Question
On October 5, 2010 I was involved in an accident. I am a Paramedic and was in the rear of the ambulance with the patient when we wrecked. I was thrown into the floor landing on my right side with my right arm outstreatched partialy breaking my fall. I was then thrown sideways into two steel oxygen tanks. My left hand had ended up behind my back I landed squarely on the rear of my left shoulder and crunching into the bottles. I felt pain in my shoulder and going straight down my spine. I then was slammed onto the floor squarely on my back twice, feeling excrutiating pain in my spine immediately. The pain is middle of the shoulder blades and down to just below my bra line. The when we impacted the embankment I was projected into the center console neck and shoulders first and felt what felt like a shotgun blast or explosion in my spine relative to aproximately the bottom of my shoulder blades. MRI and XRAYS of thoracic spine and cervical spine have all came back clean. Oddly enough, in '07 I had a ruptured disk that went undiagnosed for 9 months because of a clean mri. I have radiating pains around my rib cage and into my breastbone, clavicles. In relation to the shoulder, pain is along the scapula, the front of the shoulder jint relative to the bicep tendon, and the area where the shoulder joint and scapula seem to meet. I cant lateraly raise my shoulder past horizontal. I need some help and information! I cannot get my doctor to listen to me! Any info or advice would be extremely helpful! Thank you

Answer
Dear Lenya,

I am sorry to hear of your accident and your pain.

First of all, this is a very recent injury. Your accident was only 1.5 months ago, so it is not uncommon for you to still be feeling some significant pain. Time heals wounds... but it does take time.  Bones can take several months to become stable, and they are still healing for up to two years. Muscles, again, require several months to heal, and ligaments, if they are going to heal at all, require months to years.

There is the potential of several injuries here.  it is possible that you have injured your cervical spine, thoracic spine, glenohumeral joints, Acromioclavicular joints, etc.  

Glad that the x-rays and MRI's have come back clean on the C spine and T spine.  If the studies were done early on, however, they might have missed injuries that only show up after a fracture has had some time to start healing.  You might consider additional x-rays or MRI's if the tests were done right after the accident.  Often, compression fractures of the thoracic spine are hard to see.  Also, rib fractures often go unseen.  Remember, an MRI or X-ray of the cervical and/or thoracic spine regions does not rule out injuries to the shoulder joint components.

Inability to raise the arm laterally indicates possible rotator cuff muscular strain or tearing. You might have your MD/DC take a look at that, and other possible injuries to the shoulder girdle.

The most important thing, however, is that if you feel that you doctor is not getting to the bottom of your problem, and if the doctor is not listening to you and is not willing to rule in/out other problems, it is time to find a new doctor!  Please be aware, if you are seeing an MD, he/she is always going to take the "lets wait and see" approach.  They will give you medication for pain, but they will likely not treat you much. They believe that all that you need is time, and they often have little or no faith in chiropractic care of even physiotherapy at times.

If you are seeing a chiropractor, make sure that they are taking into consideration the possibility of occult or hidden fractures.  He/she should also be evaluating your shoulder for injury, and treating you with physiotherapies and not just adjustments.

I hope that this helps you a little bit. Be patient. Give yourself some time to heal.

Keith Biggs, DC
http://www.eastmesachiropractor.com