Diagnostic Tests for Cervical Herniated Discs

If your doctor suspects that you have a herniated disc in your cervical spine (neck) as the result of a work-related injury, you may be referred to undergo diagnostic tests to confirm a diagnosis. 

MRI 

An MRI (Magnetic Resonance Imaging) scan is the most common test used to diagnose a herniated disc. An MRI scan can image disc bulges, herniations, and nerve root impingement.

CT Scan

A CT (computerized tomography) scan combines x-ray views from many different angles to produce cross-sectional images of the bones and soft tissues inside your body. A CT scan may also performed using injected contrast dye, called a CT myleogram, to better visualize nerve root compression.

Discography 

Discography involves the insertion of a small needle into the discs to inject contrast dye. If the injection reproduces your pain, it confirms that the injected disc is the source of your pain.

EMG 

An EMG (Electromyography) is an electrical test involving stimulating specific nerves and inserting needles into various muscles in the arms and legs that may be affected by a pinched nerve. An EMG can help confirm the presence of nerve impingement, and help pin-point which nerve is causing you trouble.

In Minnesota, if you’ve sustained a work-related injury, and your doctor directs you to undergo an MRI, a CT scan, a discography, or an EMG to help diagnose your injury, these tests are often covered by Minnesota workers’ compensation insurance. Referrals for diagnostic studies such as MRIs, CT scans, discograhpies, or EMGs, are commonly the source of disputes in Minnesota workers’ compensation cases.

If the workers’ compensation insurance company is refusing to authorize the diagnostic procedure your doctor has recommended, a Minnesota workers’ compensation lawyer can help you get the medical care you need. Call Meuser & Associate at 877-746-5680 or click here to send us an email for a free, no-obligation Minnesota workers’ compensation legal consultation. 

What is a Spinal Burst Fracture?

Spinal burst fractures are extremely serious injuries, and are usually caused by severe trauma such as a motor vehicle accident or a fall from a height. 

Extreme amounts of force exerted onto the spine can crush the vertebrae of the spine. A burst fracture involves extreme compression, or crushing, of the vertebra, causing the edges of the bone to spread out in all directions. With bony fragments and edges spreading out in all directions, there is a strong possibility that the spinal cord will be injured, resulting in paralysis or partial neurological injury. A burst fracture also causes severe instability of the spine at the affected area.

Neurological injury from a burst fracture can (in some lucky cases), cause no injury at all, or it can cause complete paralysis if the spinal cord damage is severe. The degree of neurological injury is usually determined by the amount of force at the time of injury, and the severity of the damage to the spinal canal. Bony fragments from a fractured vertebra can be forced into the spinal canal, resulting in loss of strength, sensation, or reflexes below the level of the injury. Mild burst fractures can result in relatively minimal symptoms or mild or no neurological injury.

Following an accident where a spinal injury is suspected, x-rays, CT scans, and/or MRI scans may be used to determine the amount of soft tissue trauma, bleeding, or ligament disruption, the presence and location of fracture, the type of fracture, and the amount of spinal canal compromise. All of these elements help determine the course of treatment.

Burst fractures, even without neurological injury, can be extremely painful, and can cause severe, long-term disability. Spinal burst fractures with neurological or spinal cord injuries can be physically, emotionally, and financially devastating.

If you or a loved one sustained a spinal fracture as a result of a work-related accident, or a car accident due to someone else’s fault, you may be entitled to compensation in Minnesota. For a free, no-obligation case evaluation, contact Meuser & Associate at 877-746-5680, or click here to send us an email to schedule an appointment with one of our attorneys. We can help you get the compensation you are entitled to. 

Alternative Treatments for Neck Pain

If you’ve got constant, severe neck pain that just won’t go away, it can be difficult to perform your activities of daily living, such as self-cares, cooking or cleaning, it can cause you to be depressed or irritable, leading to friction in your family relationships, and it can make it difficult, if not impossible, to be remain gainfully employed.

If you’re suffering from neck pain, and you’ve tried a variety of traditional treatment options, such as physical therapy, cortisone injections, narcotic pain medications, or surgical intervention, and you’re looking for other options, you may wish to ask your treating physician about alternative forms of treatment.

You might want to ask your doctor about:

Acupuncture: Many patients experience neck pain relief after a course of acupuncture treatments. Practitioners believe that acupuncture can help restore the healthy flow of energy in the body, which in turn can lead to pain relief. Acupuncture involves the insertion of fine needles into your body at specific points.

Herbal remedies: Ask your doctor before trying any herbal remedies. Some herbal remedies have side effects, and some can interfere with other prescribed medications. Some herbal remedies that may help with neck pain relief include capsaicin cream, devil’s claw, or white willow bark.

Massage: Stress can cause neck pain, and it can make neck pain worse. Massage helps release tension, and can help reduce muscle inflammation and pain.

Yoga or Pilates: Yoga and Pilates help increase your core strength, help improve your balance and posture, and help reduce stress. Increased strength, better balance and posture, and reduced stress can all help decrease neck pain.

Minnesota workers’ compensation covers almost any type of medical treatment, so long as it is reasonable and necessary, and causally related to your work injury. Several of our Minnesota workers’ compensation clients who are suffering neck injuries have had success in reducing their pain with acupuncture and massage. Unfortunately, workers’ compensation insurance companies sometimes tend to be somewhat wary about approving or paying for so-called “alternative” therapies.

For a free, no-obligation evaluation of your Minnesota workers’ compensation case, contact Meuser & Associate at 877-746-5680 or click here to send us an email.

Types of Spinal Fractures

A spinal fracture is when you break a bone in your spine. The spine is made up of vertebrae stacked on top of each other, and they can break, just like other bones in your body. Spinal fractures, however, can be more severe than other bone breaks because a spinal fracture can result in trauma to the spinal cord.

There are number of different ways to classify spinal fractures depending on the area of the vertebrae that is fractured, the severity of the fracture, and the kind of fracture.

There a variety of different types of spinal fractures, including:

Compression fracture: Compression fractures are common in patients with underlying osteoporosis. Sudden force or pressure applied to the vertebra can cause the vertebrae to fracture, especially if the vertebra is already weakened. A wedge fracture is a type of compression fracture, where the anterior, or front, of the vertebra collapses and becomes wedge shaped.

Burst fracture. Burst fractures are caused by extreme trauma, such as car accidents. They happen when the vertebra is crushed by extreme forces, and it is fractured in multiple places. Bony fragments from the fracture can cause spinal cord injury. Burst fractures are usually severe.

Flexion-distraction fractures. Sudden forward forces, such those involved in a high speed rear end collision, that cause extreme stress on the spine can break vertebrae. A flexion-distraction fracture usually involves the posterior (back), and middle portions of the vertebra.

Fracture-dislocation. Any spinal fracture can also involve dislocation, where the vertebra moves significantly, and causes the spine to become very unstable. Fractures of the spine are severe injuries, and can be caused by car accidents or workplace accidents. They can involve significant medical care and disability. If you’ve sustained a spinal fracture as a result of your work activities, or as the result of a car accident, a Minnesota workers’ compensation attorney or personal injury attorney can help you get the benefits you’re entitled to. For a free, no-obligation case consultation, contact Meuser & Associate at 877-746-5680, or click here to send us an email. 

Osteoarthritis of the Neck and Back: Minnesota Work Comp

Osteoarthritis, also known as degenerative joint disease, is a common cause of neck and back pain. It is the result of the mechanical breakdown of the cartilage between the facet joints in the spine, which can cause frictional pain. Development of bone spurs can irritate or entrap spinal nerves.

Osteoarthritis or degenerative joint disease of the neck or back can be caused by work activities, or work activities may aggravate or accelerate the condition. An acute work injury can also aggravate a workers’ pre-existing spinal osteoarthritis.

Medical evaluation for neck or back pain typically involves a discussion of symptoms and a detailed medical history, a physical examination, and if osteoarthritis is suspected, a series of x-rays. Other tests, such as MRI’s or CT scans may be performed to confirm the diagnosis or to rule out other conditions. For more information about osteoarthritis visit Spine-health.com.

Unfortunately, a workers’ compensation claim for a back injury can become complicated if there’s a concurrent or underlying diagnosis of osteoarthritis or degenerative joint disease. Workers’ compensation insurance companies typically try to argue that the injured worker’s condition was “pre-existing,” or that if they did sustain an injury, it was simply a “temporary aggravation.” They commonly use these arguments to deny an injured workers’ work comp. claim entirely, or to limit the amount of benefits they have to pay if that worker becomes disabled due to neck or back pain.

For a free, no-obligation evaluation of your Minnesota workers’ compensation case, contact Meuser & Associate at 877-746-5680 or click here to send us an email.

Epidural Steroid Injections of the Neck and Back: Minnesota Workers’ Compensation

Epidural injections deliver steroids into the epidural space around the spinal nerve roots to relive pain caused by irritated spinal nerves. The steroid reduces inflammation of the nerves, which are often the source of pain. About 50% of patients receive significant pain relief following an injection. The purpose of epidural steroid injections is to help patients get enough pain relief in order to be able to undergo rehabilitation program. Unfortunately, epidural steroid injections don’t actually cure the underlying problem.

Spinal nerves can become inflamed due to irritation from a damaged disc or contact with bone spurs. Symptoms of nerve inflammation can cause pain and/or numbness and tingling in parts of the body associated with the nerve.

Nerve irritation in the cervical spine can cause:

• Neck pain, tingling, or numbness. 
• Shoulder pain, tingling, or numbness. 
• Arm pain, tingling, or numbness. 

Nerve irritation in the thoracic spine can cause:

• Upper back pain. 
• Pain along the ribs to the chest wall. 
• Pain in the abdomen. 

Nerve irritation in the lumbar spine can cause:

• Low back pain. 
• Hip pain. 
• Buttock pain. 
• Leg pain, tingling, or numbness. 

Before the injection is administered, the patient is given a local anesthetic to the area that is to be injected. The injection is performed using a guided x-ray procedure called fluoroscopy. Contrast dye and a combination of numbing medicine and an anti-inflammatory medicine are injected into the epidural space. The procedure generally takes about 30 minutes, followed by approximately 45 minutes of recovery time. Some patients may experience partial numbness from the anesthetic in the arms or legs, which usually subsides after a few hours. Pain levels after an epidural steroid injection should be documented in a “pain diary” so the treating physician can evaluate the effectiveness of the injection. Improvements in pain will generally occur within 10 days after the injection, and may begin as soon as one day after the injection.

For more information about spinal epidural injections check out Spine-Health.com.

Workers with neck and back injuries frequently undergo one or more epidural steroid injections, with varying degrees of success. If you’ve sustained an on-the-job injury, contact Meuser & Associate for a free, no obligation consultation to learn more about your Minnesota workers’ compensation rights. Call us at 877-746-5680 or click here to send us an email. 

Causes of Herniated Discs

Disc herniations in the neck and back are some of the most common work-related injuries we see in our Minnesota workers' compensation practice.

A disc herniation is when the intervertebral disc, or the cushion in between the vertebrae in your spine, pushes or bulges out, or even ruptures. A bulging or ruptured disc can cause significant pain, or even spinal cord or nerve compression. Herniated discs in the neck and back are usually caused by 1) wear and tear, 2) injury, or 3) a combination of wear and tear and injury.

Herniated Discs Caused by Wear and Tear on the Spine 

A herniated disc is often the result of daily wear and tear on the spine. This is also known as disc degeneration. The spine carries and helps distribute our weight, and the intervertebral discs act as shock absorbers for movements such as walking, twisting, and bending. Discs can wear out over the course of time. The tough outer layer of the disc, or the annulus fibrous, can start to weaken over time, allowing the jelly-like inner layer of the disc, known as the nucleus pulposus, to push through, creating a bulging or herniated disc.

Herniated Discs From Injury 

Injury to the spine can also cause a herniated disc. For example, a car accident or fall at work can cause a herniated disc when the sudden jerking motion or force puts too much pressure on the disc, causing it to herniate. You can also herniate a disc by lifting a heavy object incorrectly, or by extreme twisting.

Herniated Discs From a Combination of Wear and Tear and Injury 

An intervertebral disc that has been weakened by wear and tear, or degeneration, can make it more susceptible to herniation, should you experience a traumatic event. If a disc is already weakened by degeneration, even minor traumas, such as bending awkwardly, or even sneezing, can cause a disc to herniate.

Different doctors sometimes use the term “disc herniation” to mean slightly different things, but they are often categorized as four types:

1. Disc degeneration. During the first stage of a herniation, the nucleus pulposus weakens due to changes in the disc associated with wear and tear. 
2. Prolapse.  During the second stage, the form or position of the disc changes. A slight bulge or protrusion may begin to form, which may impinge the spinal cord or nerve roots. 
3. Extrusion. During the third stage, the nucleus pulposus breaks through the annulus fibrosis, but still remains within the disc. 
4. Sequestration. During the final stage, the nucleus pulposus may break through the annulus fibrosus and move outside the disc into the spinal canal. 

In Minnesota, if you’ve sustained a herniated disc as a result of your work activities, you may be entitled to workers’ compensation benefits, including medical expense benefits, wage loss benefits, permanent partial disability benefits, and rehabilitation benefits.

Whether you have a herniated disc that was caused by an injury, one that was caused by wear and tear, or one that was caused by a combination of both, your injury may be covered by workers’ compensation so long as your work activities were a substantial contributing factor in the development of your disc herniation.

For a free, no-obligation workers’ compensation consultation to learn more about your rights under Minnesota workers’ compensation law, contact Meuser & Associate at 877-746-5680, or click here to send us an email to schedule an appointment with one of our attorneys. 

Degenerative Disc Disease and MN Workers’ Comp: Exercise and Physical Therapy for Pain Management

Degenerative disc disease is one of the most common causes of low back and neck pain, and it can significantly impact your ability to do your normal day to day activities, and your ability to work.

Degenerative disc disease refers to changes to the spinal discs from chronic wear and tear or injury. There are a variety of treatment options for degenerative disc disease, including exercise and physical therapy. For individuals suffering from degenerative disc disease, a regular routine of back or neck exercises can prevent neck or back pain and/or reduce the frequency, severity, and duration of flare-ups. Stretching exercises can improve range of motion, which in turn, can reduce neck or back pain. Strengthening exercises can help stabilize the spinal segments, and stronger muscles can help compensate for degenerated discs. Before beginning an exercise or therapy program, consult with your spinal specialist.

In the context of workers’ compensation, in many cases, degenerative disc disease is a condition that is covered for work comp benefits. The condition itself may be caused by an employee’s work activities, or an employee’s work activities may have substantially contributed to the condition.
Alternatively, an employee may suffer an aggravation of underlying degenerative disc disease, which is covered by workers’ compensation.

While the term “degenerative disc disease” refers to a medical condition, for workers’ compensation insurance adjusters, the term is also a legal defense to a claim for benefits. In plain language, what that means is that if you are injured at work, and you are diagnosed with degenerative disc disease, or there’s even a reference to degenerative disc disease in your medical records, be prepared for the work comp. adjuster to deny your claim on the basis that your condition is pre-existing.

Just because the workers’ compensation insurance company says your condition is pre-existing, doesn’t mean they’re right! 

In many cases, an individual’s work activities caused, or substantially contributed to, wear and tear on the spine over time, resulting in degenerative disc disease. That is a condition that IS covered by workers’ compensation, and is often referred to as a repetitive motion injury, or a Gillette-type injury.

In other cases, an individual’s work activities or an injury substantially aggravated or accelerated pre-existing degenerative disc disease. Again, in that instance, the injury IS covered by workers’ compensation.

If you are suffering from degenerative disc disease as a result of your work activities, you can expect that the workers’ compensation carrier will dispute your claim. It is important to speak with a Minnesota workers’ compensation lawyer to protect your rights. For a free, no-obligation consultation, contact Meuser & Associate at 877-746-5680 or click here to send us an email.

Good Posture Key to Preventing Back Pain at Work

Back injuries are the single most common type of work-related injury that we see in our Minnesota workers’ compensation legal practice.

According to WebMD good posture while standing or sitting is an important way to prevent back pain. Check your posture by standing with your heels against a wall. Your calves, buttocks, shoulders, and the back of your head should the wall. You should be able to fit your hand between the wall and the small of your back. If your posture changes when you step away from the wall, correct it to the position you were in when you were standing against the wall. If you stand for long periods of time at work, wear flat shoes with good arch support, and use a 6 inch box or step to rest one foot on periodically.

While seated, a good work chair should support your hips comfortably, but the backs of your knees should not touch the seat. The back of the chair should be set at an angle of approximately ten degrees, and it should comfortably cradle the small of your back. Your feet should rest flat on the floor. Your forearms should rest on your desk or work surface with your elbows at a right angle.

Work activities that require you to stand or remain seated for prolonged periods or in awkward positions can lead to neck or back injuries and chronic neck or back pain. For a free, no-obligation Minnesota workers’ compensation consultation, call Meuser & Associate at 877-746-5680, or click here to send us an email to schedule an appointment with one of our attorney to learn about your workers' compensation rights.

Facet Joint Disorders and Back Pain: MN Workers’ Compensation

One common source of neck and back pain among our Minnesota workers’ compensation clients is facet joint disorders. Facet joints are small stabilizing joints located between and behind the vertebra of the spine. Facet joints prevent excessive motion, over-twisting, and slipping of the vertebrae. They slide on each other and are normally coated by a very low friction, moist cartilage. A small sack or capsule provides lubricant for the facet joint.

The facet joints are in almost constant motion with the spine, and they often become degenerated, or wear out, due to overuse. When facet joints become worn or the cartilage is torn, bone spurs can develop in adjacent areas. This can cause considerable pain with movement and is known as “facet joint disease” or “facet joint syndrome.”

Diagnosing facet joint problems can be difficult because the symptoms can be similar to other types of conditions, such as a herniated disc, a vertebral fracture, or a torn muscle. Symptoms of facet joint problems can include:

• Acute episodes of neck or back pain a few times a month or year. 
• Persistent point tenderness overlying the inflamed facet joints. 
• Loss of spinal muscle flexibility, also known as guarding. 
• More discomfort with backward leaning than forward leaning. 
• Radiating pain down the buttock and the back of the upper leg. 
• Locally radiating pain, or pain into the shoulders or upper back. 

Diagnosing facet joint problems often involves x-rays or a CT scan. Facet joint injections can also be used to diagnose a facet joint problem if a patient experiences pain relief following the injections.

There are a number of treatment options for facet joint disorders that can help with reducing the severity, persistence, and frequency of flare-ups. Conservative measure can include physical therapy and exercise, heat or cold therapy, avoiding static position, use of anti-inflammatory medications, chiropractic or osteopathic manipulation, and traction. More invasive options can include facet joint injections, facet rhizotomy, or fusion surgery.

Diagnosing facet joint problems often involves eliminating other possible causes of neck or back pain. This can be a frustrating process. It can also lead to disputes in workers’ compensation cases due to the difficulty in diagnosing the condition. As a rule, the more difficulty a condition is to diagnose, the more difficulty a patient will have securing the medical care they need from their workers’ compensation insurer.

Visit Spine-Health.com for more information about facet joint problems. 

If you’ve suffering from facet joint problems, or any other back problem, due to a work injury or your work activities, we can help make sure you get the medical care you need. We can also make sure you get the Minnesota workers’ compensation benefits you’re entitled to if you’re having difficulty doing your job because of your symptoms. For a free, no obligation consultation, contact Meuser & Associate at 877-746-5680 or click here to send us an email. 

Whiplash Injuries and Minnesota Car Accidents

Whiplash injuries are one of the most common types of injuries we see in our Minnesota personal injury practice. Whiplash is most commonly caused by a rear-end car accident. Whiplash is also known as a hyperextension/hyperflexion injury.

Whiplash is a neck injury that often occurs as the result of a rear-end auto collision, when your head suddenly moves backward, then forward. The extreme forces involved in an auto collision can push your neck muscles and ligaments beyond their normal range of motion. Whiplash can be relatively minor or it can be more severe.

Most whiplash symptoms develop within 24 hours after the injury, and often include:

• Neck pain and stiffness
• Headaches
• Dizziness
• Blurred vision
• Fatigue

Some people also experience:

• Difficulty concentrating
• Memory problems
• Sleep disturbances
• Ringing in the ears
• Irritability

You should seek medical care promptly if:

• The pain spreads to your shoulders or arms
• Moving your head becomes painful
• You experience numbness, tingling, or weakness in your arms

Many people recover from mild whiplash injuries within a few weeks, but up to half of people who suffer a whiplash injury continue to have pain for months after the injury.

When you see your doctor, he or she will probably ask how the injury occurred, and he or she may test your range of motion, or how far you can move your neck in various directions. He or she may also check to see if certain areas of your neck are particularly tender to touch. To rule out neurological deficits, your doctor may also check for diminished muscle strength, reflex abnormalities, or numbness. To rule out more serious injuries, your doctor may also order x-rays, a CT-scan, or an MRI.

Whiplash is commonly treated with:

• Medications, such as over-the-counter pain killers, prescription pain-relievers, injections, or muscle relaxers
• Physical therapy, including ice, heat, ultrasound, strengthening, and exercises
• Or, chiropractic care, massage, acupuncture, and electrical muscle stimulation.

For more information , visit the Mayo Clinic’s page about whiplash injuries.

Whiplash can be extremely painful, it can limit your ability work, and it can interfere with your ability to do things you enjoy doing. Unfortunately, insurance companies consider whiplash injuries to be very minor injuries. Your No-Fault insurance company will almost invariably seek to discontinue your entitlement to medical expense benefits if you’ve sustained a whiplash injury, and the at-fault party’s insurance company will almost always view these types of injuries as minimal.

If you’ve sustained injuries in a car accident as the result of someone else’s fault, you may be entitled to compensation for your medical expenses, your wage loss, and your pain and suffering. For a free, no-obligation with one of our Minnesota personal injury attorneys, call Meuser & Associate at 877-746-5680 or click here to send us an email.

What is a Pinched Nerve?

Nerves extent from the brain through the spinal cord into the arms and legs and transmit messages in the form of electrical impulses to and from the brain and throughout the body. Nerves that extent from the spine into the arms or legs are called peripheral nerves.

If the nerve is pinched, the flow of messages is reduced or blocked. If the nerve is pinched or blocked long enough, the nerve may lose its ability to transmit electrical charges, and the muscles controlled by those nerves may not function properly, or the skin linked to that nerve may feel numb.

A nerve may become “pinched” as it leaves the spine by a herniated disc or bone spurs.

The symptoms of a pinched nerve depend on which nerve is being affected. A pinched nerve in the low back often includes radiating pain or numbness down the leg. A pinched nerve in the neck can cause pain or numbness in the arm and hand.

Muscle spasms and strains can also put pressure on a nerve, causing temporary pinched-nerve like symptoms. If your pinched nerve symptoms are caused by muscle spasm or sprain, you may be able to relieve those symptoms by:

• Alternating between heat and ice on the painful area
• Taking a hot shower
• Laying down with a rolled up towel under your neck
• Using a handheld massager
• Getting a massage
• Do range of motion stretches
• Take a light walk
• Take an over-the-counter anti-inflammatory

If you’ve suffered a pinched nerve as the result of a Minnesota work injury, you may be entitled to workers’ compensation benefits. For a free, no-obligation consultation to learn about your legal rights, call Meuser & Associates at 877-746-5680 or click here to send us an email.

Types of Spinal Cord Injuries Caused by MN Car Accidents and Work Injuries

Even minor damage to the spinal cord can result in catastrophic injury. Approximately 250,000 Americans currently live with a significant spinal cord injury. Of these Americans, 52% suffer from paraplegia, which means they have suffered a spinal cord injury in the thoracic (mid-back) or lumbar (low back) area, and 47% suffer from quadriplegia, which means they have significant injury to their spinal cord in the cervical (neck) spine. It is estimated that about 12,000 people per year suffer spinal cord injuries.

Spinal cord injuries refer to damage to the spinal cord, which results in paralysis, impairment in normal functioning, decreased mobility, and loss of sensation. Most spinal cord injuries are caused in work-related accidents (28%) or motor vehicle accidents (24%).

Symptoms of spinal cord injury include:

• Loss of sensation and movement;
• Loss of bowel or bladder control;
• Back pain or neck pain;
• Difficulty breathing;
• Weakness;
• Paralysis;
• Numbness in extremities;
  

Different levels of the spine control different functions in the body. As a result, the level at which the spinal cord injury occurs is usually determinative as to the level of impairment.

Cervical Injuries

Cervical (neck) injuries usually result in full or partial tetraplegia (Quadriplegia).

• C3 vertebrae and above : Typically results in loss of diaphragm function, necessitating the use of a ventilator for breathing.
• C4 : Results in significant loss of function at the biceps and shoulders.
• C5 : Results in potential loss of function at the shoulders and biceps, and complete loss of function at the wrists and hands.
• C6 : Results in limited wrist control, and complete loss of hand function.
• C7 and T1 : Results in lack of dexterity in the hands and fingers, but allows for limited use of arms. C7 is generally the threshold level for retaining functional independence.
  

Thoracic injuries

Injuries at or below the thoracic spinal levels result in paraplegia. Function of the hands, arms, neck, and breathing is usually not affected.

• T1 to T8 : Results in the inability to control the abdominal muscles. Accordingly, trunk stability is affected. The lower the level of injury, the less severe the effects.
• T9 to T12 : Results in partial loss of trunk and abdominal muscle control.
  

Lumbar and Sacral injuries

The effects of injuries to the lumbar or sacral regions of the spinal cord are decreased control of the legs and hips, urinary system, and anus.

If you’ve sustained a spinal injury as a result of a work-injury or car accident, contact Meuser & Associates at 877-746-5680 or click here to send us an email, for a free, no-obligation consultation. Make sure you get the benefits you are entitled to.

Increased Costs for Neck and Back Injuries Equals Increased Denials on Minnesota Workers' Compensation Claims

Apparently, there’s a new study that suggests that more U.S. health care dollars are spent on back pain and neck pain than almost any other medical condition. After adjusting for inflation, medical costs associated with back and neck pain increased by 65% between 1997 and 2005, to about $86 billion a year.

Back injuries are the most common work-related injury we see in our Minnesota workers’ compensation law practice. In one survey, one in four adults reported low back pain within the previous year.

According to a study published in the Feb. 13 issue of The Journal of the American Medical Association, the estimated annual individual expenditures among adults with back and neck problems were $4,695 in 1997 and $6,096 in 2005.

Some of the largest increases in costs related to neck and back treatment relates to prescription drugs. Pharmaceutical expenses related to back and neck pain increased by 188% between 1997 and 2005, and the cost of prescription narcotics increased 423%.

So what does this mean for Minnesota workers who have neck and back injuries? From what we have been seeing over the past couple years, it appears that workers’ compensation insurance adjusters are more aggressive in claim denials to reduce their per-claim expenditures, whether it be in their denials of primary liability, or in denying various treatments, including MRI’s, prescriptions, cortisone injections, or surgery for back and neck injuries.

Don’t ignore disputes over medical expenses with your workers’ compensation insurer!

If you are having difficulty procuring the medical treatment you need for your Minnesota workers’ compensation injury, contact Meuser & Associates, P.A., at 877-746-5680 or click here to send us an email for a free, no-obligation consultation with one of our Minnesota workers’ compensation lawyers.

Spinal Disc Herniation Injuries

One of the most common injuries we see in our workers’ compensation and personal injury practice is disc herniation. If you’ve suffered a disc herniation as the result of your work activities, or as the result of a motor vehicle collision, you may be entitled to compensation.

A disc herniation, also commonly referred to as a prolapsed disc, ruptured disc or “slipped disc,” is a medical condition affecting the spine, where a tear in the outer, fibrous ring (annulus fibrosus) of an intervertebral disc allows the soft, central portion (nucleus) of the disc to bulge out. A tear in the outer disc ring may cause the release of inflammatory chemicals into your body, causing severe pain. If the bulge or prolapse compresses on a nerve root, it can cause pain and symptoms extending from the neck or back into the arms or legs. A disc herniation may begin as a disc protrusion, or disc bulge, where the outer layers of the disc are intact, but protrude outward when the disc is under pressure.

Disc herniations can occur at any level of the spine, but most commonly, they occur in the cervical spine (neck) or in the lumbar spine (low back). Lumbar disc herniations occur 15 times more often than cervical spine disc herniations. Cervical disc herniations occur in 8% of cases, and herniations occur only 1-2% of the time in the thoracic spine (mid-to-upper-back). Lumbar disc herniations often cause leg pain, which is commonly referred to as sciatica.

Lumbar herniations occur most commonly between the fourth and fifth vertebrae (L4-L5), and between the fifth vertebrae and the sacrum (L5-S1). Symptoms from a herniation in the lumbar spine can affect the low back, buttocks, hips, thigh, calf, foot, and toes. The sciatic nerve can be affected, causing symptoms of sciatica. The femoral nerve can also be affected, causing a numb, tingling feeling throughout one or both legs, or a burning feeling in the hips and legs.

Cervical herniations occur most often between the sixth and seventh vertebrae (C6-C7). Symptoms from a herniation in the cervical spine can affect the back of the skull, the neck, shoulder girdle, scapula, arm, and hand. The nerves of the cervical plexus and brachial plexus can also be affected.

Interestingly, most disc herniations occur to persons in their thirties or forties. After age 50 or 60, intervetebral discs tend to “dry out” and are less likely to herniated. Low back pain after the age of 50 or 60 is more frequently caused by spinal degeneration or spinal stenosis.

Disc herniations can be caused by repetitive motions, overuse, general wear and tear, blunt force trauma, lifting injuries, sharp impacts, or a variety of other strains.

Symptoms of a herniated disc depend largely on the location of the herniation. Herniations can cause little or no pain, isolated to the neck or back, or they can cause severe and disabling pain throughout virtually the entire body. Other than pain symptoms, herniated discs can cause sensory changes, such as numbness, tingling, muscular weakness, paralysis, paresthesia, decreased sensation and decreased reflexes. Generally, symptoms are experienced on one side of the body or other, in correlation whith the side of the spine where the herniation has occurred. If the herniation is large and presses on the spinal cord or cauda equina in the lumbar spine, both sides of the body may be affected.

A herniated disc is diagnosed by a doctor based on the patient’s history, symptoms, and physical examination. If a disc herniation is suspected, X-rays, a CT-Scan, an MRI, or a Myelogram may be performed to confirm a suspected herniation and to pinpoint its location.

Many herniated discs will heal after several weeks or months without surgical intervention. Often, conservative therapies including chiropractic treatment, physical therapy, bed rest, support belts, prescription anti-inflammatory medications, yoga therapy, prescription pain killers, spinal decompression, prescription muscle relaxers, oral steroid medications, and cortisone and steroid injections, are used to treat the symptoms of a herniated disc.

Surgery is generally considered as a last resort after conservative treatments fail to relieve pain or heal the disc herniation. Surgery is generally required if a patient has a significant neurological deficit, such as paralysis or cauda equina syndrome (in which there is incontinence, weakness and genital numbness). This condition is considered a medical emergency.

Surgical options include:

• Microdiscectomy 
• IDET 
• Laminectomy 
• Hemilaminectomy 
• Lumbar/Cervical fusion
• Anterior cervical discectomy and fusion
• Disc arthroplasty 
• Dynamic stabilization
• Artificial disc replacement 
• Nucleoplasty

If you have sustained a herniated disc as the result of a work injury or car accident, a workers’ compensation lawyer or personal injury can help you get the compensation you deserve. To schedule a free, no-obligation consultation with one of our attorneys, call Meuser & Associate at 877-746-5680 or click here to send us an email.

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Cortisone Injections, Epidural Steroid Injections, and Other Therapeutic Injections for Work Injuries

If you’ve sustained a work injury, your doctor may prescribe a cortisone injection, epidural steroid injection, or other therapeutic injection procedure. 

Often, cortisone injections, epidural injections, and other therapeutic injections, are considered an “intermediate” treatment, falling somewhere in between conservative therapies and more drastic procedures, such as surgery.

These therapeutic injections are covered by Minnesota workers’ compensation if they are reasonable and necessary to cure or relieve the effects of your work related injury.

Cortisone Injection

Cortisone injections are injections of a synthetic corticosteroid (cortisol) medication into an affected area of the body. Injections of cortisone are used to suppress immune response which in turn can decrease inflammation and pain. A numbing medication, such as novacaine, is typically mixed with the cortisone to provide some immediate relief and to help the cortisone spread throughout the affected area.

Cortisone injections are typically used to treat inflammatory problems that can cause pain and loss of function, including arthritis, epicondylitis (“tennis elbow”), trigger finger, de Quervain’s tenosynovitis, trochanteric bursitis of the hip, subacromial bursitis of the shoulder or shoulder impingement syndrome.

The relief provided by cortisone injections varies from person to person. Typically, cortisone starts to take effect within about a week, but may take up to two weeks to reach maximum effectiveness. Sometimes, cortisone injections don’t work for some people. In that case, it may be that your problem is not primarily an inflammatory condition, or your condition is too far along in its course for cortisone to provide relief.

Epidural Steroid Injection

Epidural steroid injections are very similar to cortisone injections, except that they are done on the spine. Epidural steroid injections are injections of corticosteroid medication and local anesthesia (numbing medication) into the lumbar, thoracic, or cervical spine, using a needle and syringe. This type of injection is aimed at providing relief from neck or back pain.

When nerve roots are irritated by a bulging or herniated disc, or by degenerative conditions such as spinal stenosis, it can cause pain and numbness, which may extend from the neck into the shoulders and arms, or from the back into the buttocks and legs.

The medication is injected into the epidural space around the nerve roots at the affected level of your spine. Epidural steroid injections work by reducing inflammation of the nerve roots, which is swelling and irritation, thereby providing pain relief. Some people receive immediate relief from epidural steroid injections, although it may take up to two weeks for the treatment to reach maximum effectiveness. Some people experience permanent relief of their neck or back pain following an epidural steroid injection, but for most people, the relief lasts for up to a few months.

Facet Joint Injection

Facet joints are small pairs of joints where vertebrae meet on the back side of the spine. These joints provide stability to spine by interlocking two vertebrae. Facet joints also allow the spine to bend forward (flexion), bend backward (extension), and twist. Inflammation of the areas surrounding the facet joints can cause pain and discomfort.

Facet joint injections are very similar to epidural steroid injections, but they are aimed at relieving inflammation in the facet joints rather than the nerve roots.

Sacroiliac Joint Injection

The sacroiliac (SI) joint connects the sacrum (the triangular bone at the bottom of the spine) with the pelvis (iliac crest). This joint transmits all the forces of the upper body to the pelvis and legs and acts as a shock-absorbing structure. This “joint” does not have much motion. The sacroiliac (SI) joint can become inflamed from an acute injury or from chronic postural abnormalities. Pain from a sacroiliac joint problem occurs in the low back, buttock/hip, abdomen, groin, or legs.

The sacroiliac joint can become inflamed from an acute injury or from chronic postural abnormalities. Undue stress on the joint following low back fusion surgery can also cause inflammation and pain here. Pain from sacroiliac joint abnormalities occurs in the low back, buttock/hip, abdomen, groin, or legs.

A sacroiliac joint injection can serve two purposes. First, the injection can be used as a diagnostic tool to confirm whether or not the pain is coming from that joint. Second, the local anesthetic and cortisone medication can provide symptom relief which can help facilitate a program of rehabilitation.

Neurotomy

Facet joints are pairs of small joints that separate the vertebra on the back side of the spine in the lumbar (low back), thoracic (mid-back), and cervical (neck) regions. These joints can become inflamed and painful from either injuries or arthritic conditions. When facet injections of local anesthetic and/or cortisone provide temporary pain relief, you may be a candidate for a facet neurotomy.

A facet neurotomy involves destroying the nerves that relay pain messages from the facet joints. This is accomplished by using a technology called Radio Frequency Thermal Coagulation (RFTC). Under x-ray guidance, your physician places a fine probe, not much larger than the needle used in facet injections, down to the nerves that supply the facet joint(s). A controlled heat lesion is then made using RTFC. Each facet joint has at least two nerve branches therefore several lesions may need to be done at the time of the procedure.

Neurotomies are more intensive procedures than epidural steroid injections or facet joint injections. Expect moderate pain for several days following the procedure, and it may take several weeks to experience the maximum effect of the treatment. A neurotomy can provide up to six months or more of relief.

There are several other types of minimally-invasive injection-based therapies available for people suffering from work injuries to the hips, knees, elbows, shoulders, neck or back. The workers’ compensation lawyers at Meuser & Associate can help you get the medical treatment you need to treat your work injuries. Call us at 877-746-5680 or click here to send us an email to schedule a free, no-obligation consultation.

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MN Workers' Compensation and Neck and Back Disc Injuries

The most common type of injury we see in our workers’ compensation practice is disc injuries in the low back and neck, including disc herniations, bulges, protrusions, and tears.

The vertebrae of the spine are held together by muscles, tendons and ligaments. In between each vertebrae are discs, which act as a cushion between the bones. When these discs are injured, they cannot effectively act as “shock absorbers” between the vertebrae. Extrusions, bulges and herniations of the discs can impinge or press on nerve roots, which can cause pain which radiates into the arms or the legs. In addition to pain, severe impingement on nerves can cause numbness, incontinence, or even paralysis.

A herniated disc occurs when the disc ruptures and a portion of the inside of the disc protrudes. If the protrusion impinges on the spinal cord or on a nerve root, it can cause radiating pain and/or numbness into the arms or legs. A bulging disc occurs when a portion of the disc protrudes into the spinal canal. If the protrusion presses on the spinal cord or nerve root, it can cause radiating pain in the arms or legs.

Disc injuries in the neck or back, such as herniations or bulges, can be caused by many things at work, including reaching for objects, poor posture, poor body mechanics in lifting, pushing, pulling or carrying, repetitive lifting, twisting or bending while lifting, heavy lifting, fatigue, poor footing, falls, or vibrations.

If a disc injury is suspected, you may undergo a CT-Scan or an MRI. Often disc injuries are initially treated conservatively, with chiropractic treatment, physical therapy, and cortisone injections. Sometimes, disc injuries will become asymptomatic with time, rest, and conservative treatment. If the disc is impinging on a nerve root, or if the vertebrae surrounding are chronically unstable, surgery may be necessary.

There are number of different surgeries that may be performed to correct disc and vertebral injuries including fusion, discectomy, laminectomy, laminotomy, decompression, intradiscal electrothermoplasty, or radiofrequency discal nucleoplasty.

Back or neck disc injuries can be very serious. They can cause severe and chronic pain, can cause you to miss substantial time from work, and can prevent you from going back to your trade or profession. Dealing with the Minnesota Workers’ Compensation system and the work comp insurance company when you have a neck or back injury can be frustrating, at best. Give us a call at 877-746-5680 or click here to send us an email to schedule a free consultation. We can help take some of the frustration and uncertainty out of dealing with a work-related neck or back injury.

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