Clay-shoveler’s fracture

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.