Question
I was in an auto accident about 3 mos ago where someone pulled out in front of me & I T-boned them. I hit my chin on the steering wheel. The doctors told me I had a subluxation of C1/C2 with torticollis. Before the accident, I was diagnosed with two herniated discs in my lumbar spine. I have never had problems with my mid or upper back. Since the accident, I have had progressive & extreme pain in my mid/upper back radiating towards my neck and around my shoulder blades. It hurts more when I twist rather than go forward or backwards. I have frequent headaches in my forehead & at the base of my skull. After the accident, my teeth didn't line up but they told me there was not fractures or dislocation in my jaw or any of my bones. The accident aggravated my herniated discs & I have more frequent sciatica pain. After the accident, I had numbness down my left arm & leg & my ring & pinky fingers & toes only on the left side which has since gotten better. What is getting worse is my upper back. My x-ray report says that there is minimal levoscoliosis of the thoracic spine & osteophytes in the mid thoracic spine suggestive of spondylosis. Can an auto accident cause this type of scoliosis? If not, can it cause symptoms there because there is scoliosis? I haven't ever been told I've had scoliosis before & I've had several x-rays on my back in past years. What do you think I should do? I am in chronic pain & all they are doing is treating me with alot of pain meds. I recently stopped wearing my cervical collar & they want to start on physical therapy for my neck. I tell my doctors about my upper back pain and they say "one thing at a time". This is very frustrating... Please help!

Answer
Dear Pam,

Yes an auto accident can easily cause pain and dysfunction in the upper back.  It happens all the time and I see this frequently in my office.  The fact that you have a scoliosis in the upper back will complicate the issue, but it is more likely that the scoliosis was there before the crash and was undetected...a thoracic scoliosis is usually the result of a lumbar scoliosis.  You would have to get your old x-rays and have them measured to compare the curvature pre and post to be sure.

Now, the upper neck pain can be referred form the neck or it could be primary in that location.  Referred upper back pain is the most common type of pain after a motor vehicle collision, with the exception of neck and headache pain, and is actually the result of torn ligaments, cartilage damage and disk derangement in the neck followed by muscle spams.  This is called sclerotogenous pain... check out the below link  for a complete definition with illustrations.

http://www.suncoasthealthcare.net/glossaryofterms/

I would suggest that you seek out the care of a chiropractic physician who has additional training in auto crash injuries.  There are good post-doctoral programs out there and many chiropractors have completed them. You can find doctors who are educated on the specifics of auto injury through the International Chiropractic Association, www.chiropractic.org, and the Spine Research Institute of San Diego, www.srisd.com.  Both of these organizations have quality programs , and referral listings of doctors certified through there programs.  If you cannot find a chiropractor that is certified, just go with one who treats these types of patients, and get a consultation before you decide on care.  By the way, a chiropractic physician will treat all areas of the spine at the same time...not one thing at a time.

Physical therapy is a good step for you as you definitely need active exercise protocols, but please make sure your PT understands the injuries before they give you exercise protocols.  I have seen patients after PT where the exercises were inappropriate for the injuries they had, and this is often the treating doctors fault not the PT.  If you have not had flexion/extension views of the neck taken or a MRI called a flar study, any ligament injuries you have were probably missed and went undiagnosed.

Good luck Pam!  Feel free to follow-up if necessary.

Respectfully,
Dr. J. Shawn Leatherman
www.suncoasthealthcare.net