< b>Fracture, clay-shoveler's: An uncommon breakage of the spine of the vertebrae
from the lower neck or upper back as a result of stress.
Clay-shoveler's fracture usually occurs in laborers who perform activities involving
lifting weights rapidly with the arms extended. Examples of these activities include
shoveling soil, rubble or snow up and over the head backwards, using a pickax or
scythe, and pulling out roots.
The shear force of the muscles (trapezius and rhomboid muscles) pulling on the
spine at the base of the neck actually tears off the bone of the spine.
Symptoms of clay-shoveler's fracture include burning, "knife-like" pain at the
level of the fractured spine between the upper shoulder blades. The pain can sharply
increase with repeated activity that strains the muscles of the upper back. The
broken spine and nearby muscles are exquisitely tender.
Clay-shoveler's fracture is diagnosed by x-ray examination of the spine.
While the intense pain gradually subsides in days to weeks, the area can intermittently
develop burning pain with certain activities that involve prolonged extending of
the arms (like computer work).
Most patients require no treatment. Pain medications, physical therapy, and massage
can be of help. Occasionally, surgical removal of the tip of the broken spine is
performed for those with longstanding pain.
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