Question
I am a 27 year old female. Three years ago, I fractured my T12 vertabrae and I was in a brace for 3 1/2 months until the fracture healed. My orthopedic surgeon didn't recommend physical therapy. About a year later, I was experiencing upper back pain, neck and shoulder pain. At that time, my doctor recommended physical therapy. I went for 8 weeks and continued with some of the exercises. I started to feel better but my left shoulder constantly clicked and my arm would become numb. About a year ago it got so bad that I went to the ER and they ran tests on me: CAT scan and an MRI and everything appeared to be fine. While the pain has persisted, I have learned to live with it because I have been evaluated and nothing is wrong. Recently, it has gotten to the point that my left arm is completely weak and my shoulder pain is constant. It woke me up last night. The weakness bothers me during the day. It travels down into my fingers at times. My shoulder blade never stops clicking when I rotate my arm and it hurts when I turn my arm. What do you recommend as far as follow up and could this be related to my vertabrae injury? Thank you.

Answer
Hi Shannon,

It may be indirectly related but not directly related. T12 has nothing to do with your arm strength. The trauma you received fracturing T12 certainly could effect surrounding soft tissue structures and subtly effected bone alignment.

You need to see a good neurologist and have a thorough exam, the weakness will be picked up immediately on physical exam and an EMG should follow. This should pinpoint the spot of entrapment. Also, it would be safe to assume, you need hands on biomechanical restoration of your cervical and thoracic spine, getting this evaluated and treated by a Chiropractor would be high on my list.
If the weakness is prolonged, it will be obvious to the examining doctor since muscle atrophy should be visible. An MRI or CT could easily miss the problem; a good exam including thorough muscle testing and nerve conduction velocities would shed enough light on the problem to make an educated therapeutic decision instead of a 搕rail and error?one. To successfully treat something, you have to first know what you抮e treating. If you had physical therapy for 8 weeks not having a concrete diagnosis, it doesn't surprise me the outcome was poor.
I would get a fresh start and get a D.C. and/or a Neurologist. You will most certainly need a Chiropractor; you may need the Neurologist for the EMG.

Hope this helps,

Dr. Timothy Durnin
drs.chiroweb.com