the other driver’s insurance company. She attended for treatment, but her symptoms worsened rather than improved.
Despite her worsening condition, her solicitors attempted to persuade Rose to settle her claim based upon the general practitioner’s prognosis. After bringing some pressure to bear upon them, they eventually agreed to obtain a further medical report, this time from an orthpaedic surgeon. As with the general practitioner, this consultant was instructed through a medical agency. Although the problems that Rose was experiencing were primarily to her right shoulder, neck and the upper part of her back, they instructed an orthopaedic surgeon whose special interest was knee surgery!
The orthopaedic surgeon was of the opinion that not only were her symptoms “unexplainable” but that “they cannot in my opinion be related to the subject accident”.
Her solicitors were reluctant to challenge this opinion and in some desperation she looked around for alternative representation.
Rose instructed BLB Solicitors who are specialists in chronic pain. By this time the pain had now spread over the middle and lower parts of her back and was radiating into both shoulders, not just her right shoulder as before. She had funded a variety of different treatments, including osteopathy, chiropractic treatment and the “Bowen Technique”. She was struggling to lift anything remotely heavy, was in constant pain, and was reliant upon Diazepam to help her sleep. The effect on her day to day life was considerable, and she was struggling with most of the heavier aspects of her housework, was unable to carry her shopping and could not pick up her grandchildren. As a result of these ongoing limitations she had developed anxiety and depression, for which she was prescribed medication.
BLB Solicitors obtained a complete set of medical records, including those from the variety of treatment providers whom Rose had seen since her accident. Thereafter, we directly instructed a nationally recognised expert in pain medicine who was firmly of the opinion that Rose had developed Myofascial Pain Syndrome (MPS) and that this had been caused solely by the road traffic accident.
Myofascial Pain Syndrome is a chronic regional pain syndrome affecting either a single muscle or a group of muscles. It results in localised muscle spasm and pain, together with the presence of trigger points, which are often extremely sensitive to touch.
The pain specialist recommended that she urgently be referred to a pain medicine specialist to co-ordinate her treatment. In particular, he recommended that Rose should have injections of local anaesthetic into the trigger points which, if this resulted in short term pain relief, should then be re-injected with Botox to relax the muscle fibres enough to allow a physiotherapist to start to work on the affected muscles.
In tandem with her physical treatment, we arranged for Rose to be assessed by a clinical psychologist who recommended a lengthy course of Cognitive Behavioural Therapy (CBT).
Whenever possible it is important that treatment takes place before a claim settles. This is because a settled long term prognosis is often not available from the medical experts until treatment has concluded. Without a settled long term prognosis, accurately calculating future losses (eg earnings, care, equipment, transport, further treatment) is extremely difficult.
As with most cases, we arranged for Rose’s treatment to be funded by the other driver’s insurance company. With the recommended treatment, Rose’s condition improved significantly and although she will never be symptom free, her condition no longer has the dominating effect upon her life that it did before.