Question
I AM A 17 YEAR OLD FEMALE , I WAS INVOVLED IN A CAR ACCIDENT ABOUT 5 MONTHS AGO (MARCH 21ST) I WAS AT A COMPLETE STOP AND TWO CAR CARS REARENDED ME.THE DOCTOR HAD GIVEN ME MORE THAN 5 TYPES OF MUSCLES RELAXERS AND PAIN MEDS. NOTHING RELIEVED THE PAIN.I HAD AN MRI,I WAS TOLD I HAVE SOME "MILD"BULGING DISKS (C3-4, C4-5,6-7).AFTER 2 MONTHS OF NO RELIEF I  RECIEVED 3 TRIGGERPOINT INJECTIONS IN THE MID-SHOULDER(LEFT), AND UPPERBACK. .I DID  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

Answer
Dear Amy,

Well, this is normal..unfortunately...the medical professionals you have been treated by have completely missed the boat on this, and you should have been going to a chiropractic physician for the entire time...not a physical therapist, and drugs/TENS will not fix anything...they have no therapeutic value, only palliative values.  I see this all the time, and often get patients in my office after they have been to all the other medical professionals in the area...usually because they have tried everything else, not because they have been referred to my practice.   It isn't really the medical professionals fault - they just haven't been trained to deal with these types of injuries - they are more concerned with focal blood loss, fractures, and significant blunt trauma injuries.

Car crashes, especially rear impacts cause very specific injuries, and these are often overlooked by the medical community.  Specifically, we see torn ligaments (posterior longitudinal ligament, anterior longitudinal ligament), capsular ligament, in the neck and structural derangement of the disk without focal herniations.  The best way to visualize this damage is with stress radiographic views in the neck or DMX-dynamic motion x-rays, (both diagnostic tools are not commonly utilized  by medical doctors or hospitals) or a special high field MRI view called a FLAR study.

Also common is cartilage damage in the facet joints, and the lack of motion in the neck after injury makes the problems worse over time leading to degeneration and chronic pain.  Often torn muscles accompany this, but their healing rates are better than ligament or disk tissue (muscles have a better blood supply, therefore a better repair capacity).

The pain you are experiencing into the upper back and shoulder blades is called sclerotogenous pain.  It is referred from the neck not the back.  Many medical professionals do not know what sclerotogenous pain is and therefore try to treat the back when they should be focusing on the neck.  For a better explanation of sclerotogenous pain referral and illustrations, please check out the below link. Terms are in alphabetical order:

http://suncoasthealthcare.net/glossaryofterms/

Listen Amy, you need to pursue more active treatment options, and I would recommend that you seek out the care of a local chiropractic physician who has advanced training in car crash injures.  

You can find doctors who have advanced training in this subject at the Spine Research Institute of San Diego, and the International Chiropractic Association (CCST: Certification in Chiropractic Spinal Trauma) Also, with the history of injury, you probably need to have structural rehab protocols (chiropractic biophysics) to restore the neck curve as it is often damaged and reversed from the normal structure due to the forces generated in the crash.  I see this in over 90% of my patients.  The below links will help you research the key organizations for appropriate and effective treatment.

www.srisd.com
www.chiropractic.org
www.idealspine.com

Additionally, please respond back to me, and I will send you a copy of my office treatment protocols.  I am answering this question from home and do not have access to the material I would like to send you...it is in my office computers.  I would be more than happy to copy and paste my outline treatment regime for auto trauma and mild traumatic brain injury if you sustained a concussion.  The information is a bit dense, but you can read it with your parents and provide it to any prospective chiropractic physicians you may schedule consultations with.

Lastly, I would be more than happy to try and help you  find a qualified chiropractor in your area if you have any difficulty.

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