Do injections increase your settlement?

By Michael Shemtoub, trial attorney, Beverly Law. Updated November 2026.

What spinal injections do

An epidural steroid injection places anti-inflammatory medicine into the space around the spinal nerves, according to Cleveland Clinic. Doctors use it for problems such as herniated or bulging discs and spinal stenosis, usually after physical therapy or medication has not helped enough. Cleveland Clinic reports that about half of patients get pain relief, which can last weeks to months and rarely up to a year. In most cases the shot does not cure the cause of the pain, and many providers limit patients to two or three a year.

A facet joint injection targets the small joints that link the vertebrae, or the nerves that serve them. The Hospital for Special Surgery explains that some are done to diagnose, using only a numbing medicine. If pain drops by 70 to 80 percent for about 48 hours, the doctor knows the facet joint is a source of the pain. A procedure called radiofrequency ablation may follow, with relief that can last six months to a year.

Both procedures carry risks. Cleveland Clinic lists a short flare of pain, raised blood sugar in people with diabetes, and a severe headache from a spinal fluid leak in under 1 percent of cases, along with rare nerve damage. Go to an emergency room right away if back pain comes with loss of bladder or bowel control, numbness in the buttocks or inner thighs, or leg weakness, which Cleveland Clinic lists as signs of cauda equina syndrome, a medical emergency.

What an injection record shows, and what it does not

A referral for injections tells a reader that a physician judged earlier care to be insufficient. A diagnostic block can point to a specific pain generator, and the doctor’s notes on your response become part of the medical story. If your doctor later recommends surgery, those notes often explain why. Our page on surgery after a car accident covers that step.

An injection does not prove the crash caused the problem. Texas makes this point in its statute on billing affidavits: an affidavit about the charges “is not evidence of” causation (CPRC 18.001). The defense will often argue that disc changes were already there, and its own doctor may examine you at a defense medical exam. Good relief from a shot also does not establish that you will need more of them. In California, future medical costs are recoverable only for care you are reasonably certain to need, under CACI 3903A.

How injection bills are counted in each state

The amount on an injection bill and the amount that counts in a claim are often different numbers.

In California, the Supreme Court held in Howell v. Hamilton Meats (2011), quoted in CACI 3903A, that a privately insured plaintiff recovers no more than the amounts paid by the plaintiff or the insurer, or still owing. When a provider agreed ahead of time to take less than the billed amount, the full bill “is not itself relevant” to past medical expenses. Under Pebley v. Santa Clara Organics (2018), a patient with insurance who chooses to treat outside the plan is treated as uninsured for this purpose.

Texas reached a similar place by statute. CPRC 41.0105 limits medical expenses to the amount “actually paid or incurred,” and in Haygood v. De Escabedo (2011) the Supreme Court of Texas held that only evidence of recoverable expenses is admissible at trial. Section 18.001 lets a provider’s affidavit serve as enough evidence that a charge was reasonable and the service necessary, unless the defense serves a counteraffidavit from a qualified person within the statute’s deadlines.

Washington asks for reasonable value. Its Court of Appeals, quoting Patterson v. Horton in Beltran-Serrano v. City of Tacoma (2019), said a plaintiff “must prove that medical costs were reasonable” and cannot rely only on records and bills. In that case the two sides’ witnesses disagreed about whether the billed charges reflected reasonable value, and the court sent the question to trial.

The honest answer about treatment and value

Some people hear that a claim with injections settles for more and wonder whether to ask for them. Do not choose treatment for the claim. The law in all three states pays for care that is reasonable and necessary, and every one of these rules gives the defense a way to test that. A chart that shows treatment driven by a lawsuit, rather than by symptoms, invites that attack and can hurt your credibility on everything else.

The better path is ordinary good care. Describe your symptoms accurately and follow the plan you and your doctor agree on. Before any procedure, ask what it is meant to do and what the risks are. If an injection helps, that is good news for your health. If you are treating on a lien, read medical liens after a car accident so you know what the provider can collect.

What this means for your case

Tell your lawyer how each injection was paid for, whether through health insurance, MedPay or a lien, because that changes the figure that counts. Keep a simple note of your pain before and after each procedure, since your doctor will ask and the records will reflect it. Injections connected to a disc injury are discussed on our page about a herniated disc after a car accident. For how the noneconomic part of a claim is valued, see how pain and suffering is calculated.

Texas cases are handled by the firm’s Texas-licensed attorneys, Joyce Ondich and John Efstathiou.

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Important: This page is general information, not legal or medical advice, and reading it does not create an attorney-client relationship. Every case is different; talk to a lawyer about yours. Texas cases are handled by the firm’s Texas-licensed attorneys, Joyce Ondich and John Efstathiou. Last reviewed: November 7, 2026.