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Tag: Chronic Myofascial Pain

$95,000 Non-Pecuniary Assessment For Chronic Pain with Psychiatric Overlay

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Reasons for judgment were published today by the BC Supreme Court, Vancouver Registry, assessing damages for chronic pain symptoms with psychiatric overlay caused by a series of collisions.
In today’s case (Sandhu v. Bates) the Plaintiff was injured in three collisions.  Fault was admitted by the Defendants.  The Plaintiff suffered injuries which developed into a myofascial pain syndrome.  She further developed somatic symptom disorders.  Her prognosis for full recovery was guarded.  In assessing non-pecuniary damages at $95,000 Madam Justice Winteringham provided the following reasons:

[137]     In summary, I make the following findings of fact respecting Mrs. Sandhu’s injuries:

a)    Mrs. Sandhu sustained moderate soft tissue injuries to her neck, lower back, buttock, right hip, right ankle, and right knee in the accidents.

b)    Rather than following a typical course of recovery after the accidents, Mrs. Sandhu experienced chronic low back pain affecting her buttock and pain down the right leg and associated numbness in the left buttock. Her chronic pain worsened in the first and second years following the accident and persisted at the time of trial.

c)     I accept Dr. Squire’s opinion that the diagnosis for her physical injuries is most consistent with myofascial pain syndrome of the lumbopelvic area and that the intermittent exacerbations are likely episodic acute muscle spasms and the right leg pain is likely referred pain from the myofascial pain syndrome. I also accept that she continues to experience intermittent neck pain.

d)    Dr. Joy, Dr. Anderson and Dr. Suhail all agree, and I find, that Mrs. Sandhu developed somatic symptom disorders. I note that though their diagnoses were not identical, Dr. Anderson and Dr. Suhail report that she meets the diagnostic criteria of somatic symptom disorder with predominant pain, following the accidents.  In addition, I accept Dr. Anderson’s opinion that following the accidents, Mrs. Sandhu suffers from a generalized anxiety disorder.

e)    I find that, as Mrs. Sandhu’s psychological condition deteriorated, her ability to cope with pain was poor. Dr. Suhail’s opinion, with which I agree, was that “as here pain would trigger her anxiety, her subsequent psychological problems would reduce her ability to cope with pain. Whenever she would be stressed and anxious, her back pain would increase.”

f)      Dr. Joy, Dr. Anderson, Dr. Suhail, Dr. Chapman and Dr. Kashif all agree that Mrs. Sandhu suffered from anxiety after the accidents. They disagree about prognosis. I find that the first accident, and aggravated in the second and third, caused Mrs. Sandhu’s generalized anxiety disorder. The medical experts are all of the opinion that Mrs. Sandhu’s prognosis is guarded, particularly if she is unable to address her anxiety disorder. Dr. Suhail indicated some recent improvement and, with ongoing cognitive behavioral treatment, there is some reason for cautious optimism.

…

[153]     I have reviewed the cases referred to by the parties. On my review of Mrs. Sandhu’s cases, as her counsel admits, the injuries suffered in some of those cases were more serious than what I have found in the present case. Similarly, I have found the cases relied on by the Defendants involved Plaintiffs with lesser injuries than those I have found in Mrs. Sandhu’s case.

[154]     In all of the circumstances, and taking into account the authorities I have been referred to, I am satisfied that an award of $95,000 will appropriately compensate Mrs. Sandhu for her pain and suffering and loss of past and future enjoyment of life, for which the Defendants are responsible.

$90,000 Non-Pecuniary Assessment For Chronic Myofascial Pain

Written by admin on . Posted in ICBC Chronic Pain Cases, ICBC Soft Tissue Injury Cases.

Reasons for judgement were released today by the BC Supreme Court, Vancouver Registry, assessing damages for partly disabling chronic myofascial pain symptoms following a collision.
In today’s case (Camilleri v. Bergen) the Plaintiff was injured in a 2011 collision.  The Defendant admitted fault.  The Plaintiff suffered from chronic myofascial pain symptoms which were not expected to improve.  In assessing non-pecuniary damages at $90,000 Madam Justice Loo provided the following reasons:

[74]        As discussed above, Ms. Camilleri now suffers from chronic myofascial pain as a result of the accident. She is unlikely to recover and, at best, she may mitigate some of her symptoms. I can do no better than to summarize her symptoms as set out in Dr. Dost’s report. She complains of:

1.   Constant cervical or neck pain that radiates to the interscapular region, left shoulder and diffusely down her arm to her third and fifth fingers;

2.   Constant thoracolumbar or back pain, without radicular symptoms, but with numbness and tingling;

3.   Headaches almost daily. About four days a week she has a dull headache, occipital pressure, and some nausea. Three days a week her headaches are quite severe and radiate to her left eye with pressure, pounding, nausea, and light and noise sensitivity;

4.   Sleep disruption secondary to pain;

5.   Altered mood;

6.   Light-headedness (a faint-like sensation that occurs early in the morning);

7.   Increased tinnitus;

8.   Increased blurred vision requiring stronger prescription glasses; and

9.   Difficulties with memory, processing speed, multitasking, attention and recall.

[75]        Her symptoms are not likely to improve. The evidence suggests that she can only learn to cope with her symptoms with psychiatric or psychological counselling, a physiatrist to deal with the physical complaints, and possibly a pain clinic to help her deal with her pain.

[76]        Ms. Camilleri’s life has been affected dramatically and profoundly by the accident. Her symptoms have been a tremendous challenge for her both emotionally and physically. She was a very high energy person who was fully committed to her family and to her work. She was a leader in her field. I could not help but have the impression that Ms. Camilleri was so committed to her work and patients at the eating disorder clinic that she was more concerned about helping the patients and the community rather than making money. She could easily have made more money in private practice but she was committed to helping those who could not afford private care. She was so committed to her work that she increased her hours of work after the accident so that her patients would continue to have treatment despite the toll it has taken on her physical and emotional health.

[77]        Ms. Camilleri said that it has been emotionally challenging for her to be forced to step back into what she considers a lesser role in the treatment of the eating disordered. She enjoyed her volunteer positions, she enjoyed teaching, she enjoyed the continuing education opportunities with other health professionals, and she enjoyed research. Those are things she can no longer enjoy.

[78]        She was also a physically active person who enjoying skiing with her family, running, cycling, water-skiing, gardening, and she enjoyed sharing many of those activities with her husband and daughters. Those are things she can no longer enjoy. She no longer even travels.

[79]        I have no reason to doubt Ms. Camilleri’s evidence. There is no suggestion that she is anything other than a credible, straightforward witness who keeps doing her best in situations where others likely would have given up. But she has been forced to give up many of the things in life that she enjoyed…

[88]        I conclude that an appropriate award in this case for non-pecuniary damages is $90,000.

$50,000 Non-Pecuniary Damages Assessment for Chronic Myofascial Pain

Written by admin on . Posted in ICBC Back Injury (soft tissue) Cases, ICBC Chronic Pain Cases, ICBC Soft Tissue Injury Cases. 50 Comments on $50,000 Non-Pecuniary Damages Assessment for Chronic Myofascial Pain

Reasons for judgement were published today by the BC Supreme Court, New Westminster Registry, dealing with non-pecuniary damages (money for pain and suffering and loss of enjoyment of life) for chronic soft tissue injuries.
In today’s case (Thauli v. Gill) the Plaintiff was injured in a 2005 motor vehicle collision.  It was a ‘t-bone’ crash.  The Plaintiff was a passenger at the time and the issue of fault was admitted by ICBC on behalf of the offending motorist.  The Plaintiff suffered a variety of soft tissue injuries which resulted in a chronic myofascial pain syndrome.  In assessing non-pecuniary damages at $50,000 Mr. Justice Crawford provided the following reasons:

[35] Pain is doubtless one of the discussion footballs in medical science.  It is subjective.  Many of us have seen people receive devastating injuries, bear with them stoically and sometimes recover in very short time.  We see the professional footballer or hockey player do that on a regular basis, but many cannot.  Many are built differently and respond differently to different injuries.  Dr. Sidhu said that he expected Ms. Kalsi, given her lifestyle, to have largely recovered in six or eight weeks from the car accident.  And as I noted, Dr. Chu said in his evidence perhaps the neural pathways are somehow compromised in some people and continue to send messages of pain to the head, and in fact the soft tissues are already recovered.

[36] In any event, I found Ms. Kalsi an honest and straightforward young lady.  The evidence of the witnesses recorded in consistent fashion how busy, vivacious and outgoing she was prior to the accident, how there had been a continuing complaint of pain to her upper left back area, as vague as that might be, and that had continued to be of a consistent concern to her and to her doctors…

[38] I am satisfied the plaintiff was injured in the car accident in May of 2005.  The injuries to her knee, neck and left upper back are consistent with being thrown over the restraining seat belt and extending the soft tissues in her upper back and neck on the left side.  It is likely those injured areas of her body have recovered.  It is also likely her ongoing complaints of pain in turn caused the depression, but that was well treated in 2007.

[39] Medically the pain is chronic and the symptoms have been collated under the heading myofascial pain.  That is real to Ms. Kalsi.  It is, on her own word to her doctors, largely moderated in 2007 and in my view there is a fair chance it will continue to improve, if not wholly, at least be well within her control.

[40] In sum, then, I award general damages at $50,000.

$70,000 Non-Pecuniary Damages for Chronic Myofascial Pain

Written by admin on . Posted in ICBC Back Injury (soft tissue) Cases, ICBC Chronic Pain Cases, ICBC Soft Tissue Injury Cases, Uncategorized. 49 Comments on $70,000 Non-Pecuniary Damages for Chronic Myofascial Pain

Reasons for judgement were released this week by the BC Supreme Court, New Westminster Registry, (Bove v. Lauritzen) awarding a Plaintiff just over $180,000 in total damages as a result of a 2006 BC Car Crash.
Liability was admitted by the Defendant in the lawsuit leaving the Court to deal with only the issue of damages.
Madam Justice Gray accepted the opinion evidence of Dr. Hunt, an expert in the field of “emergency medicine and pain medicine” in its in entirety.  Most of Dr. Hunt’s opinion is reproduced at paragraph 42 the highlights of which are as follows:

Medical Diagnosis

1.         Chronic myofascial pain involving the right SI joint and right buttock with referred pain to the right hip.

2.         Chronic myofascial pain right inguinal region.

3.         Chronic myofascial pain right shoulder girdle.

4.         Mechanical low back pain of a posterior element pattern localizing to the right L5/S1 facet joint region.

5.         Mood disorder (mild) and sleep disorder (moderate) secondary to chronic pain condition.

6.         Left trochanteric bursitis (mild).

MEDICAL VOCATIONAL CONSIDERATIONS

1.         Restrictions with respect to her lower back and right buttock with referred pain.

(a)        She must avoid all repetitive bending, twisting, stooping and moving in and out of awkward positions.

(b)        She must work only in the sedentary category.

(c)        She must avoid all prolonged sitting with no periods greater than 20 min or prolonged standing with periods no greater than 10 min or prolonged walking greater than 20 min.

(d)        She must be able to stand, sit and move at will.

(e)        She must avoid all lifting greater than 5 lbs and must keep the weight that she is lifting close to her body and avoid carrying it for any distance.

(f)        Materials handling or activity is best done between mid chest and waist.

(g)        She must avoid activities which involve extension of the spine.

(h)        She must avoid walking repetitive flights of stairs or inclines.

2.         Restrictions with respect to her mid thoracic spine and right shoulder girdles include:

(a)        Avoid prolonged static positions of the neck and thoracic spine such as leaning forward.

(b)        All activities with regards to the upper limb should be done below mid chest and she should avoid any repetitive reaching, pushing or pulling activities of the right upper limb.

When she is capable of attempting to return to a productive life, it will need to be on a very paced graduated return to work basis; it should take place over approximately two months and should be supervised by an occupational therapist and/or vocational counselor.

In assessing the Plaintiff’s non-pecuniary damages at $70,000 Madam Justice Gray provided the following summary of the Plaintiff’s accident related injuries:

[45]        In summary, I find that the January 24, 2006 accident caused Ms. Bove moderate to severe chronic myofascial pain in her right buttock and lower lumbar region with symptoms reaching into the right hip and right inguinal region, and chronic myofascial pain in her right shoulder girdle, mechanical low back pain, mild mood and sleep disorder, and mild left trochanteric bursitis. It is likely that the bursitis will resolve fully. It is likely that the other problems will be ongoing, although there may be improvement in the low back pain and sleep disorder.

[46]        Ms. Bove’s need for frequent changes of position, and the other restrictions described by Dr. Hunt, make it unlikely that Ms. Bove can be competitively employable…

54] Ms. Bove is entitled to $70,000 for non-pecuniary damages arising from the January 24, 2006 accident