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. This injury is referred to as a herniated disc. Sometimes, the best treatment for this injury is epidural steroid injections.
Our firm has handled scores and scores of herniated disc injury cases. Our first trial at Miller & Zois was a herniated disc verdict 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 was 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 2020 with more recent settlements and verdicts and new information on epidural steroid injections I have learned from handling more of these cases.
Treatment Options for Herniated Disc Injuries
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.
Epidural Steroid Injections
Therapeutic spinal epidural injections or select nerve root blocks are the type of injections our lawyers usually see. There are three primary approaches with 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 that 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 was saying 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 is going to get the surgery, she should wait to resolve her case until after the surgery because I believe you could drive a truck through the difference between herniated disc injury cases that are treated with steroid injection and those that require surgery.
Value of Steroid Injections
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, but cases we found through research. My need for clarity on this point will become clear in about 2 seconds.
- 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 with a chiropractor and orthopedist. She plaintiff required an epidural steroid injection in her back. The jury awarded $40,000 (but it was reduced by 25% for comparative negligence).
- 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 in permanent injury. Jury awards plaintiff $32,500.
- Swell v. Metro Transit Authority (2018): 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 but it gets reduced to $24,180 based on the plaintiff’s 38% comparative negligence share.
- 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 steroid and trigger point injections. 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.
- 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.
- 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.
- 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. 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 just for getting 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 (new word I just made up for emphasis): 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.
Medical Literature on Steroid Epidural Injections
- 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. Study underscores that 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
- 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. The study takes a look at a small number of patients who had success with injections.
CONTACT US ABOUT YOUR HERNIATED DISC
If you or someone you know was recently in a car accident and may have a herniated disc or other injury, contact our office at 1.800.553.8082 or submit a request for a free consultation.