Effect of manipulation technique using ultrasound-guided cervical nerve root block on range of motion at the shoulder joint in frozen shoulder: a retrospective study.

PURPOSE: The aim of this study was to evaluate the range of motion (ROM) at the shoulder joint before and after silent manipulation. METHODS: This retrospective study included all patients who underwent silent manipulation at our institution between January 2013 and December 2017. In total, 1,665 shoulders in 1,610 patients (519 men, 1,146 women; mean age 55.4 ± 8.8 years) were treated during the study period. The mean symptom duration was 6.6 ± 7.1 months. ROM at the shoulder joint was measured in flexion, abduction, and external rotation before silent manipulation and at 1 week and 1, 2, and 3 months after the procedure. RESULTS: Mean ROM at the shoulder was 98.8° (95% confidence interval [CI] 97.9-99.8) before silent manipulation and 155.5° (154.1-156.8) after 3 months in flexion (p = 0.0000), 75.6° (74.5-76.8) and 152.9° (151.0-154.9), respectively, in abduction (p = 0.0000), and 12.7° (12.0-13.4) and 45.9° (44.4-47.4) in external rotation (p = 0.0000). All ROM values were significantly increased at all time points after the procedure. There were no unanticipated adverse events or serious adverse reactions. CONCLUSIONS: This study reports on the efficacy and safety of manipulation using conduction anesthesia for shoulder contractures in a large group of patients. Silent manipulation can increase ROM at the shoulder safely and effectively.