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Had blow on head, Have shoulder pain and physiotherapy. CT Scan of spine done. Findings?

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General & Family Physician
Practicing since : 2005
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I had a blow to my head about 7 weeks ago. My neck and right shoulder are still in a fair ammount of pain. I have been having physiotherapy and recently had a ct scan done of my cervical spine. My results didn't show any signs of bone, disc damage. The only thing that showed is that the report states that "There is a loss of normal cervical lordosis possibly reflecting splinting from patient." I am not sure what that means? I have been told that I should be fit to return to work on light duties based on the ct results. But I still feel in pain, if it is just muscle damage how long can I expect to still feel pain. Am I taking longer to recover due to Lupus and what other tests could I ask to due to further investigate my injuries, because I feel very sore and its affecting my everyday chores being a mother.

Kind Regards
Posted Mon, 23 Sep 2013 in Back Pain
Answered by Dr. Shanthi.E 54 minutes later
Brief Answer:
loss of normal contour of the cervical spine

Detailed Answer:

I am sorry about the injury you sustained and the persisting pain.

I have read the CT scan report that you have written. "There is a loss of normal cervical lordosis possibly reflecting splinting from patient." - This means to say that the normal curve of the cervical spine in the neck region is lost.

In normal people, there is cervical lordosis. It is nothing but a bend or curve in the spine. Look at this picture in the below link.

Normally we do see 2 bends in the spine - one in neck region, the other at lower back.

This cervical lordosis is lost in you and the cause for this is possible splinting from you externally on the neck. Have you used a cervical collar to your neck or some other neck splint? If so, please stop its use as this can cause further loss of the normal cervical lordosis.

I hope this is clear. If not, let me know. I shall explain in simpler terms.

It is not muscle damage, it is the loss of normal position of the cervical spinal bone.

Please check if your physiotherapy is going-on the correct way. Sometimes, incorrect exercises can cause this too. Please show your scan report to the physiotherapist. I hope you are under the care of an orthopedic surgeon who knows about this scan finding.

The pain would gradually disappear in 3 months time with correct exercises. Do not use any external splint to your neck.

No, lupus is not hampering the recovery process. It is not related to your current problem.

You do not require further investigations. I empathize with your difficulty in daily chores as a mother. I am sorry about this.

Please make sure you do the right physiotherapy exercises, and take simpler milder analgesics like Panadol for pain relief as and when required.

Rest your neck well. You should be fine soon.

My wishes to you for an early recovery

Above answer was peer-reviewed by
Follow-up: Had blow on head, Have shoulder pain and physiotherapy. CT Scan of spine done. Findings? 1 hour later
Thank you for answering my questions.
With this injury loss of normal cervical lordosis, I have never worn a neck splint. I have been pressured to return to work on light duties next week when I still feel the same pain, the last physio hurt for days and I walked away feeling worse. If I return to work what if it worsens my pain? What are my rights and length of time I should be unfit for work? according to my ct scan stating loss of normal cervical lordosis. I'm frustrated because people think I am well enough to return to work, when I don't. Do I talk to my doctor about it if I find I can't cope on light duties? I feel like I have been pressured by the work insurance company. Or is returning to work doing me good? My neck, upper back and right shoulder burn and hurt, when sitting up or doing anything physical.
Answered by Dr. Shanthi.E 5 hours later
Brief Answer:
Better to return to work

Detailed Answer:

I understand that you have never worn a neck splint. I also see that you are being pressured to return to work on light duties next week.

There is something wrong with your physiotherapy. In my view, it is worsening your condition. Please go to the physiotherapist after consulting and taking opinion from the Orthopedician about the physiotherapist. Do not choose your own physiotherapist.

Doing light work or duty would not worsen the pain. You are actually not unfit for light work. You can proceed with your work next week with restriction only to light duties and not heavy duties.

I know it is difficult but try it. You will feel better. Doing mental work will not strain your neck. And easy writing, and suggesting and taking actions can be easily done by you. I am sorry; I am not aware of the nature of your work to suggest specifically.

Yes, definitely. Please talk to your doctor if you can't cope with whatever duties you are assigned with.

I hope my opinion helps you in taking an informed and wise decision.

Take care of yourself.

Above answer was peer-reviewed by
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