Adhesive Capsulitis or Cervical Herniated Disc or something completely different.. That is the Question !

by Angel
(Glasgow, Scotland)

My symptoms started 6 months ago with a sharp pain when I awkwardly twisted both my neck & head in an upwards movement to prevent a door that was coming of its hinges landing on me. Since then I have had various theories from different GP's.
1st)was Torticollis
2nd) was Frozen Shoulder
3rd) was disc herniation
4th) now back to Frozen Shoulder wait 12 months and see how things are.

My symptoms are pain down left centre back of neck, pain radiating down left trapezius muscle but no discernible tingling in fingers or hand.

I can rotate my neck towards the good side but find it painful to rotate to the left. Limited movement of left shoulder and I can't lift my left arm up my back.

I am receiving physiotherapy via NHS and when I told physiotherapist that the Bakody Test relieved my pain, she asked me what was the Bakody Test !!!

Can you please give me your opinion, I am on an NHS waiting list for an MRI because I have made a complete nuisance of myself demanding that if they don't send me for one I want it recorded on my case notes that my health and wellbeing is in severe jeopardy due to lack of a proper diagnoses.

Hello Angel,
I like your spunk! And I confess I too had never heard of the Bakody test! Where did you find out about it? It's usual name is the Shoulder Abduction Relief sign, or SAR.

However, SAR is relief of arm pain by taking the traction of the nerve root. And as I understand you have no symptoms radiating down the arm. Thus in my book this does not constitute a positive Bakody test, or SAR.

Disc herniation is certainly a possibility, but I think unlikely. Do you have any changes in reflexes and skin sensation on pin prick? Has anyone done the "Upper Limb Tension Test" on you. Find it using the Search Site function at Chiropractic Help.

Also ask if anyone has done Spurling's test on you.

The lower neck is very connected to the shoulder and my guess, note I have no examined you, is that the diagnosis of torticollis is the closest fit; it's an old fashioned name for a cervical facet syndrome. It's an entrapment of a part of the capsule around the facet joint. Because the nerve root passes close by, any swelling may affect the arm; in your case the shoulder.

All of this is speculative obviously, but a cervical facet syndrome usually responds very quickly and well to a chiropractic adjustment; unless there is old injury at that level, in which case it may be more complicated.

Do stretch that shoulder gently, otherwise you may end up with a neck and a shoulder problem.

You are right; I'm reminded of an old Giles cartoon with four doctors standing around a patient's bed. One says: Well at least we've narrowed it down to one of four conditions.

Have you had xrays? What do they show? And an opinion from a local chiropractor?

I hope this contributes.

Dr B

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Interesting challenges of the day

1. Mr S is a 76 year old man with neck pain of some 9 months duration. Luckily, most of the discomfort is upper cervical which is only rarely arthritic; his lower cervical spine is a degenerative mess that I've left alone. After seven treatments his pain and stiffness is 50 percent better, and he's happy in the circumstances. He can sleep through the night now and that makes a huge difference.

2. Mr P is 32 year old man with very severe lower back pain radiating to the big toe which is 30 percent numb. He had an episode three weeks ago, took anti inflammatories and was soon better as is typical of the medial disc herniation. But before it healed, after a trivia it came roaring back, much worse. The characteristic crossed sign was evident; sitting in a chair, straightening the right leg provoked severe left back pain and tingling in the leg. He's doing well.

3. Severe lower back pain is scary; just ask Mrs P. Just watching her get out of the car I she was in trouble; she had a slipped disc at L4 making her lean towards the opposite side; luckily she had no pain in the leg. Despite family pressure that this was far too severe for a chiropractor, she persevered. Within five days she was standing upright, and after two weeks almost painfree. 

Despite a hectic job, she wisely took my advice and stayed home for what I call exercising bed rest.

4. Mr S has had lower back, groin and back of thigh and calf pain for fourth months.

He has a pincer deformity in the hip causing the stabs in the groin, and a degenerative facet causing the sciatica. Both are responding well to chiropractic and he's well pleased; sixty five percent better after three treatments.

5. Mr T is a wise man; he's taken a warning TIA seriously and has lost 15 pounds, and has at least as much again to lose. A change to a low starch diet and half hour daily walk has made the difference; but the walking is making his foot and back miserable. The expensive orthotic is hopeless; luckily his hips and back are fine, but he needs a simple heel lift.

6. I too have had serious lower back issues, luckily fixed by my own chiropractor; so I too have to do my exercises, take care when lifting supers full of honey, gardening and using the chainsaw. Regaining the function of your spine is just as important as the pain.

7. My own granddaughter, only 7 is hypermobile giving her pelvic, knee and ankle issues. Xrays show a mildly dysplastic hip. Years ago we would have called it growing pains. She too regularly needs chiropractic care and luckily responds well. Increased range of motion is more difficult than too stiff in my opinion. Our care is for kids too.

8. This 65 year old lady is a serious gardener; every day she is bending, lifting and digging for 2 to 3 hours a day. It regularly catches her in the sacroiliac joint, so she has a treatment once a month that sorts it out. She does her lower back exercises faithfully.

9. This 88 year old lady is an inspiration; every day she is busy in the community. With a nasty scoliosis she manages very well with a chiropractic adjustment every six weeks and exercises faithfully done.  

10. Mr X is a 71 year old retired man who wants to continue with maintenance care every six to eight weeks; he had suffered from two years of lower back pain when he first came a year ago. He has no discomfort now after 8 chiropractic treatments, but is aware that danger lurks.

11. Mrs C has been having severe headaches, and taking a lot of analgesics. It's a non complicated upper cervical facet syndrome, and she's doing well.

12. Mr D is a 38 old year man with chronic shoulder pain after a rotator cuff tear playing cricket. It responded well to treatment, but he knows he must do his exercises every day; for two years he couldn't sleep on that shoulder.

13. Mr D, a 71 year old man, has a severe ache in the shoulder and midback since working above his head. Trapped nerve tests are negative but he has advanced degenerative joints of Luschka; after just two treatments he is 50 percent better. Can we reach 90?

And so the day goes; chiropractors shouldn't be treating the elderly most medical sites state but that's so much bunkum.

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