Clay-shoveler’s fracture is a breakage of the vertebrae in the spine as a consequence of stress in the neck or upper back. It is often described as a steady fracture during the process of a vertebra happening at C7 or C6, classically at some of the cervical or thoracic vertebrae.
Clay-shoveler’s fracture usually occurs in laborers who engage in tasks involving lifting weights with the arms stretched. Examples of these actions include physical activities like shoveling soil, rubble or snow up and over the head backwards, using a pickax or scythe, and pulling out roots.
Back in Australia in the 1930s, men digging deep ditches tossed clay 10 to 15 feet above their heads using long handled shovels. Rather than separating, the clay would stick to the spade; the employee would hear a pop followed by a sudden pain between the shoulder blades, making them unable to continue working.
The mechanism of injury is thought to be secondary to reflex and muscle strain through the supraspinous ligaments with force transmission.
The spinous process is pulled on by the enormous force. The fracture is diagnosed by plain film examination. The shear power of the muscles (trapezius and rhomboid muscles) yanking on the spine at the bottom of the neck actually tears from the bone of the spine.
Symptoms of clay-shoveler’s fracture include burning, “knife- like” pain in the level of the fractured spine between the top shoulder blades. The pain may increase with repeated action that strains the muscles of the upper back. The broken spine and muscles that are nearby are exquisitely tender. Often these injuries found incidentally years later when the cervical spine is imaged for other explanations and only are unrecognised in the time.
Acutely, they tend to be associated with:
The fracture is seen on lateral radiographs as an oblique through the spinous process, usually of C7. There’s usually substantial displacement. Other radiographic characteristics of the fracture include ghost signals on an AP view (i.e. double spinous process of C6 or C7 caused by displaced fractured spinous process).
While the extreme pain slowly subsides in days to weeks, the region may intermittently develop burning pain with certain activities that involve prolonged extending of their arms (such as computer function).
No therapy is required for most patients. Physical therapy, pain drugs, and massage can be of help. Surgical removal of the suggestion of the spine is performed for anyone who have pain.
The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
By Dr. Alex Jimenez
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