This post will help you understand how epidural steroid injections impact the settlement compensation payouts in motor vehicle accident cases where the victim suffers a herniated or bulging disc.
A disc herniation is a type of disc injury that is frequently caused by car accidents. The impact of a car accident often exerts significant force and pressure on the spine. This pressure can cause a tear and rupture or bulge of the spinal discs, which act as pads or cushions for the spine. Sometimes, the best treatment for this injury is epidural steroid injections.
Our First Trial Was an Epidural Injection Case
Our firm has handled scores and scores of herniated disc injury cases. Our first trial at Miller & Zois was a herniated disc verdict twenty years ago in 2003. Our doors had been open for about a month. The defendant offered $25,000 to settle a no-property damage herniated disc injury case where the most aggressive treatment had been epidural steroid injections.
Laura Zois and I tried the case. We got a $300,000 verdict. Our firm has handled these cases ever since. We have earned millions in settlements and verdicts in herniated disc injury cases.
I originally wrote this page in 2018 but updated it in 2023 with more recent settlements and verdicts and new information on epidural steroid injections. I continue to learn from handling these cases and I share what I know with you.
What Are the Treatment Options for a Herniated Disc?
Having a herniated disc is like saying you are an actor. You might be Tom Hanks bringing in $20 million a film. Or you could be the understudy at a local dinner theater. About 20% of us have a herniated disc. Many of us do not even know we have a herniation because we cannot feel it. Some of us have very slight herniations that cause great pain every day.
So there is a food chain of increasingly intensive treatment when dealing with a herniated disc that goes something like this:
(1) Conservative Treatment. The first level of treatment typically involves a course of anti-inflammatory drugs combined with physical therapy.
(2) Steroid Injections. If the initial conservative treatments are not successful, then the next level treatment option is often steroid injections. The steroids are injected into the spine to reduce swelling and alleviate pressure on the nerves caused by the disc herniation.
(3) Surgery. If both conservative treatment and steroid injections fail, the third level of treatment options for disc herniation is surgery. Surgical treatment options range from minimally invasive procedures to open back surgery.
Which Epidural Steroid Injections Treat Disc Injuries?
Therapeutic spinal epidural injections or select nerve root blocks are the type of injections our lawyers usually see. There are three primary approaches to epidural steroid injections:
- Interlaminar epidural injection: injecting anti-inflammatory medicine and steroids into the epidural space. This is the most common type we see in personal injury cases.
- Transforaminal epidural injection (often called nerve blocks): injecting local anesthetic and steroid into the area where the spinal nerves exit (lumbar, cervical, or thoracic).
- Caudal epidural injections: injecting caudal steroid into the epidural space through the sacral hiatus. Our lawyers usually do not see this kind of injection until after back surgery which did not prove the victim with relief.
Many studies are showing the effectiveness of epidural steroid injections in treating low back and neck pain. Do they always work? No.
My Call with a Disc Injury Client
I was talking to a client last week who is receiving epidural steroid injections for a C3-C4 herniated disc after a rear-end car accident. She said that she wanted to get the case resolved, if possible, and get the surgery next year when she had fewer commitments.
Now, I don’t want my client to think I’m suggesting getting surgery to improve the value of her case. Because I’m not. But the reality is that if she will get the surgery, she should wait to resolve her case until after the surgery.
Because you can drive a truck through the difference between herniated disc injury cases that are treated with steroid injection and those that require surgery.
Many of you reading this do not want to hear this. Yes, steroid epidural injections will likely increase the settlement payout of a disc injury claim. But getting surgery can have a real multiplier effect on settlement value.
When it comes to settlement compensation, all things being equal, steroid injections increase the settlement compensation more than conservative chiropractic or physical therapy, and surgery increases a herniated disc injury settlement amount more than epidural steroid injections.
What is the Settlement Value of Steroid Injection Cases?
So how much of a difference is there between steroid injections and surgery? I pulled some recent verdicts to see what the steroid injection verdicts look like.
Please keep in mind these are not Miller & Zois cases (well the most recent one is), but cases we found through research. My need for clarity on this point will become clear in a moment.
- Plaintiff v. State Farm (2023): Our client was driving home from North Carolina to her home in New York when she was involved in a serious accident in Maryland. At the time of the accident, she was 53-years-old and she had a very good driving record. As a result of accident, our client experienced aggravation of her pre-existing degenerative disc disease resulting in chronic pain. Her treatment included extensive physical therapy and epidural steroid injections. We settled with the at-fault driver for his policy limit of $100,000. We then brought a claim against State Farm for UIM benefits to cover the rest of our client’s damages. We were unable to settle with State Farm so the case went to trial in Baltimore County. We were seeking $282,000 for future medical expenses (steroid injections 3 times per year for the rest of the client’s life) and $60,000 in past medical expenses. We also sought $1.1 million in pain and suffering damages. The client testified at the trial and was a very effective and convincing witness. Her testimony and the impression she made on the jury were a key reason for the verdict. We also presented testimony from four fact witnesses regarding our client’s pain and suffering. The jury ultimately awarded $1,282,000 in damages.
- Plaintiff v. Defenddant (2023): The plaintiff claimed she suffered a herniated disc in her next that was managed with conservative treatment methods and steroid injections. The plaintiff’s expert submitted a lifecare plan exceeding $300,000. The defense presented a counter lifecare plan of $170,000. The defense’s medical expert testified that the plaintiff had a permanent injury to the cervical spine, and the court confirmed this with a directed verdict. The defense argued that the herniation was a pre-existing condition and any future treatment should be limited to the reasonable care outlined in their lifecare plan. The plaintiff decided not to seek compensation for past medical expenses and instead requested $2.333 million from the jury. After a few hours of deliberation, the jury returned with a verdict, awarding the plaintiff $245,782.
- Webb v. Wison (2022): A 50-something truck driver was rear-ended in a chain-reaction collision in Texas. He suffered cervical and lumbar herniations. The man underwent chiropractic therapy and steroid injections. He alleged negligence against the at-fault driver. The man claimed she failed to watch the road and timely slowdown. A jury awarded $41,116
- Leverett v. Wray Trucking (2020): A 70-year-old man was sideswiped by an eighteen-wheeler. He is diagnosed with a neck herniation. When PT fails, he gets steroid shots. The jury awarded him a $639,000 verdict.
- Mouton v. United States (2020): A man suffered multiple injuries after an FAA-owned vehicle struck him. He suffered a soft-tissue cervical injury, the aggravation of a pre-existing disc injury, and a concussion. The man received steroid injections for his injured back. He testified that his aggravated disc injury necessitated future surgery. So this is the classic “I will get the surgery later” case. The man sued the FAA, which disputed the extent of his injuries. The verdict was $169,756
- Nazario v. Exclusive Ambulette Service (2020): A woman was rear-ended as she was stopped at a red light. She suffered C3-4 and C4-5 disc herniations. The woman initially underwent 12 steroid injections and physical therapy. This treatment did not successfully resolve her pain. She then underwent a discectomy to replace her C3-4 and C4-5 discs. The woman missed eight weeks of work. She also claimed residual pain that affected her ability to do basic activities. The jury awarded her $1,100,000. However, she could recover the negotiated stipulated limit of $800,000. (She got the surgery so this case arguably does not belong.)
- Nie v. Uwamwiza (2020): A man was sideswiped by a driver who failed to maintain a single lane as they were traveling on the same feeder road. He suffered C4-C5, C6-C7, and L4-5 disc herniations. The man also suffered sprains to his thorax and shoulder as well as headaches. He underwent steroid injections, which relieved some of his lower back pain. The man sued the other driver for failing to take evasive action and keeping a proper lookout. The defendant denied negligence and claimed that the man’s actions contributed to the accident. A jury awarded a $35,352 verdict.
- RGraccino v. Blue Sky Logistics (2019): The plaintiff, a 28-year-old truck driver, was rear-ended by a truck. He suffered a C6-C7 disc injury treated with epidural steroid injections and cervical disc decompression surgery. This was a bench trial. This means the claim was decided by a judge instead of a jury. The judge awarded the plaintiff $116,898.
- Ramirez v. Thomas (2019): The plaintiff was rear-ended and suffered injuries to the discs of her cervical and lumbar spine. She treated by a chiropractor and orthopedist. The plaintiff required an epidural steroid injection in her back. The jury awarded $40,000.
- Diaz-Pineda v Hill (2018): The plaintiff rear-ended and suffers disc herniations at multiple levels. Herniated discs are treated with steroid injection therapy and result, allegedly, in permanent injury. The jury awards the plaintiff $32,500.
- Swell v. Metro Transit Authority (2018): A transit bus makes an unlawful right turn on a red light and hits the plaintiff who is crossing an intersection in the crosswalk on his bicycle. The plaintiff suffers cervical disc herniations that are treated with epidural steroid injections but no surgery. Jury awards $39,000.
- Dutra v Mohan (2018): The plaintiff gets T-boned by the defendant pulling out of a parking lot. She suffers L5-S1 disc protrusion which is treated with epidural steroids and trigger point injections. The jury awards $17,460 in damages.
- Janson v. Scaccio (2017): The plaintiff was rear-ended while at a red light. She sought damages for cervical disc herniation. Her treatment included therapy and a course of steroid injections. She was awarded $5,200.
- Leitzel v. Oji (2016): The plaintiff was a passenger in a car that was t-boned at an intersection by the defendant. The plaintiff’s primary injury was cervical disc herniation, which was treated with steroid injection therapy. He was awarded damages of $12,250.
- Zopp v. State Farm (2015): The plaintiff was rear-ended and suffered cervical disc herniation. Her treatment included an extensive course of epidermal steroid injections and she was found to have 18% permanent impairment of the cervical spine. The jury awarded the Plaintiff $12,500. In this case, it is fair to say the injection has little impact on the jury’s payout.
- Jamison v. Beach (2015): The plaintiff alleged to have suffered an L4-L5 disc herniation in an auto accident. Treatment included spinal steroid injections. The plaintiff was awarded $18,000.
- Enweze v. Greco (2014): The plaintiff collided with the defendant’s car as the defendant was backing out of her driveway. The plaintiff suffered lumbar disc herniation and was treated with therapy and steroid injections. The plaintiff was awarded $38,000 for medical expenses and lost wages.
- Jefferies v. Daniels (2014): Plaintiff and defendant collided when the defendant made an illegal left turn, crossing over the plaintiff’s lane of travel. The plaintiff claimed she suffered a herniated disc in her cervical spine. Treatment was limited to therapy and injections. After a bench trial, the plaintiff was awarded $9,300.
- Rogers v. Mathis (2013): The plaintiff stopped at a red light and was rear-ended by the defendant. The plaintiff sought damages for cervical disc herniations with 9% permanent impairment and lumbar disc herniations with 5% permanent impairment. The victim’s treatment did not go beyond therapy and steroid injections. The plaintiff was awarded $39,000.
- Castillo v. MAIF (2013): The plaintiff was rear-ended at a low speed in stop-and-go traffic in Maryland. He sought damages for L4-L5 disc herniation of the central spine which was treated with steroid injections. The final award was $9,300.
- Bosley v. Wirts (2011): The plaintiff was hit from the rear on the highway by the defendant and suffered “spinal nerve” damage. He was treated with steroid injections and awarded $41,000 in damages. NOTE: Although this case involved steroid injection treatment, the plaintiff’s injuries may have been somewhat more extensive than a herniated disc. Most cases have multiple injuries that impede the ability to find value by looking at sample verdicts and settlements.
Oh my goodness. It turns out that you can fit a lot more than a truck between a herniated disc surgery cases and one treated just with steroids. I mean, I’ve asked a jury for more than these compensation payouts just for receiving the injections themselves. Have you seen those needles?
These verdicts are beyond awful. I want to say it is a small sampling size, but we found 10 herniated disc injury cases that were treated with steroid injections. I can tell you emphatically, categorically, for-sureedly (a new word I just made up for emphasis) that these are not representative of our results in these disc injury cases. Look at a few of the Miller & Zois verdicts on this list. I don’t think any of our cases here were surgery cases.
Don’t Get Silly with “Average” Statistics
One final note… Another law firm saw the traffic this post gets and wrote a similar post. One difference: they use the word average as if average steroid injection settlement or verdict statistics exist.
You can’t fall for that kind of nonsense. There is no data on the average steroid injection disc injury case settlement or verdict or how much a steroid injection increases your settlement amount. Those numbers do not exist. Nor is it helpful to better understand the settlement value of your case.
Can I Call a Lawyer to Get an Estimated Settlement Amount for My Claim?
Our lawyers get calls almost every day asking for the expected settlement amount for their claim. I wish it was that easy. But you determine settlement compensation by reading the medical records, considering how the injury impacted the client, the jurisdiction, the insurance policies, the insurance company, and a host of other factors. If you call a lawyer to ask about the settlement value of your bulging or herniated disc case, you will get a useless answer.
Medical Literature on Steroid Epidural Injections
In lawsuits alleging a disc injury, our lawyers used medical experts to discuss the patient’s injuries. Here are some of the key articles on the efficacy of steroid injections in disc injury cases before considering surgery and the risks the patients assume when getting injections, particularly as the number of injections increases.
- Napoli, A et. al (2023): Smith, J., & Johnson, R. (2023). Minimally Invasive Procedure with Steroid Injections: A Superior Solution for Sciatica. Radiology, 300(5), 100-110. Study revealed that a combined approach of minimally invasive procedure along with the administration of epidural steroid injections resulted in superior pain reduction and improved disability over a span of one year in individuals suffering from sciatica. This research, published in the journal Radiology, demonstrated that this combined treatment strategy was more effective than the administration of steroid injections in isolation.
- Stynes, S, et. al (2022). Predictors of Outcome Following an Epidural Steroid Injections for Disc-Related Sciatica: A Consensus Study, Orthopaedic ProceedingsVol. 104-B, No. SUPP_9 (2022). Study looks at what predicts a succesful outcome after a steroid injection.
- Manchikanit L, et. al (2021). Epidural Corticosteroid Injections for Sciatica: A Cochrane Review of Epidural Corticosteroid Injections Distorts the Truth. Spine, July 2021, Vol. 46, Issue 13: p. E750.
- Vydra D, et al (2020). Current Trends in Steroid Dose Choice and Frequency of Administration of Epidural Steroid Injections: A Survey Study. Journal of Injury, Function, and Rehabilitation, 2020 Jan;12(1):49-54. A study conducted by a pain medicine fellow at the Mayo Clinic in Florida his colleagues that underscores epidural injections come with risks that increase cumulatively.
- van Helvoirt H, et al (2014). Transforaminal epidural steroid injections followed by Mechanical Diagnosis and Therapy to prevent surgery for lumbar disc herniation. Pain Med 2014;15: 1100-1108. There is universal acceptance of the idea that all non-surgical interventions must be explored for a herniated disc before surgery. This article shows injections may give patients a chance to avoid surgery. Herniated disc injury lawyers use this article to underscore that a part of the settlement compensation in any given lawsuit is what the plaintiff was willing to endure and risk to relieve the pain.
- Desai MJ, et al (2013). Directional preference following epidural steroid injection in three patients with acute cervical radiculopathy. Pain Pract 2013 September;13(7): 559-565. Cervical radiculopathy is a condition often caused by nerve root issues due to inflammation or mechanical problems, leading to neurological symptoms. This report discusses three patients diagnosed with this condition, whose preferred treatment direction only became apparent after receiving a specific type of steroid injection in the neck. These three men experienced severe neck pain and disability and showed no improvement with an initial mechanical diagnosis and therapy evaluation. They presented symptoms of weakness, sensory changes, and/or reduced reflexes. After receiving one or two specific types of steroid injections, their preferred treatment direction became clear, enabling more effective treatment. Following the injections, each patient saw significant improvement in their condition with every physical therapy session. Their pain levels decreased, the pain centralized, and their disability scores gradually reduced. After four physical therapy sessions, they were all discharged with minimal to no pain and disability. So what did we learn? We learned that both inflammation and mechanical factors contribute to spine-related pain, making treatment challenging. But using a methodical, multidisciplinary approach may be beneficial for managing cervical radiculopathy and similar conditions in the future.
Hire a Disc Injury Lawyer in Maryland
If you or someone you know was recently in a car accident and may have a herniated disc or other injuries, contact our office at 1.800.553.8082 or submit a request for a free consultation.