Question
First of all Im 21 years of age and was physically healthy and fit I, could even say i did some heavy weights before. I never injured my self before until I my left shoulder started to hurt so I went to a guy to crack my left shoulder to adjust the promblem, then he said he wanted to adjust my right shoulder saying that the pain will travel to my right shoulder, well after the manipulation a few days after my upper/mid back started to hurt so, I went to the same guy to adjust the promblem, he just manipulated my left and right shoulder again, then within the next day I started to feel pain on my right shoulder and started to pop it alot. So I went to a chiropractor to supposely heal the pain well as soon as left my first manipulation from the chiropractor my tailbone started to hurt. So I took incharge in recuperating my self I did some streching and within 3 weeks my pain between my upper back and mid back was gone. I still had excurciating pain on my right shoulder so I decided to go to the chiropractor again so maybe he could heal my right shoulder and possible my tailbone,well at my third manipulation and the first two he could not crack my upper and mid back just my lower back and adjusting my neck. Well on my third manipulation he cracked my upper/mid back it was almost I felt that what he did would affect me conderably my entire back caved in a v shape form, so then when I went to my car I pulled my head back and started to feel horrible back pain in my upper/mid back. Well then I went to the doctor and he said just muscles spasms and precriped me muscle relaxers. I went to another doctor he just said there is really nothing wrong with me. Then finally a doctor order to have some x rays on my back and right shoulder. It turns out that the guy who manipulated my right shoulder misalned my clavilce with my shoulder, thats why my right clavicle is slightly larger than my left one. And for my back it turns out that I have spondloysis, a crack in my lower vertabrae, which could explain why my tailbone hurts and lowerback hurts as well I could make poping sound when I extend my leg. In addition to that my upper/mid back still hurts mostly on my right side closely to my spine I could some how crack that region when I put force on a object and somehow my poping noise on my back on my right side when I put my shoulder back then put it foward. So my question is could have the chiropracter cause me to have a craked vertabrae and have pain in my upper/mid back? And the other guy to slightly misalned my clavicle. What should I do to heal my back and right shoulder besides going to physical therapy?, in which I would be goint to one soon and go to a orthopedic surgeon to take some MRI on my manipulation done to me. Could the manipulations done to my back and shoulder heal in regards to not feeling pain in anymore? It has been almost a year and I still have pain in my mid/upper back right side. And my right shoulder does not seem to hurt only that it pops and when I extend my shoulder foward my clavlie slightly pops or moves causing a slight pain. Also, when I do sit ups I hear a poping sound on mu lower back. The x-rays turned negative on my upper/mid back so it could be tissue realted?

Answer
Dear Gustavo,

The first thing that sticks out is that you should never let anyone manipulate your shoulder or your spine who is not a doctor with advanced training in manipulations or adjustments.  I am not sure who it was who "cracked" your shoulder, but I would opine that you should not have let them touch you at all.

Your statement that your clavicle and shoulder are misaligned could have happened years ago, or just recently, there is really no way to tell when it happened because you did not have a proper examination and x-rays before you were manipulated the first time.  The fact that the clavicle is slightly larger on one side versus the other is actually common...the clavicle is frequently injured in children without knowing and will result in anomalous growth.  That being said, it is possible that the guy who manipulated the shoulder actually made it worse, and most likely caused instability of the joint capsule that holds the clavicle at the shoulder (acromio-clavicular joint).

Concerning the chiropractor breaking/cracking your vertebra, this is very unlikely.  the forces that are needed to break a vertebra are very high and it is almost impossible to break a vertebra unless it is in an old person with degenerated bones (osteoporosis/tumor).  You are too young to really have that problem.

You have a chronic condition that most likely is being caused by continual irritation and inflammation along with muscle spasm.  And yes you probably have some form of shoulder dysfunction, but I doubt that you need to have your shoulder manipulated at all, and that was probably not the correct treatment for you to begin with.  I very rarely manipulate the shoulder, it is a joint that tends toward instability therefore manipulation would actually make it worse.  Rehab exercises for the rotator cuff would be more appropriate as well as addressing any muscular imbalances in the upper back complex which is common in the population.

Concerning the spondylysis, this is a condition found most commonly in the L5 and L4 vertebra and is considered to occur as a congenital malformation (from Birth) or from a significant trauma such as a fall from a high distance or car crash.  It is likely that the spondylysis has been there for years and has just been found.  I see this on x-rays all the time...it will not change my treatment, but only the way in which I would administer it...it is still safe to adjust these areas.

My advise to you is to find a better chiropractor, one who has advanced training in sports injuries and diagnosis. From what you have described, it doesn't sound like any of the doctors you have visited have performed an in-depth functional examination of the neck, upper back and shoulder.  This should have been done by all of them.  orthopedic testing of the joints and spine along with a complete history of the injury is the best way to arrive at a correct diagnosis which will determine the proper treatment. Check out www.acbsp.com for a listing of doctors who have advanced certification.

Depending on what is found on functional and passive examination, you may also need to have an MRI of the shoulder to verify instability, scar tissue, inflammation etc...If there is significant instability associated, you may need an orthopedic consult and surgery to fix the shoulder depending on the extent of injury.

I think I have addressed all your concerns Gustavo.  Feel free to write back if you need further clarification or have any other questions.

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