Question:I have two separate problems: a frozen shoulder and a pinched nerve in my neck. If I have the shoulder manipulated, it could make the nerve problem worse. What can I do?
You didn't say what treatment you've already tried. Sometimes conservative care can make a difference. Anti-inflammatory drugs and physical therapy are the first treatment options. The physical therapist can help restore a balance in the soft tissues. Special techniques can be used to help the nerve move freely and smoothly.
If that doesn't work, then manipulating the shoulder while under anesthesia may be tried. The doctor grasps the arm and moves it through all its motions. This is called a traditional manipulation.
There are some problems with this method, so a new technique has been reported. This is called translational manipulation (TM). In this method, the patient only needs a local nerve block instead of a full anesthesia. The doctor has more control over the force and direction of the manipulation. This way there's less damage to other structures.
TM has been shown safe and effective in use with patients who have a shoulder and a neck problem. There's less stress on the nerves when TM is done with the head bent toward the affected arm while keeping the elbow slightly bent.Jeffrey D. Placzek, MD, PT, et al. Theory and Technique of Translational Manipulation for Adhesive Capsulitis. In The American Journal of Orthopedics. April 2004. Vol. 33. No. 4. Pp. 173-179.
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