Back Clinic Personal Injury Chiropractic Team. Injuries from an accident can not only cause physical harm to you or a loved one, being involved in a personal injury case can often be a complicated and stressful situation to handle. These types of circumstances are unfortunately fairly common and when the individual is faced with pain and discomfort as a result of trauma from an accident or an underlying condition that has been aggravated by the injury, finding the right treatment for their specific issue can be another challenge on its own.
Dr. Alex Jimenez’s compilation of personal injury articles highlights a variety of personal injury cases, including automobile accidents resulting in whiplash, while also summarizing various effective treatments, such as chiropractic care. For more information, please feel free to contact us at (915) 850-0900 or text to call Dr. Jimenez personally at (915) 540-8444.
Whiplash has been difficult to study because its pathoanatomy has remained poorly known, however, the facet joints have been recently isolated as a site of pain in many people that are whiplash-injured.
In a typical rear-end collision, the occupant’s pelvis, chest, and head are hastened forward in rapid succession. The massive inertia of the head leads to a horizontal translation (retraction) of the initially stationary head relative to the forward-accelerating torso, and this movement induces compression, shear, and ultimately tension in the cervical spine.
Recent studies have localized the chronic pain of several whiplash patients to the facet joints. Subsequent experiments involving both human subjects and cadaveric cells have demonstrated that harm to the capsular ligaments may play a part in the pathoanatomy of whiplash injury.
Kinematics of Whiplash Injuries
Biomechanical studies of whiplash injury have used human subjects, animals, cadavers, and mathematical models to investigate possible mechanisms of whiplash injury. Researcher ignorance of the tissues responsible for the pain has often limited the insights. Recent studies, however, has identified a candidate tissue for whiplash injury, and it has provided a focus for research into the mechanics of whiplash injury.
The comprehension of injury mechanics begins with an appreciation of how individuals respond to the kinds of perturbations that create whiplash injury. Rear-end collisions, where an occupant’s vehicle is struck from behind and hastened forward, have been associated with an increased risk of whiplash injury and a higher frequency of symptoms compared to other crash directions. As a result, perturbations that simulate a collision have been used by most biomechanical experiments conducted to investigate whiplash injury. Many research groups have studied subjects exposed to whiplash perturbations, and despite differences in subjects, vehicles, seats, and the crashes used with these groups, a stereotyped reaction has been observed in normally seated subjects.
The pelvis is hastened forward, due to a combination of occupant posture and seat compliance, acceleration of the torso lags behind acceleration of the pelvis. This difference in motion between the pelvis and upper torso produces a small rotation of the torso and leads to an initial flexion of the neck, despite the fact that the head is still effectively stationary at this stage in the induced kinematic response. As the torso accelerates forward relative to the head, a horizontal translation develops between the base of the head and the spine, causing the lower vertebrae of the spine to extend. The horizontal shear stiffness of the upright spine is inadequate to overcome the rotational and transitional inertia of the head, and because of this, the upper cervical segments bend. The changing configuration of the vertebrae results in the cervical spine being better able to encourage horizontal forces, and these forces both accelerate the bottom of the skull forward and establish a rearward rotation (expansion) of the head.
In the presence of a properly positioned head restraint, both the head extension angle and the horizontal translation between the torso and head (retraction) are arrested and reversed by the combination of an external force applied to the head from the head restraint and inner forces developed by both the ligamentous cervical spine and the reflex contraction of the cervical muscles.
Larger extension and retraction motions occur, and head motion could be arrested and reversed by inner ligamentous and muscle forces if no head restraint is present or if there exists a gap between the back of the head and the head restraint. The positions of the head and head restraint at effect can therefore have a substantial influence on the magnitude of the head and neck kinematics, and ultimately on the size of the loads applied to the tissues of the cervical spine.
After the interaction with the seat back and head restraint, the head and chest rebound forward. Forward torso motion could be limited by a seatbelt, whereas forward motion of the mind seems to be controlled by sustained activation of the posterior neck muscles.
The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .�
By Dr. Alex Jimenez
Additional Topics: Automobile Accident Injuries
Whiplash, among other automobile accident injuries, are frequently reported by victims of an auto collision, regardless of the severity and grade of the accident. The sheer force of an impact can cause damage or injury to the cervical spine, as well as to the rest of the spine. Whiplash is generally the result of an abrupt, back-and-forth jolt of the head and neck in any direction. Fortunately, a variety of treatments are available to treat automobile accident injuries.
Many accident victims report neck pain in the days after a car accident. This neck pain is due to whiplash. Whiplash pain may not surface following a car accident till a day or two. The pain does not happen until a week or even longer.
Whiplash is an injury to the neck muscles out of rapid forward and backward motion of the neck brought on by a trauma (eg, a car accident). It can cause acute (short-term) neck pain as well as restricted movement on your neck. This is the reason why it is extremely important to get medical care from a chiropractor if you do not have pain or any visible injuries.
Your spine is evaluated by the chiropractor as a whole. He or she’ll examine the entire spine because other regions of the spine may be affected (not your neck).
Chiropractic Evaluations for Whiplash
The healthcare professional or chiropractor will identify any areas of spinal injury, muscle strain, and joint movement. They may use a technique called motion and static palpation. Your chiropractor will feel for tenderness and make sure your spinal joints move.
He or she will examine how you walk, and take note of your posture and spinal alignment. These details will help the chiropractor understand that your body’s mechanisms and your spine works, assisting with the identification process.
Mechanism of Injury: MRI Scan
Besides the chiropractor’s test of your spine, he or she may order an MRI of your backbone to evaluate any changes which might have existed before your whiplash injury or an x ray. Your neurological and own physical evaluation’s diagnostic pictures and results are compared to create the treatment plan.
Before and After X-Rays
Whiplash CT Scan
Soon after whiplash occurs, the chiropractor will work on reducing neck inflammation using various therapy modalities (eg, ultrasound). They may also use gentle stretching and manual treatment techniques (eg, muscle energy therapy, a type of extending). Chiropractors promote recovery in the affected regions, and can assist in relieving pain, by using different therapy methods.
Your treatment plan depends on the seriousness of your whiplash injury. The most common technique is spinal manipulation. Some manipulation methods utilized are:
Chiropractic Adjustment: By performing spinal manipulation, via movements or thrusts, chiropractors can move the involved joint. This helps create flexibility, strength and promotes recovery.
Muscle Comfort and Muscle Stimulation: Using calm gentle stretches to the muscles that are affected, tension can be relieved. These stretches can also be combined with ‘finger pressure techniques’ on certain pressure points to alleviate pain.
Exercises: A variety of stretches and exercises can help decrease the symptoms associated with whiplash and neck pain. Chiropractors can recommend several of these to patients to perform at home on their own. This provides the patient a bit more control in the healing procedure.
The chiropractor might also recommend you apply an ice pack on your neck or a mild neck support to use for a period of time. The pain decreases and as your neck becomes inflamed, your chiropractor will execute other methods or gentle spinal manipulation to restore normal motion.
Using these techniques, a chiropractor will allow you to increase your daily activities. He or she’ll work hard to tackle any mechanical (the way the backbone goes) or neurological (nerve-related) causes of the own miscarriage.
The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
By Dr. Alex Jimenez
Additional Topics: Automobile Accident Injuries
Whiplash, among other automobile accident injuries, are frequently reported by victims of an auto collision, regardless of the severity and grade of the accident. The sheer force of an impact can cause damage or injury to the cervical spine, as well as to the rest of the spine. Whiplash is generally the result of an abrupt, back-and-forth jolt of the head and neck in any direction. Fortunately, a variety of treatments are available to treat automobile accident injuries.
Unfortunately, many people can relate to having been involved in a car crash or motor vehicle crash (MVC) at a certain point in their lives. Whether it was a major accident or a little one, MVC’s are no fun and can cause a variety of injuries. These injuries can often be whiplash injuries.
The implications of a motor vehicle crash, in addition to interruption of your daily routine because of whiplash, can often lead to injuries or conditions which may take years to recover from.
With much more distracted drivers texting and speaking on their telephones, MVC’s are on the rise, making for even more dangerous roadways. While other people’s behaviors can not be controlled by us, we can drive more cautiously and defensively to avoid being in an auto accident. Because MVC’s can occur, however, having a plan in mind and being prepared is vital to getting up on our feet and recovering fast.
More serious automobile accidents mean more critical injuries, ranging from wounds and cuts to broken bones or fractures, brain damage, and even death. At first, less serious motor vehicle crashes may not look like a major deal, with sufferers walking away without a scratch, believing they’ve escaped the collision unscathed. Others may just complain of a small headache, neck pain, and/or a stiff neck, resorting to carrying over the counter pain killers, or even wearing a neck brace to assist with their healing — something that’s far from treating the source of the injury.
Cervical Lordosis in Whiplash Prevention
What many people don’t realize though is the extent to which the cervical lordosis, or curvature in your neck as seen from the side, can play an essential role in both: the extent of the initial injury to the occupant(s) and; the long term pain and suffering from whiplash injury to the occupants. Furthermore, the MVC itself will affect the cervical lordosis.
Concerning the degree of initial injury, researchers have found that a well maintained cervical lordosis actually prevents neck tissue damage to the sensitive cervical spine and its structures, in the case of an automobile accident. In the figure on top, the right hand picture demonstrates what a typical curve looks like when seen from�the side and the person is facing to the right. In contrast, the same researchers identified that straightened cervical curves and worse yet, reversed (kyphotic) cervical curves predisposed to more severe cervical spine tissue injuries due to more extreme forces acting on the neck during the exact same MVC circumstances. The x-rays above at the far left and the middle show abnormal neck curves where more severe injury to the person is likely to result should they be involved in an MVC.
Therefore, if you already have an abnormal cervical curvature prior to a MVC, it’s in your best interest to rehabilitate the form and volume of your cervical lordosis. You’re in a higher risk of having significant injuries should you be involved in an automobile collision or other type of accident.
Concerning long term pain and distress, many research studies have identified the patients who undergo long-term whiplash injuries and suffering are in fact the ones who have abnormal cervical lordosis. Straightened, abnormal s-curves and reversed cervical curvatures have been found to pre-dispose after MVC to the following conditions:
Neck pain and stiffness,
Headaches,
Arm pain,
Thoracic outlet symptoms,
Dizziness,
Lack of concentration,
Degenerative arthritis in the cervical spine,
Disc herinations.
What many individuals who’ve suffered whiplash injuries don’t see is that a small pain or neck pain is a genuine indication of a more serious injury to your cervical lordosis and inherent neck tissues. Misalignments as a consequence of motor vehicle crashes, or MVC’s, sudden jolt may manifest immediately, or not become evident at all for a period of time. But this doesn’t signify that the spine is healthy or that no harm was sustained.
Discussion
The fact is that MVC�s statistically damage the shape of your cervical lordosis. Researchers from Chiropractic BioPhysics have identified that the average patient exposed to a MVC will lose 10 degrees of their cervical lordosis, develop a mid cervical kyphosis, and have increased forward head posture as a result of the MVC.
A misaligned cervical curvature as a result of an MVC is a severe medical condition. Altered cervical curves will cause nerve interference � hindrance of critical nerve energy that is responsible for every function of our organs, and every movement of our limbs. Ignoring the cervical spinal misalignment can manifest into pain and discomfort, fatigue, sleep disorders, organ dysfunction, depression, and finally disease.
The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .�
By Dr. Alex Jimenez
Additional Topics: Automobile Accident Injuries
Whiplash, among other automobile accident injuries, are frequently reported by victims of an auto collision, regardless of the severity and grade of the accident. The sheer force of an impact can cause damage or injury to the cervical spine, as well as to the rest of the spine. Whiplash is generally the result of an abrupt, back-and-forth jolt of the head and neck in any direction. Fortunately, a variety of treatments are available to treat automobile accident injuries.
Definitely, the most frequent injury caused by automobile accidents is whiplash, amounting up to 80 percent of car crash injuries.
Whiplash is a cervical spine, or neck, injury that is caused when the head is jolted either backwards or forward by acceleration or deceleration. The acceleration or deceleration in automobile accidents is typically abrupt, which will cause the head to jerk unexpectedly and be stretched beyond its normal range of motion, straining the neck’s muscles and ligaments. Whiplash can happen at any speed �even when vehicles are traveling as slowly 25 mph.
Severe cases of whiplash can even cause fractures to the neck vertebrae. These accidents might need time off from work and physical activity in order to recover and are painful although a complete recovery is likely.
Level of Damage from Whiplash
Most commonly, whiplash is the result of a rear-end automobile collision, rather than a side impact or head-on collision, though that is possible. In the vehicle, kinetic energy will keep the bodies moving forward in the event of a car accident. Due to restraints like seat belts, the body will be stopped while the head will continue to be thrown backward. This unnatural movement of the neck leads to hypertension injuries. Depending on the seriousness of the impact and how fast the cars were traveling at the time of the incident, the extent of the whiplash will differ.
Traumatic brain injuries will be caused by the whiplash. A healthcare professional will often perform both a physical examination and an X-ray or CT scan to examine the possibility of whiplash in those who were involved in an auto collision. Doctors monitor and might examine brain function to be able to ascertain whether there was damage or injury to the structures surrounding the neck. With acceleration and deceleration injuries, the brain may swell and cause bruising and bleeding. This can be potentially life-threatening.
Cervical acceleration or deceleration injuries result in trauma to the deep anterior neck muscles. When a muscle is torn, it is strained. When a ligament is sprained, it is stretched or torn. As the ligaments in the neck are responsible for maintaining a curve of their neck this can be painful. Neck injuries of this sort will involve micro-tears, but hypertension will result in fractures and larger tears. Many vehicle crash victims after healing, will experience what’s known as myospasm. This symptom involves the sudden contraction of the neck muscles. These spasms can be painful.
Front impact crashes have a greater risk of death and serious injury. Whiplash resulting from a collision can cause injury to the cervical spine and hyperextension. Severe strain of this nature can leave a victim suffering from tension headaches, migraines, and even vision problems for some time even after the neck has healed. The extent of the injuries may depend on which type of vehicle the person traveled in. The size of the vehicles can have a tremendous effect on both severity and the nature of the injuries. Airbags are required in vehicles for safety purposes, but they can actually cause injuries because of their impact when deployed.
If you or a loved one were involved in an auto accident, then you may be suffering from the painful side effects of whiplash and cervical spine injuries. The driver who hit on you may have been cited with a violation, but you might be able to take actions and receive the proper healthcare you deserve.
The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .�
By Dr. Alex Jimenez
Additional Topics: Automobile Accident Injuries
Whiplash, among other automobile accident injuries, are frequently reported by victims of an auto collision, regardless of the severity and grade of the accident. The sheer force of an impact can cause damage or injury to the cervical spine, as well as to the rest of the spine. Whiplash is generally the result of an abrupt, back-and-forth jolt of the head and neck in any direction. Fortunately, a variety of treatments are available to treat automobile accident injuries.
Fractures of the process of the lower spine or upper thoracic spine are often referred to as clay-shoveler’s fractures.
Initially reported in 1940, these fractures were described among employees in Australia who dug drains in clay soil and also threw the clay overhead with shovels. The mud wouldn’t discharge from the spade, causing excess power to be transmitted into the supraspinous ligaments and leading to an avulsion fracture of one or more spinous processes.
The following frequently describes the mechanism of injury for clay shoveler’s fractures. The contraction of the paraspinal and trapezius muscles on the ligaments along with the attachment to the spinous processes make this a common injury during athletics with a flexed position of the shoulders and neck. The consequent fracture or apophyseal avulsion is painful and frequently requires a visit to the doctor, together with plain films, computed tomography (CT) scans, or magnetic resonance imaging (MRI) confirming the identification.
Often a period of rest will allow a return to activity, although treatment of these fractures hasn’t been clarified. We present a collection of adolescent athletes who underwent surgical interventions to treat the fracture of the spinous process, after rest and physical therapy with persistent symptoms.
Surgical Intervention Study
Dr. Hedequist operated on 3 patients using a spinous process nonunion within the study time period. The patients’ average age was 14 years; the location of the spinous process fracture was the T1 vertebra in all patients. Two patients sustained the injury while playing hockey and one while wrestling. The average duration of symptoms before surgery was 10 months; all patients had seen physicians without a diagnosis before test in institution. All patients had a trial of physical therapy and all had been unable to return after trauma to pain.
Examination of patients showed pain directly over the fracture site and accentuated by forward flexion of the neck and neck. Evaluation of harm plain films revealed a fracture fragment in two patients (Figure 1). All 3 patients underwent CT and MRI scans confirming the identification. MRI confirmed areas of increased signal at the tip of the T1 spinous process, with inflammation in the supraspinous ligament directly at that area (Figure 2). The CT scans confirmed the presence of a bony fragment correlating with the suggestion of the T1 spinous process (Figure 3).
Figure 1
Figure 2
Figure 3
Surgery was performed under general endotracheal anesthesia using a midline incision over the affected region down to the spinous procedure. The supraspinous ligament was opened showing an identified and ununited ossicle, which has been removed without taking down the ligament. All 3 nonunions have been noted to be atrophic with no evidence of surrounding inflammatory tissue or bursa. The residual end of the spinous process was smoothed down with a rongeur. Standard closure was performed. There were no surgical complications.
All patients had complete relief of pain at followup; 1 individual returned to full sports activity at 6 months and the other 2 returned to full sports activity at 3 months. There was no loss of peripheral movement or trapezial strength at follow-up. All patients expressed satisfaction together with the decision.
Discussion
Clinical practice suggests that most patients with spinous process fractures will become pain-free; however, that is not universal. This series demonstrates that a tiny subset of patients with this trauma will continue to have significant symptoms despite a period of rest. In those patients who want a yield to sports, we recommend consideration of surgical excision after confirmation of nonunion with studies. The inherent risks of surgical treatment are minimal with this procedure, and the advantages include return for athletes, with the physical and psychosocial benefits to pain-free sports activity.
The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .�
By Dr. Alex Jimenez
Additional Topics: Automobile Accident Injuries
Whiplash, among other automobile accident injuries, are frequently reported by victims of an auto collision, regardless of the severity and grade of the accident. The sheer force of an impact can cause damage or injury to the cervical spine, as well as to the rest of the spine. Whiplash is generally the result of an abrupt, back-and-forth jolt of the head and neck in any direction. Fortunately, a variety of treatments are available to treat automobile accident injuries.
Fractures of the cervical spinous processes are considered to be rare injuries. Isolated spinous process fractures are even rarer instances, some of which are rare injuries in rare case reports. Approximately xixteen percent of isolated process fractures of the cervical spine involve more than one level. Isolated cervical spinous process fractures are in fact, commonly referred to as clay-shoveler’s fractures.
The term “fracture” can be employed in medical scenarios that deal with a broken bone. This can vary from acute breaks to small fractures, or anything which will impact the integrity and stability of the bone.
Bone fractures could result from numerous distinct situations. Women in particular that suffer from osteoporosis or other conditions, or older people, may lose strength in their bones, making them more fragile and vulnerable to breaks and cracks, even with minimal impact. As the bones have not fully grown, young children are also vulnerable to bone fractures, particularly because they frequently participate in activities that heighten the risk of injury.
However, falls, automobile accidents, and also a number of other dangers can lead to bone fractures, and depending on the severity, these may often require a range of short and long-term treatment options.
What is a Clay Shoveler’s Fracture?
A clay shoveler’s fracture is an avulsion fracture of the spinous process. It happens with flexion of the head, like that reported with automobile accidents, diving, or even wrestling injuries. It also occurs with repeated stress caused by the pulling of the trapezius and rhomboid muscles on the cervical and thoracic spinous processes. Repetitive and forceful muscle contraction breaks the spinous process and pulls the avulsion segment away from the original spinous process.
A clay shovelers fracture commonly occurs from the cervical and upper thoracic spinous processes C6, C7, and T1. The avulsion and fractures are caused by damage or injury from direct blows to the base of the neck. This is usually a stable fracture and doesn’t create any additional deficits.
X-ray examination of the spine can help diagnose a clay-shoveler’s fracture. On the lateral side (side view) x-rays, an oblique radiolucent fracture line could be seen through the base of the spinous process. It’s more likely to maintain the trunk or distal tip of the lower cervical and upper thoracic spinous process. Serrated edges or rough margins are generally seen with the fractures, which distinguishes it from nonunion of this secondary growth centre of the process. Additionally, bones from the head and neck would not be displaced or have the serrated margins. The distal portion of the fractured spinous process is often displaced downward (caudally or poor). This is due to the pull on the avulsion segment of bone.
Chiropractic Care for Clay Shoveler’s Fractures
Chiropractors can help alleviate some of the long-term and immediate concerns associated with bone fractures, such as clay shoveler’s fractures. A chiropractor may not perform treatment procedures to the fracture until the damage or injury has started to heal and inflammation is reduced. A chiropractor can help with compression techniques which are beneficial in maintaining the bone in place for healing. A chiropractor may also advocate wellness techniques, such as appropriate diet, and this will optimize the body’s ability to restore its original health and wellness. Chiropractors may also educate a patient on a variety of exercises and stretches to reduce the likelihood of complications and which, if done properly and at fixed intervals, will promote quicker recovery.
The advantages of seeing a chiropractor for wellness and health are many and well documented, but chiropractors are particularly effective as first line and treatment practitioners for bone fractures of any sort. When many kinds of fractures and acute breaks may require immediate therapy, a chiropractor can help rebuild strength and ensure proper recovery, which makes the chiropractic procedure an excellent cure and ensuring long-term good health.
The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .�
By Dr. Alex Jimenez
Additional Topics: Automobile Accident Injuries
Whiplash, among other automobile accident injuries, are frequently reported by victims of an auto collision, regardless of the severity and grade of the accident. The sheer force of an impact can cause damage or injury to the cervical spine, as well as to the rest of the spine. Whiplash is generally the result of an abrupt, back-and-forth jolt of the head and neck in any direction. Fortunately, a variety of treatments are available to treat automobile accident injuries.
Fractures in the cervical spine may occur with severe or repetitive trauma. Clay shoveler’s fracture is an avulsion fracture of the spinous process. It happens with abrupt flexion of the head, most commonly from a variety of accidents. It also occurs with stress caused by the pulling of the muscles around the thoracic and cervical spinous processes. The process breaks up and pulls on the avulsion segment from the original spinous procedure.
Clay shoveler’s fracture most frequently results in the lower cervical and upper thoracic spinous processes, namely C6, C7, and T1. Fractures and spinal avulsion can also be brought on by damage or injury as in direct blows to the neck’s base. This is a fracture that is stable and doesn’t produce any neurologic deficits. This part of the bone isn’t near nerve roots or the spinal cord, although patient’s are alarmed when they hear the term fracture or fracture in the neck.
Clay shovelers fracture derives its name from a common event among clay miners in Australia during the 1930s. The workers were digging deep ditches and tossing clay 10-15 feet above their heads with long handled shovels. Instead of having the clay come off the shovel, it would stick. The sticking clay produces a contraction of the trapezius and rhomboid muscles in reaction from the weighted shovel. The muscles react forcefully and immediately, contracting to stabilize the spine and shoulders. The Australian clay shoveler’s will hear a pop and feel a sharp contrast between the shoulder blades. They would feel sharp pain, making them unable to continue working because every time the trapezius or rhomboid muscles could contract. The mechanism of injury is believed to be caused by powerful and abrupt muscle contraction transmitting pressure via the ligaments. The enormous force is concentrated round the spinous processes and creates an avulsion fracture over the cervical and upper thoracic spine’s spinous processes.
Plain Film X-rays and Examination
Regarding lateral (side view) x-rays, a triangular radiolucent fracture line can be seen via the base of the spinous procedure. It is more likely to maintain the distal or trunk tip of the lower cervical and upper thoracic spinous procedure. Rough margins or serrated edges are commonly seen with the acute fractures, which differentiates it from this secondary expansion center of the process.The distal part of the fractured spinous process is frequently displaced down (caudally or inferior). This is due to the pull on the segment of bone.
Frontal x-rays (anterior to posterior) may demonstrate the look of two spinous processes at a single vertebrae, which can be called the “double spinous process sign.” Especially when the cervicothoracic junction is visualized on the view this signal is helpful for determining a clay shoveler’s fracture. An MRI (magnetic resonance imaging) or CT (computed tomography) is not typically required. A bone density scan could be indicated in a person who has undergone prior avulsion, thoracic, or lumbar spinal compression fractures. A bone density scan can evaluate and measure lumbar and cervical spine t-scores; which gauges relative risk of spinal compression fractures if bone density is in question.
Symptoms of Clay Shoveler’s Fracture
Clay shoveler’s fracture can occur with almost any repetitive and forceful activity utilizing the trapezius and rhomboid muscles. It might occur with automobile accident injuries for traumatic blows to both sides and top of the spinous procedure. Generally, pain is associated immediately after the injury and can be described as a burning or “knife-like” traumatic pain. Other symptoms include muscular stiffness and pain which increases with repeated action, similar to muscle strain at the top back joints or muscle strains. The broken spine is very tender, as are the muscles.
Treatment of Cervical Spine Avulsion Fractures
Most cases resolve in a few weeks. Pain or aggravation to the area could be associated with the tendon and muscle junctions that insert on the spinous process or avulsion segment. Some patients do not require treatment apart from remainder or NSAIDS (non steroidal anti medication). Others may benefit from pain medicine or muscle relaxers.
Medications could be applied at the neck and upper back into the muscles to ease soreness and possible rhomboid muscle strains. Bones and ribs shouldn’t be influenced or produce back pain. Some individuals require physical therapy or massage therapy, including chiropractic care, to help decrease muscle pain and stiffness. Ice, heat ultrasound, mild stretching, and range of motion exercises can help relieve neck and upper back pain. Some individuals respond to course IV cold laser treatments (low level laser treatment) to help reduce pain and inflammation in the muscles and tendons. Others might benefit from muscle treatments like Active Release Technique or Graston Technique to break up scar tissue or adhesions associated with years of repetitive activities. Patients may expect some discomfort for several weeks during the healing process.
Symptoms may worsen at the the front of the body with arms and the head, such as driving or working in the computer. With time and some therapy, symptoms will decline with time. Exercise and strenuous activity might need to be avoided for 1-2 months post injury. For patient’s having a history of stress fractures or avulsion fractures, a bone density scan could be indicated. Some kinds of fractures need immediate attention and could be unstable. Fractures must be assessed to make sure they are stable and tracked by an orthopedic surgeon.
The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .�
By Dr. Alex Jimenez
Additional Topics: Automobile Accident Injuries
Whiplash, among other automobile accident injuries, are frequently reported by victims of an auto collision, regardless of the severity and grade of the accident. The sheer force of an impact can cause damage or injury to the cervical spine, as well as to the rest of the spine. Whiplash is generally the result of an abrupt, back-and-forth jolt of the head and neck in any direction. Fortunately, a variety of treatments are available to treat automobile accident injuries.
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