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Rawson L. Wood
Mathew J. Greenston
Charles E. Bain
, and
Charles N. Brooks


Complaints of spinal pain are common after motor vehicle collisions (MVCs), and evaluators may be asked whether the collision caused permanent injury to the spine, including aggravating intervertebral disc degeneration (IDD) and/or causing a disc herniation. To determine causality, evaluators can use the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) to understand if a low-speed collision caused IDD. Injury causation analysis (ICA) is the scientific method used to analyze the mechanism and magnitude of injury for people who experience an MVC. ICA involves comparing the mechanical forces involved in the incident with the body's injury tolerance. Low back pain (LBP) is a common complaint following MVCs, but the literature regarding automobile collision testing has been compared to the body of evidence regarding real-world collision data and shows that, for low-speed impacts, any injuries are minor and self-limiting. Further, disability due to LBP was predicted by an abnormal baseline psychological test profile or a previously disputed compensation claim. The motions, forces, and accelerations generated in low-speed collisions are less than those encountered in activities of everyday living. ICA suggests that disc degeneration and disc herniations are pre-existing and are not caused by low-speed MVCs. Although the pain caused by a muscle sprain associated with a low-speed collision may prompt imaging studies that show disc pathology, these are coincidental and are not causally related.

in AMA Guides® Newsletter