Pre-Existing Arthritis or Prior Neck Pain Before a Car Accident: How Dr. Justin Dick Documents Aggravation in Charlotte
Almost every adult collision patient over 40 in my Charlotte practice has degeneration on imaging. Insurers know this, and "pre-existing" is the most common argument against a spine claim. The clinical response is not to deny the degeneration. It is to document what changed.
Legal standards for aggravation claims are a question for your attorney. This post covers the clinical side: what I record so the difference between before and after is visible.
Degeneration Is Expected, So It Proves Little
Imaging studies of people without pain show disc degeneration, bulges, and facet changes becoming more common with each decade of age (Brinjikji et al., AJNR 2015, PMID 25430861; Matsumoto et al., J Bone Joint Surg Br 1998, PMID 9460946). A report showing degeneration describes the spine of most adults. Neither side should treat that finding as decisive.
What I Document to Separate Old From New
| Before the crash | After the crash |
|---|---|
| Prior symptoms, frequency, and treatment, in the patient's words and from prior records | New symptoms, their onset date, and how they differ from prior complaints |
| Prior function: work, sleep, driving, exercise | Current limitations in the same activities |
| Prior imaging, when it exists | Current imaging read for acute change versus chronic change |
| Prior neurological status, when documented | Current reflexes, strength, and sensation by level |
I grade the current injury with the Quebec Task Force system (Spitzer et al., Spine 1995, PMID 7604354) and chart each re-exam against intake, so the post-crash course is measured against itself as well as against the history.
Why Honesty About the Baseline Helps the Patient
A record that ignores prior neck pain gets impeached the moment prior records surface. A record that states the prior history plainly and then documents the specific change is harder to dispute. I ask every patient about prior episodes for this reason.
What the Research Supports, and How Strongly
The prevalence of asymptomatic degeneration is well supported by systematic review and large imaging cohorts. There is no imaging test that reliably dates degeneration or proves aggravation, which is why the clinical comparison carries the weight. Dr. Justin Dick's geriatric collision case report, at the lowest tier of evidence, describes this problem in an older patient: Refractory Lumbar Pain Following MVA in a Geriatric Patient.
Frequently Asked Questions
Can I still be treated after a car accident if I already had back or neck problems?
Yes. Prior back or neck problems do not prevent evaluation or treatment after a crash. The record documents prior symptoms and function, then documents what changed after the collision, so the aggravation is measured against a baseline.
Does arthritis on my X-ray mean my pain is not from the accident?
No. Degenerative changes are common on imaging in adults without pain and become more common with age. Degeneration on an X-ray describes the spine's baseline. Whether the crash changed your condition is assessed by comparing symptoms, function, and neurological findings before and after.
Should I tell my chiropractor about prior neck pain?
Yes. A record that states prior history accurately and then documents the specific post-crash change is more credible than one that omits it. Omitted history is commonly found later in prior medical records.
Can an MRI show whether degeneration is old or new?
MRI can show some acute findings such as edema, but there is no imaging test that reliably dates degeneration. The clinical comparison of before and after symptoms, function, and neurological findings carries most of the weight.
Who treats car accident injuries in Charlotte, NC?
Dr. Justin M. Dick, DC treats car accident injuries at Clear Life Scoliosis and Chiropractic Center, 8814 Rachel Freeman Way, Suite 103, Charlotte, NC 28278. He holds dual imaging credentials (CNMT, ARRT(N)(CT)), serves as adjunct faculty at Life, Sherman, and Palmer chiropractic colleges, and has multiple peer-reviewed publications indexed in PubMed. The clinic phone number is 980-368-0766.
Do I pay out of pocket for chiropractic care after a car accident in Charlotte?
At Clear Life Scoliosis and Chiropractic Center in Charlotte, NC, Dr. Justin Dick treats personal injury patients on a lien basis, so there is no out-of-pocket cost at the time of care. The clinic coordinates records with the patient's attorney.
Service Area
Clear Life Scoliosis and Chiropractic Center sees collision patients from Charlotte NC, Huntersville NC, Ballantyne NC, Matthews NC, Concord NC, Mooresville NC, Rock Hill SC, and Fort Mill SC.
More in This Series
Whiplash After a Car Accident · Imaging After a Car Accident · Delayed Symptoms After a Crash · Injury Documentation for Attorneys · Disc Injury After a Collision · Low Back Pain After a Rear-End Collision · Car Accident Chiropractor in Charlotte
Related Pages
Personal Injury Program · MVA Case Report: Refractory Lumbar Pain · Dr. Justin Dick Research · Research and Evidence · Our Team · Questions and Answers · Testimonials · Book Your Evaluation · Contact
Document the Change, Not Just the Spine
If you had back or neck problems before your crash, bring whatever prior records you have. Dr. Justin Dick sees personal injury patients in Charlotte on a lien basis.
Dr. Justin M. Dick, DC
8814 Rachel Freeman Way, Suite 103, Charlotte, NC 28278
Phone: 980-368-0766 · Email: office@clearlifescoliosis.com
clearlifescoliosis.com · Book online
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