Question:

I was in an accident driving at work when there was another vehicle struck. This was over 4 weeks ago and I still have a lot of pain. Even simple things like scrubbing a dish hurts from my shoulder blade all the way down my arm. Nothing has shown up on x-rays of back and neck, but I know that something is not right. I’ve done what the doc has asked in not lifting over 10 lbs since the accident. The doc wants me to start physical therapy, but I don’t know how much of it I will be able to do. First of all, what does this injury sound like could be wrong? Second, should I insist on an MRI before starting physiotherapy?

Answer:

Sorry to hear about your accident.  I know it can be difficult to deal with injuries while sorting out the details on your car as well.  I hope its OK!

At this point I would stress that it is very important for you to see your Physiotherapist.  It has been 4 weeks and you are still suffering.  I can say without question that your injuries are significant enough that they must be addressed.  Physiotherapists have many skills and assets that can be used to alleviate your pains and discomfort while guiding you through the rehabilitative process.  They work with acute cases such as yours on a daily basis!

There are a few different things that could be wrong when analyzing the symptoms you have described.  When clients report pain down the arm your Physiotherapists first matter of business is to rule out significant nerve damage.  It could be due to injuries sustained at the nerve root (in the neck) or further down the chain at the shoulder.  They will check the function in the neck and establish if your issues are joint related, muscle related or both.

As previously mentioned it is important for your to pursue treatment.  Often these types of injuries are much easier to deal with in the early stages before they become chronic in nature.  It is possible that your symptoms are a matter of simple nerve irritation and maybe easily fixed.  We will not know that until you are assessed by a Physiotherapist.

At this point I would not suggest waiting for the MRI before starting rehabilitation.  Physiotherapists are highly trained professionals and can determine the nature of the injury and indeed can get you on the road to recovery even if they feel the MRI is still necessary.