What everyone assumed. That the shoulder pain originated in his neck. Acting on that, the nerves running from his neck into his shoulder were ablated.
It didn’t do anything.
What I found. When I moved his neck for him, the joints moved well and without much restriction. When he moved it himself, there was significant restriction, tightness and pain. Passive movement is largely about joints, ligaments and capsules; active movement brings the muscles in. When those two findings disagree that clearly, the muscles are where I look.
What I did. Soft tissue work, spinal decompression, stretching, and a search for the areas of tension that had gone unaddressed while the attention was on his nerves. I adjusted a few things, but the adjustment wasn’t the focus, because other systems mattered more here.
Where he is now. He gained roughly forty degrees of range of motion in his neck by the end of that first visit.
There were several things worth addressing before anyone started burning tissue in his neck. That’s the part I’d want someone in a similar position to know.