There are a variety of chronic pain conditions. This article will look at:
- Complex Regional Pain Syndrome
These are unusual conditions. Often difficult to diagnose as chronic pain develops over time and is frequently out of proportion to the original minor injury. For example, a minor whiplash leading to debilitating symptoms affecting a Claimant’s quality of life and ability to work. Where minor injuries lead to disproportionate symptoms, Defendants often allege that the Claimant is exaggerating, malingering or that the chronic pain would have occurred in any event.
Solicitors are not expected to diagnose these medical conditions but if a Claimant is not recovering within the expected diagnosis period and reporting symptoms such as pain, fatigue, muscle stiffness, headaches, poor sleep and irritable bowel symptoms, then the possibility is that they may have developed a chronic pain condition.
Fibromyalgia is a rheumatological condition with widespread pain lasting for over 3 months with at least 11 of 18 trigger points in the body being affected. The NHS describes it as a long term condition that causes pain all over the body.
Complex Regional Pain Syndrome (CRPS)
CRPS is the most painful chronic pain condition causing persistent, severe and debilitating pain which is much more severe and long lasting than normal. The pain is usually in one limb (regional) and the skin becomes so sensitive that just a slight touch can provide intense pain. It can cause colour change in one limb, mottling, temperature differences, sweating, swelling, restriction of movement and furry black hair on the back of the hand or leg.
There are certain matters to be considered in running a chronic pain claim:
- The importance of choosing the correct medical expert
- Looking at what was going on before the accident
- Whether the Claimant had a good work history
- Whether there were any un-associated problems that might provide an explanation for the chronic pain condition
- The continuum of pain and consistency of presentation.
This is illustrated by the following cases:
Bennett v. Smith 2003
The Claimant had a road traffic accident in 1997 at the age of 36. Before the accident she suffered from lower back pain as a teenager and had chest pains in the year before the accident. Her accident injuries were whiplash and a minor problem with her jaw. In the following months she went on to develop stiffness and pain in her neck and she tested positive for various “trigger points” for the presence of pain. She developed widespread muscolo-skeletal pain and fatigue from poor sleep. Four experts gave evidence and the Court preferred the evidence of the expert who was most experienced in diagnosing and treating Fibromyalgia. The Claimant was successful because she was able to prove a continuum of pain post-accident with no other reasonable explanation for her symptoms.
In contrast in Lodge v. Scott 2007 the Claimant had a road traffic accident with whiplash and subsequently experienced frequent attacks of dizziness which was diagnosed as vertigo. She was referred to a heart specialist and treated for epilepsy. She claimed that the whiplash caused these other injuries. The Defendants disagreed alleging that the true cause of her symptoms was an unrelated viral ear infection. Medical experts were called to give evidence.
The Court held that the Claimant had failed to establish a link between the original accident and her ongoing symptoms. The Court found that the viral ear infection was the cause of her pain and not the road traffic accident. She had failed to prove a continuum of pain and there was an alternative explanation for her condition.
In terms of medical experts the Courts have suggested as good practice that medical reports are obtained from the following experts:-
- For Fibromyalgia – a Rheumatologist and probably a Psychiatrist or Psychologist
- For Chronic Regional Pain Syndrome – a Pain Expert and a Psychiatrist and a Psychologist
These are complex conditions arising out of straightforward injuries and if you would like to discuss further, please contact our specialist lawyers on 01908 689365.