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The defendant later filed a posttrial motion, alleging that Dr. Cicmanec's testimony concerning permanency was improperbecause Dr. Cicmanec's last examination of the plaintiff occurred approximately 30 months prior to trial. The trial courtdenied the defendant's posttrial motion, ruling that "the evidence was sufficient to submit the issue of permanency to thejury."

On appeal, the defendant argues that the trial court erred in allowing the testimony of Dr. Cicmanec concerning thepermanency of the plaintiff's injuries. The plaintiff responds that, as an initial matter, the defendant has waived thisargument because he failed to object to the testimony during Dr. Cicmanec's evidence deposition and at the time thedeposition was read to the jury.

The appellate court may only review the admissibility of testimony for error if the opposing party objected to thetestimony at trial. Miller v. Rokita, 131 Ill. App. 3d 774, 779 (1985). From a review of the record, it is clear to us that thedefendant did in fact object to the testimony concerning permanency during Dr. Cicmanec's evidence deposition. It isequally clear to us that the plaintiff has caused this court to spend unnecessary time addressing this issue on account of thismisrepresentation of the facts in the plaintiff's appellate brief. Moreover, the plaintiff cites no authority that suggests thatonce an objection in an evidence deposition is ruled upon by the trial court the objecting party must object again when thetestimony is read to the jury in order to preserve the objection for appellate review. We are convinced that no suchauthority exists, as such an absurd rule would frustrate the very reason why evidence deposition objections are ruled uponby the trial court in advance of trial.

Having dispensed with the plaintiff's argument that the defendant has waived the objection to the testimony concerningpermanency, we now turn to the merits of whether the testimony by Dr. Cicmanec was properly admitted. The defendantargues that the trial court abused its discretion in admitting the testimony because Dr. Cicmanec's last exam of the plaintiffwas not sufficiently recent to the time of trial. The plaintiff responds that Dr. Cicmanec's testimony was properly admittedand that the recency of Dr. Cicmanec's last exam was an issue that went to the weight of the testimony.

We begin our review of the relevant case authority by noting the existence of differing approaches among the appellatecourt districts when analyzing whether an examination by the testifying medical treater must be recent to the time of trialin order for testimony concerning the permanency of the injury to be admissible. Several decisions have held that a recentexam is a precursor to the admissibility of the opinion. See Knight v. Lord, 271 Ill. App. 3d 581, 587 (1995); Henricks v.Nyberg, Inc., 41 Ill. App. 3d 25, 28 (1976). Other opinions have looked to a multitude of factors, in addition to the timeinterval between the last exam and the time of trial, in answering this question of the admissibility of the testimony. SeeHoush v. Bowers, 271 Ill. App. 3d 1004 (1995); Marchese v. Vincelette, 261 Ill. App. 3d 520, 526 (1994); Courtney v.Allied Filter Engineering, Inc., 181 Ill. App. 3d 222 (1989).

It is well settled that an opinion held by an expert at the time of trial is the only opinion evidence that may be consideredby the trier of fact. Henricks v. Nyberg, 41 Ill. App. 3d 25, 28 (1976). In Henricks, the court considered whether testimonyby a physician that the plaintiff's prognosis was guarded was admissible when the last time the physician had examined theplaintiff was three years before trial. The court held that, because expert opinion testimony must be founded upon factsand not conjecture, an opinion at trial based upon an examination conducted three years prior would be unreliable andtherefore improper. Henricks, 41 Ill. App. 3d at 28. The court was persuaded that the physician's testimony concerning theprognosis he made three years prior could not represent an opinion that he held at the time of trial. Henricks, 41 Ill. App.3d at 28.

In Thurmond v. Monroe, 235 Ill. App. 3d 281, 291 (1992), the court considered whether a gap of "several years" betweenthe time of the examination and the time of trial was too great to permit testimony from a treating physician concerningthe permanency of the plaintiff's injuries. The court noted that no Illinois court had barred testimony concerningpermanency due to the length of time from the examination. In an attempt to distinguish the holding in Henricks, theThurmond court reasoned that, in Henricks, the testimony had concerned the prognosis of the plaintiff rather than thepermanency of the injuries. Because the testimony in Thurmond concerned permanency rather than prognosis, it wasirrelevant to the Thurmond court that there had been a gap of several years between the time of the physician'sexamination and the time of trial. Thurmond, 235 Ill. App. 3d at 291. Therefore, the Thurmond court permitted thetestimony concerning permanency.

The distinction set forth by the Thurmond court between testimony concerning prognosis and testimony concerningpermanency was eradicated by the court in Marchese v. Vincelette, 261 Ill. App. 3d 520, 526 (1994). The Marchese courtrejected as unsound any supposed distinction between "permanency" and "prognosis," ruling that any attempted distinctionwas "one of semantics rather than substance." Marchese, 261 Ill. App. 3d at 525; see also Knight, 271 Ill. App. 3d at 586.

In Marchese, the court considered whether the trial court had abused its discretion in permitting testimony concerning thepermanency of the plaintiff's injuries where there had been a 15-month gap between his last examination and the time oftrial. The court noted that 15 months "can hardly be considered 'recent' " but further noted that the physician had treatedthe plaintiff "over a period of years." Marchese, 261 Ill. App. 3d at 526. Following the admission of such testimony, theMarchese court reasoned, any questions concerning the validity of the physician's opinion must be resolved by the trier offact. The court pointed out that the defendant can offer evidence to counter the physician's conclusions and can argue tothe jury that the opinion was unconvincing on account of the 15-month delay. Marchese, 261 Ill. App. 3d at 527. The courtthen concluded that the trial court had not abused its discretion in allowing the testimony.

Similarly, in Courtney v. Allied Filter Engineering, Inc., 181 Ill. App. 3d 222 (1989), the court looked to factors other thanthe recency of the last examination in assessing whether testimony concerning permanency was proper. In Courtney, theplaintiff's orthopedic surgeon, who had last performed an examination "over four years ago," testified that an injury to theplaintiff's knee was permanent. Courtney, 181 Ill. App. 3d at 231. The surgeon had performed arthroscopic surgery on theplaintiff and later removed his kneecap. The court distinguished the facts in Courtney from those in Henricks, noting thatthe surgeon had treated the plaintiff for two years and had concluded, upon releasing the plaintiff after three surgeries andextensive rehabilitation, that the injury was permanent. The court also noted that the surgeon had reviewed the findings ofanother doctor, who had examined the plaintiff three years later, and found that the plaintiff's condition had not materiallychanged. Courtney, 181 Ill. App. 3d at 231.

Although Courtney stands for the proposition that an examination that is four years old may support testimony concerningpermanency, Courtney does not stand for the proposition that the recency of the examination cannot be considered by thetrial court in determining whether to permit opinion testimony on the issue of permanency. Indeed, several Illinois courtshave noted that it is well settled that a physician may not testify at trial regarding his opinion concerning the permanencyof a patient's injuries absent a recent examination. See Knight, 271 Ill. App. 3d at 585; Ficken v. Alton & Southern Ry. Co.,255 Ill. App. 3d 1047, 1057 (1993); Phelps v. Chicago Transit Authority, 224 Ill. App. 3d 229, 232 (1991). Thisproposition has also been noted by the Illinois Supreme Court in dicta. See Wilson v. Chicago Transit Authority, 126 Ill.2d 171, 176 (1988).

Moreover, the court in Knight squarely considered and rejected the argument that the recency of the examination goessolely to the weight of the opinion testimony and not to its admissibility. In that case, the court held that only after anexamination is considered recent, and therefore admissible, does the recency of the examination go to the weight of thephysician's opinion. Knight, 271 Ill. App. 3d at 587. The court noted that the 28-month gap at issue in Knight was closer tothe three-year interval in Henricks than to the 15-month interval in Marchese and held that the trial court had not abusedits discretion in barring the opinion testimony. Knight, 271 Ill. App. 3d at 587.

We also note the existence of authority that, at first blush, appears to support the plaintiff's argument that a recentexamination is not required for an opinion concerning permanency to be admissible. In Housh v. Bowers, 271 Ill. App. 3d1004, 1008 (1995), the reviewing court considered whether the trial court had erred in allowing evidence of the plaintiff'sprior felony conviction and in failing to permit testimony from two physicians as to permanency where nearly three yearshad passed since the physicians' last examination of the plaintiff. The reviewing court held that the testimony concerningthe felony conviction was improper and remanded the cause for a new trial. To avoid a later appeal on the issue of thepropriety of the physicians' testimony, the reviewing court undertook review of that issue as well.

The court utilized a totality of the circumstances approach in determining whether the testimony should be admitted. Thecourt characterized the Henricks decision as "too narrow." Housh, 271 Ill. App. 3d at 1008. The court noted that theplaintiff in Housh had been treated by the two physicians for over a year and that, based on extensive tests, one of thephysicians stated that his medical opinion was unlikely to vary if he were to reexamine the plaintiff. The court indicated indicta that, on remand, the trial court should admit the testimony as to permanency. See also Jones v. Police Board, 297 Ill.App. 3d 922, 933 (1998) (psychologist permitted to testify that police officer was not fit to return to work despite a 14-month gap between his last exam and the time of hearing where psychologist had reviewed the reports of treaters who laterexamined the officer, and the court found that the psychologist's conclusions were supported by other testimony).

We note that in Molitor v. Jaimeyfield, 251 Ill. App. 3d 725 (1993), this court appeared to embrace the notion that therecency of an examination goes to the weight and not the admissibility of the testimony. In Molitor, we consideredwhether the trial court had erred in instructing the jury concerning damages for the plaintiff's future pain and medicalexpense. The defendant argued that the physician's testimony concerning the permanency of the plaintiff's injury wasbased upon an examination that occurred 18 months prior to trial. We noted that if the defendant believed that a lengthytime interval between the examination and the time of trial weakened the testimony concerning permanency, then thedefendant should argue that point to the jury. Molitor, 251 Ill. App. 3d at 729. We then concluded that the time interval of18 months was an issue of the weight of the evidence and did not render the testimony inadmissible. Molitor, 251 Ill. App.3d at 729.

The key issue before us is how to reconcile the holding in Henricks with the holding in Molitor. The defendant argues thatthe Henricks rule is long-standing and is supported by several decisions, including the Illinois Supreme Court in Wilson.The plaintiff does not explain how we are to construe the present case in light of the rule established in Henricks and itsprogeny that a recent exam of the plaintiff is required if opinion testimony concerning permanency is to be introduced.Relying on Courtney and Housh, the plaintiff argues that the recency of the examination goes only to the weight of thephysician's opinion, not the admissibility.

We reject the plaintiff's argument that Housh and Courtney mandate that the recency of the last examination is irrelevantto admissibility. We believe that Housh and Courtney employed a totality of the circumstances approach in analyzingwhether the proposed testimony was proper, and they did not preclude consideration of the recency of the last exam.Moreover, the court's comments in Housh concerning permanency testimony were made in dicta. Housh, 271 Ill. App. 3dat 1008.

The plaintiff also argues that the court's holding in Thurmond clarifies that a physician may testify as to the permanentnature of a plaintiff's injuries regardless of the recency of the examination. After carefully reviewing Thurmond, it isreadily apparent that the holding in Thurmond is no longer good law in light of the holdings in Marchese, both caseshaving been decided by the Appellate Court, First District.

The Thurmond court permitted the testimony concerning permanency due to an erroneous distinction it made betweenpermanency and prognosis. We agree with Marchese and Knight that there is no substantial distinction, for the purposes ofassessing admissibility, between testimony concerning prognosis and concerning permanency. Accordingly, we cannotapply Thurmond to determine in the case at hand that the length of time between the last exam and the time of trial shouldnot be considered.

Although the plaintiff does not argue that this court's holding in Molitor controls the case at hand, we must neverthelessconsider whether we need to look further than the holding in Molitor to decide this case. We conclude that we do. Molitorwas decided before Knight and Marchese, both of which provide additional thought and guidance on the issue of therecency of the last examination. Accordingly, we choose not to follow Molitor in this case, and we believe that additionalinquiry into the appropriateness of the holding in Molitor is warranted.

Having failed to find adequate authority for the plaintiff's assertion that the recency of the last examination does not go tothe admissibility of the proposed opinion testimony, we must still decide what consideration, if any, the trial court mustgive to the issue of recency in making the determination of admissibility. In light of the long-standing rule announced inHenricks, we do not believe the proposition that the recency of an examination is irrelevant in determining admissibility islegally sound. However, many of the cases that adopt the Henricks rule focus on the number of months between the timeof the most recent exam and the time of trial. We believe that it is unhelpful to focus solely on the number of months indetermining whether proposed opinion testimony is admissible, and we decline to establish a bright-line rule in this regard.In short, we do not feel that considering solely the recency of the last exam is particularly instructive in mandating how acourt should determine the admissibility of testimony regarding permanency from a medical treater.

In order to fashion the appropriate test for determining whether the recency of the examination should be considered indetermining the admissibility of proposed medical testimony concerning permanency, it is necessary to review the trialcourt's role in assessing proposed opinion testimony. In deciding whether to admit expert opinion testimony, the trial courtmust consider whether the testimony would aid the jury in understanding the facts. Carlson v. City Construction Co., 239Ill. App. 3d 211, 239 (1992). In general, the factors a trial court will consider include the complexity of the subjectinvolved, the purpose for which the opinion is offered, its relation to the ultimate issue to be determined, and the danger ofundue prejudice. Wade v. City of Chicago Heights, 295 Ill. App. 3d 873, 882 (1998). The decision to allow an expert totestify in matters of opinion lies within the discretion of the trial court. Burns v. Michelotti, 237 Ill. App. 3d 923, 933(1992).

An expert's opinion is only as valid as the bases and reasons for the opinion. Damron v. Micor Distributing, Ltd., 276 Ill.App. 3d 901, 907 (1995). Where there is no factual support for an expert's conclusions, his conclusions alone do not createa question of fact. Damron, 276 Ill. App. 3d at 907. A medical expert witness may not base his opinion on guess,conjecture, or speculation. Scholle v. Continental National American Group, 44 Ill. App. 3d 716, 721 (1976).

The trial court is not required to blindly accept the expert's assertion that his testimony has an adequate foundation. Rather,the trial court must look behind the expert's conclusion and analyze the adequacy of the foundation. See Richardson v.Richardson-Merrell, Inc., 857 F.2d 823, 829 (D.C. Cir. 1988). See also Simers v. Bickers, 260 Ill. App. 3d 406, 411 (1994)(information upon which an expert bases his opinion must be reliable). Such scrutiny is required because an expert'sopinion bears an aura of reliability and trustworthiness. O'Connor v. Commonwealth Edison Co., 807 F. Supp. 1376, 1389(C.D. Ill. 1992), aff'd, 13 F.3d 1090 (7th Cir. 1994).

The trial court has traditionally functioned in a role as the gatekeeper of proposed opinion testimony that is submitted to ajury. Support for this proposition may be seen in the fact that Illinois has adopted the Frye test for determining the validityof scientific testimony. See Harris v. Cropmate Co., 302 Ill. App. 3d 364, 365 (1999). Pursuant to Frye, the trial courtclosely examines proposed opinion testimony from a scientific expert to determine whether it bears sufficient indicia ofreliability to submit to the jury. In adopting the Frye test, the Illinois courts have recognized the need to examine proposedopinion testimony to ensure that the basis for the opinion is trustworthy.

As the gatekeeper of expert opinions disseminated to the jury, the trial court plays a critical role in excluding testimonythat does not bear an adequate foundation of reliability. Part of that role is to assess the basis upon which a medical treaterconcludes that a given injury is permanent in nature and to exclude that opinion in the absence of sufficient reliability.

The trial courts do not simply allow all testimony from a treater to go to a jury. For instance, a physician must testifyeither that his opinions are within a reasonable degree of medical certainty or that his opinions are based upon specializedknowledge and experience and grounded in recognized medical thought. Plooy v. Paryani, 275 Ill. App. 3d 1074, 1082(1995). It is in recognizing the aura of reliability that medical opinion testimony conveys to the jury that the courts havefashioned rules to ensure that the aura of reliability is not merely an illusion but does, in fact, exist.

Considering together the trial court's function in acting as gatekeeper, as well as the case law concerning the recency of thelast examination, we believe that the court should make an individualized determination of whether testimony from atreater concerning permanency is proper in light of many circumstances. It is clear to us that, when the admissibility of atreater's proposed opinion testimony concerning permanency is challenged, the trial court, as the gatekeeper of opiniontestimony, should employ a totality of the circumstances approach.

In examining the reliability of opinion testimony concerning permanency from medical treaters, the trial court shouldconsider the following factors: (1) the length of time since the last examination (guided by Henricks and Knight); (2) thelength of time the patient was in treatment with the treater whose proposed testimony is at issue; (3) the nature of thepatient's injuries or condition; (4) the type of treatment received by the patient; and (5) whether a substantial change in thepatient's condition has occurred between the time of the last exam and the date of trial.

We are mindful that this is not an exhaustive list of the factors a trial court may consider in determining the reliability ofthe proposed opinion testimony regarding permanency. The list does not constitute a five-part test, in which the findingsconcerning each factor must support the admissibility of the proposed opinion testimony. While the court's considerationof the proposed testimony must be flexible, the court may not delegate its responsibility as gatekeeper to the medicalcommunity. See Harris, 302 Ill. App. 3d at 374-75.

The liberal approach suggested by the plaintiff is drastic, as is the exclusion of medical opinion testimony due solely to thelast exam being not recent. We believe that establishing the trial court's responsibility to undertake some type of review ofproposed opinion testimony concerning permanency is in line with the spirit of Henricks, Marchese, Courtney, Housh, andKnight. The factors outlined above should assist the trial courts in undertaking that review.

In this case, upon examining the above-mentioned factors, we are persuaded that the trial court abused its discretion inallowing the testimony of Dr. Cicmanec concerning permanency. The plaintiff in this case had pain symptoms of a highlysubjective nature, for which she was treated by a chiropractor for less than one year. Her treatment consisted ofnoninvasive therapies designed primarily to loosen her muscles and alleviate pain. As noted above, Dr. Cicmanec's lastexamination of the plaintiff was approximately 30 months prior to trial, which was similar to the time interval at issue inKnight. Based upon the foregoing, we do not believe that the basis of Dr. Cicmanec's opinion contained in his depositionbears sufficient indicia of reliability for submission to the jury. Accordingly, Dr. Cicmanec's opinion concerningpermanency was improperly admitted and should not have been considered by the jury in the computation of damages.

Having decided that Dr. Cicmanec's testimony concerning permanency was improper, we must determine whether reversalfor a new trial is required. Relying on Richardson v. Chapman, 175 Ill. 2d 98 (1997), the plaintiff argues that we shouldreduce the judgment by way of remittitur. The defendant argues that a new trial is warranted because the impropertestimony may have impermissibly influenced the jury in its award for pain and suffering experienced from the date of theaccident to the time of trial.

Supreme Court Rule 366(a)(5) (155 Ill. 2d R. 366(a)(5)) provides that the reviewing court has the power to grant anyrelief, including entry of a remittitur. The appellate court may modify the trial court's order to reflect the proper amount ofdamages. Paulson v. County of De Kalb, 268 Ill. App. 3d 78, 83 (1994).

As the defendant notes, the jury returned an itemized verdict form, which indicated an award for future pain and sufferingin the amount of $3,200 and an award for past/present pain and suffering in the amount of $5,000. It is clear that theimproper testimony comprised the basis of the award for future pain and suffering of $3,200. We are unconvinced,however, that testimony concerning permanency affected the jury's award of $5,000 for past/present pain and suffering.Indeed, presenting the jury with two separate entries for pain and suffering apprises the jury that past/present pain andsuffering and future pain and suffering are distinct factors. In short, we find nothing in the record or in the arguments ofthe parties to suggest that the jury disregarded the instructions provided by the trial court that would warrant a new trial.Accordingly, by way of remittitur, we reduce the judgment by the sum of $3,200.

For the foregoing reasons, the judgment of the circuit court of Lake County is affirmed as modified.

Affirmed as modified.

INGLIS, J., concurs.

BOWMAN, P.J., dissenting:

I respectfully dissent.

I disagree with the majority's opinion for several reasons. Some of the factors the majority includes in its totality of thecircumstances test are ill-advised because they will invite trial courts to substitute their judgment for that of the medicalexperts whose opinions are at issue. Additionally, even if I agreed with the majority's test, I would still disagree with themajority's conclusion that the trial court erred in admitting Dr. Cicmanec's permanency opinion. Last, I would allow thejury's award for future pain and suffering to stand.

In fashioning its totality of the circumstances test, the majority emphasizes the trial court's "gatekeeping" responsibility toinsure that the expert opinions the jury hears are reliable. While I agree that trial courts must prevent unreliable experttestimony from reaching the jury, the majority goes too far and improperly inserts the trial court into the role of expert.This approach is just as inappropriate as the unquestioning acceptance of expert opinion the majority wants to guardagainst.

By including such factors as the nature of the patient's injuries or condition and the type of treatment the patient received,the majority requires trial judges to make medical distinctions that are properly left to medical experts. I fail to see how atrial judge is qualified to determine that an expert's opinion on permanency is unreliable because the patient receivedchiropractic manipulation, for example, as opposed to surgery, or because a patient sustained a sprained back as opposedto a broken back. If a party wishes to challenge an expert's opinion on such bases, the proper way to do so is through arebuttal expert, not by asking the trial court to question an opinion a medical expert holds to a reasonable degree ofmedical certainty based on the expert's experience and expertise.

The majority's explanation of why it found Dr. Cicmanec's testimony unreliable provides a good example of the problemswith the majority's test. The majority reasoned, "plaintiff in this case had pain symptoms of a highly subjective nature, forwhich she was treated by a chiropractor for less than one year. Her treatment consisted of noninvasive therapies designedprimarily to loosen her muscles and alleviate pain. *** Dr. Cicmanec's last examination of the plaintiff was approximately30 months prior to trial ***." Slip op. at 16. The majority thus concludes that given the facts of this case it was notpossible for Dr. Cicmanec to form a reliable opinion on whether plaintiff's condition was permanent. However, themajority, not being a medical expert, does not know what facts are necessary in order for Dr. Cicmanec to be able torender such an opinion to a reasonable degree of chiropractic certainty and, consequently, is not qualified to make such adetermination. A trial court is similarly unqualified. The majority's totality of the circumstances test, however, willinevitably result in trial courts drawing such conclusions. The majority may characterize them as legal conclusions ofreliability, but they are in fact medical conclusions.

I find it significant that no other case has established such an intrusive approach. There is no support in the case law forexpanding the trial court's inquiry into the basis of expert opinions to the extent the majority suggests. Further, themajority offers no explanation as to how the type of treatment a person received or the nature of a person's injuries willhelp trial courts determine whether an expert's opinion is reliable enough to be admitted. The majority also fails to addresshow trial courts, which lack the medical experience and expertise of medical experts, can make such inquiries withoutsubstituting their judgment for that of the experts. In my view the majority's totality of the circumstances test isinappropriate and unnecessary.

Unlike the majority, I do not think trial courts need to be told what factors to consider when determining whether to admitan expert opinion on permanency of injuries. I would follow this court's approach in Molitor v. Jaimeyfield, 251 Ill. App.3d 725 (1993). In Molitor, we held that a chiropractor's trial testimony that the plaintiff would most likely continue toexperience pain and to require treatment was admissible even though the chiropractor last examined the plaintiff 18months before trial. Molitor, 251 Ill. App. 3d at 729. We concluded that the date of the last examination went only to theweight of the evidence, not the admissibility. Molitor, 251 Ill. App. 3d at 729. In my view the factors the majority setsforth in the present case, including the nature of the injury and the type of treatment received, go to the weight, not theadmissibility, of the evidence. In Molitor, we further noted that an expert's opinion need not be based on absolutecertainty, but on a reasonable degree of medical certainty. Molitor, 251 Ill. App. 3d at 729. Any medical expert's opinionon permanency that is not held to a reasonable degree of medical certainty should be excluded. However, when a medicalexpert testifies that he holds an opinion on whether a patient's condition is permanent to a reasonable degree of medicalcertainty, as Dr. Cicmanec did here, the appropriate course is to admit the opinion.

Dr. Cicmanec testified to a reasonable degree of chiropractic certainty that "[i]f the [plaintiff] continues to have problemsin the same areas, similar complaints after this long of a period of time I think it would be reasonable to assume that it wasa permanent condition." Thus, Dr. Cicmanec's opinion was based on plaintiff's current condition, not her condition whenhe last saw her in 1996. Dr. Cicmanec treated plaintiff regularly for a period of several months. Plaintiff testified that therewas no substantial change in her condition between the date of her last exam and the time of trial. Notwithstanding mybelief that the nature of plaintiff's injuries and the type of treatment she received are inappropriate factors, I believe thesefactors do not affect the reliability of Dr. Cicmanec's opinion one way or the other. Consequently, applying the majority'sfactors, I still would affirm the trial court's decision that Dr. Cicmanec's opinion was admissible.

Last, I disagree with the majority's remittitur of the jury's award for future pain and suffering on the ground that it wasbased on Dr. Cicmanec's testimony regarding permanency. In my opinion the trial court properly admitted Dr. Cicmanec'sopinion on permanency, and that opinion provided a basis for the jury's award for future pain and suffering. Even withoutDr. Cicmanec's testimony, there was sufficient evidence of future pain and suffering to allow the jury's award to stand.Expert testimony is not a prerequisite to instructing a jury regarding future pain and suffering when future pain andsuffering can be objectively determined from the nature of the injury. Neyzelman v. Treitman, 273 Ill. App. 3d 511, 518(1995). The majority incorrectly states that Dr. Cicmanec's "improper" testimony "comprised the basis of the award forfuture pain and suffering of $3,200." Slip op. at 21. The evidence in this case was that plaintiff was rear-ended by a cartraveling 45 miles per hour and, as a result, suffered sprain/strain of her neck and low back. Plaintiff testified that shecontinued to have discomfort in her neck and lower back at the time of trial. I believe this evidence provided a sufficientand objectively reasonable basis for including a future pain and suffering component in the jury's instructions.