Proving Causation In Spinal and Back Pain Claims

Between 60%-80% of people in the UK will suffer from back pain at some point in their lives.

Of the 480,000 workplace musculoskeletal disorders reported in 2019/20, 37% (176,000) were related to the spine or back. For Solicitors, proving causation in spinal and back pain claims can be highly challenging, because:

a) the origin of the pain is often ambiguous, and
b) in cases of cumulative back pain, it can be difficult to distinguish how much of the Claimant’s discomfort resulted from workplace activities and/or medical negligence.

The socio-economic impact of back and spinal pain cannot be ignored.  It results in UK employees taking an average of 12 days off per year, costing businesses millions of pounds.  Furthermore, severe back pain can negatively affect a person’s ability to earn an income and enjoy life.

One of the reasons the cause of back pain is difficult to prove is that it is not a disease in itself but a symptom.

 Back Pain Claims

Identifying the cause of back pain

Even with sensitive imaging methods, discovering the cause of back pain can be problematic. Common causes include:

  • Muscle or ligament strain – this is often caused by frequent heavy lifting or a sudden awkward movement.  If your back is constantly under strain, painful spasms can develop.
  • Ruptured, bulging, or ‘slipped’ disc – intervertebral discs are spongy pads that act as shock absorbers between the spine’s vertebrae.  If the spinal column tears open and the discs protrude outward, they can press on, or “pinch,” nearby spinal nerves causing severe lower back pain and sciatica.
  • Arthritis – usually occurs as part of the ageing process.  Osteoarthritis can result in spinal stenosis, a term used to describe the narrowing of the spinal canal.
  • Osteoporosis. Your spine’s vertebrae can develop painful fractures if your bones become porous and brittle.

If a specific cause of the discomfort cannot be found, healthcare professionals refer to back or spinal pain as ‘non-specific back pain’.  It is also important to consider that with some patients, each episode of reoccurring back pain can have separate origins.

Occupations and Industries with high levels of back pain

Not surprisingly, many work-related personal injury claims concern back and spinal pain, stemming from either ongoing stress on the spine and/or back muscles or an immediate injury from a slip, trip, fall, or impact of some kind.

There are several occupations and industries where the risk of developing chronic back pain is high.  According to a 2020 HSE report, the industries with the highest work-related musculoskeletal disorders (including back pain) in 2019/20 were:

  • Agriculture, forestry, and fishing.
  • Construction.
  • Healthcare and social care.

The top three occupations that had high incidents of musculoskeletal disorders include:

  • Care, leisure, and other service occupations.
  • Process, plant, and machine operators.
  • Skilled trade occupations.

All these industries and occupations involve regular lifting and bending to achieve tasks.

Back pain leading to medical negligence claims

Most incidents of back pain resolve themselves after a few weeks.  However, in some cases, back pain is a symptom of a serious problem.  For example, on rare occasions, spinal stenosis can lead to Cauda Equina Syndrome, where the spinal nerve roots compress. If Cauda Equina Syndrome is not quickly diagnosed and treated, the patient can suffer serious complications, including paralysis, incontinence, and impaired mobility.   Diagnosing Cauda Equina Syndrome is extremely tricky in the early stages as the only symptom may be lower back pain; therefore, although the condition is rare, misdiagnosis often leads to a medical negligence claim.

In summary

Establishing how much back and spinal pain is due to the natural ravages of age and the amount that can be linked to a workplace accident or medical negligence usually requires a medico-legal report.  An expert report will ensure that the Claimant or Defendant in a negligence claim has the evidence required to prove or disprove causation on the balance of probabilities.

Talk to our experts

Expert Court Reports provides expert witnesses and medicolegal court reports for solicitors, barristers and other agencies including the police, probation services, prisons, and third-sector organisations as well as private clients.  To discuss any issues raised in this article, please call us on 01865 587865, email, or request a call by completing our online form.