Is a patient who seeks care following an accident likely to have a difference in outcome depending on whether or not he or she has an attorney? One might imagine that patients could “play up” injuries when getting treated, hoping that it could increase the value of the lawsuit, this does not seem to typically be the case. According to a 2001 study in Spine*:
“Studies show that 15% of whiplash patients suffer severe pain for 1-3 years, between 26% and 44% of patients develop chronic, unremitting pain. In a prospective study, Hildingsson and Toolanen found that 43% of patients with cervical whiplash still had symptoms sufficiently severe to interfere with their ability to work 2 years after their injury. Hodgson and Grundy studied 40 patients 10-15 years after injury and found that 31% still had symptoms and that 30 continued to have pain even after settlement of their case.”
In the 2001 Spine study, researchers performed a procedure called radiofrequency medial branch neurotomy (RF). This procedure blocks the nerves that affect joints in the spine called facet joints, which have often been linked to pain associated with whiplash injuries. There were 46 patients in the study: a group of 28 that had whiplash injuries that had an active claim, and a group of 18 that did not have a possible claim to file with an insurance company. To address the initial question raised, the researchers proposed that the RF procedure should work as effectively in both groups regardless of potential for injury reimbursement.
Results of the study indicated that there was no significant difference in outcome between the two groups. After the RF procedure was performed, a follow-up questionnaire was performed a year later. The study found that there was no statistically significant difference between groups in terms of exacerbations. Both groups had levels of pain rated as an average of 8 out of 10 before the procedure, and after the procedure, both groups reported the pain as an average of 2 out of 10. There was no statistically significant difference between groups at a one year follow-up either. According to the authors of the study, “It is a common belief that litigation per se affects treatment outcome. . . .Our data do not support this conclusion. Therefore, the fact that litigation is pending per se should not negatively influence the management of the patient with whiplash injury”
* Sapir DA, Gorup, JM. Radiofrequency medial branch enurotomy in litigant and non-litigant patients with cervical whiplash. Spine 2001;26:E268-E273.
Dr. Brian Lancaster
Chiropractor
Frederick, MD
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