neck pain

I would hazard a guess that most readers of this blog have experienced neck pain. Neck pain is a common hindrance amongst the general population and a regular complaint that crops up time and time again in clinic.

For most people the experience of neck pain is sudden and acute and resolves effectively with treatment over a fairly short period of time. For others however neck pain can be chronic or reoccurring and often accompanied by radiating pain and headaches.

Neck pain can be the result of many different factors and successful treatment strategies vary depending on the root cause. Today I’d like to discuss the different types of neck pain that my patients tend to present with, the variety of treatments that can assist and some prevention techniques for long term spinal health.

WHAT NECK PAIN IS THAT?

WRY NECK –

The sudden stiff neck. This is the one where you wake up in the morning and for some unknown reason you can no longer turn your head. It’s generally more severe on one side and movement can be acutely painful. Wry neck pain sometimes includes spasm and may radiate out to the top of neck and all the way down to shoulder or even shoulder blade.

Generally, this occurs after poor night sleep, unusual activity or body movement but can also occasionally also occur from sudden jolt type impact / injury.

TCM diagnosis – Stagnation of Qi and Blood. Wind -Cold Invasion

How can Acupuncture and Traditional Chinese Medicine assist? – I would be aiming to promote movement of the Qi and Blood to resolve stagnation, introduce warm and alleviate and associated pain and stiffness in the local area. This can be achieved with Acupuncture, Moxibustion and Cupping.

WHIPLASH INJURY –

Whiplash is an injury that is sustained due to a sudden and forceful change of movement. This causes the head to jolt back and forth in a whip like motion. Most commonly whiplash is associated with car accidents however it can occur with other sudden jolt like incidents.

Whiplash results in inflammation and damage to the soft tissue of the neck and back. The symptoms of whiplash include sharp pain that is aggravated by use and movement. It can also cause unsteadiness and a sense of light headedness which is not surprising since your spinal system has taken a massive shake up. Chronic neck pain is often experienced in cases where people have not had effective and immediate treatment for whiplash.

TCM diagnosis – The body’s experience of whiplash causes the Qi and Blood to be disturbed and not flow smoothly resulting in stagnation. Where there is stagnation there is pain. The beauty is that Acupuncture is extremely effective at resolving stagnation. For patients experiencing chronic neck pain after Whiplash along with Qi and Blood stagnation and deficiency there is likely to be other underlying deficiencies to the Kidney and Liver systems from long term Qi stagnation. This may present as chronic pain, fatigue, poor concentration and dizziness and treatment to resolve may be more involved and longer term than in acute cases.

How can Acupuncture and Traditional Chinese Medicine assist? – Where I have a patient present with acute pain from Whiplash, I would expect to see some great improvement quickly. I would be using Acupuncture, Cupping and Moxa to encourage correct optimal flow of Qi and Blood through the affected area to alleviate inflammation and pain. In acute cases of Whiplash, I generally suggest that Acupuncture is used in conjunction with Chiropractic care. This way a Chiropractor can make sure that structurally the body is sound and in place while I can get the Qi and Blood flowing.

STRESS NECK –

Think about how you hold your body during times of stress. The emotions play a key role in all our experiences of pain, poor health and dis-ease. Traditional Chinese Medicine draws clear lines between the experience of anxiety and stress and its impact on our Liver system. The Liver governs the smooth flow of Qi and Blood. If the Liver system is unhappy or imbalanced so is the movement of our Qi. Traditional Chinese Medicine interpret the experience of pain as the result of stagnant Qi. So, as you can see where we have stress, tension or anxiety and our Liver is disturbed the result is pain. As tension builds up in the shoulders as a result of stress neck pain is experienced, often along with referred headaches and shoulder pain.

TCM diagnosis – No surprises here, Liver Qi stagnation is one common result with additional deficiencies depending on other underlying emotions at play.

How can Acupuncture and Traditional Chinese Medicine assist? – In treatment Acupuncture can elicit a relaxation response that lowers blood pressure, slows heart rate, restores energy and alleviates stress. For long term results we would need to explore the root cause of the stress, address lifestyle and dietary factors that may be impacting, nourish the Qi to resolve any deficiencies and promote Qi flow.

OSTEO ARTHRITIC NECK PAIN –

Osteoarthritis (OA) is a chronic degenerative disorder of the joints and commonly affected areas include the neck. The development of OA in the joints of the neck results in neck pain, headache and occasionally even irritation of the nerves which can result in radiating pain down the arms.

TCM diagnosis – From a Traditional Chinese Medicine point of view OA is a form of Bi Syndrome. Bi Syndrome’ refers to the syndrome characterized by the obstruction of Qi and Blood in the meridians and in western medicine would be associated with joint pain. Bi Syndrome can have many root causes including Yin or Yang deficiency, Spleen deficiency or Blood deficiency. All these present slightly differently and treatment would of course be tailored to the underlying root cause.

How can Acupuncture and Traditional Chinese Medicine assist? – Acupuncture and Traditional Chinese Medicine would be utilized to correct the Qi deficiencies, resolve stasis, remove damp, correct other internal imbalances. This would be achieved with Acupuncture, along with a variety of other TCM techniques including herbal medicine. Exploring dietary influences and potential changes to lifestyle would ensure long term successful results.

LIFESTYLE NECK PAIN / POOR POSTURE –

All the Chiropractors out there must join me in lamenting the state of the average person’s spine these days. We are pretty much all guilty of aspects of it. Many of us in desk or vehicle bound working roles find ourselves spending minimal time moving throughout our day and slumped in a poorly supported curve whilst at work. For those of us who are in less sedentary positions I doubt very much that you escape the curse of the ‘phone neck’ position every evening as you catch up on the social media scroll. These poor postures cause neck pain by putting additional strain on the supporting joints and muscles. The weight of your head the further forward your carriage is astronomical, and the consequence is extremely uncomfortable.

It sounds ridiculous but of my chronic neck pain client’s posture is a huge factor that needs to be rectified.

TCM diagnosis –  Qi and Blood Deficincy/Stagnation.

How can Acupuncture and Traditional Chinese Medicine assist? – This is another time I would urge you to combine Acupuncture with Chiropractic Care. Chiropractic care can ensure that your bones and sitting where they should and can provide some great exercises that can be practiced at home to help counter this forward carriage and slumping of our shoulders that has come with the tech age. Acupuncture and TCM techniques can work to alleviate inflammation and pain from poor Qi circulation and stagnation.

TRADITIONAL CHINESE MEDICINE TREATMENT TECHNIQUES –

Traditional Chinese Medicine is made up of many different forms of therapy including Acupuncture, Cupping, Herbal Medicine, Tui Na, Gua Sha and Moxibustion. Below I will detail how some of these therapies may be useful in the support of neck pain recovery.

DISTAL ACUPUNCTURE –

Just when you thought Acupuncture couldn’t get much more fascinating along comes Distal treatment. Distal, by definition means ‘situated away from the center of the body or from point of attachment’ The beauty of Distal Acupuncture is that we are able to place the needles away from the site of the discomfort of pain. By using Distal Acupuncture, we can illicit the desired response from the Qi without causing any undue discomfort or anxiety to the patient at the thought of the area that is in pain being touched. If you have avoided Acupuncture as a means of treatment for injury or pain in the past because you felt unsure or uncomfortable about localized treatment, then seeking out a Practitioner that is able to treat you with Distal Acupuncture would certainly be beneficial.

Distal Acupuncture is over 2500 years old and wears a few different hats. You may also hear it referred to as The Balance Method, I-Ching Method or Distal Point Acupuncture.

The best description of how Distal Acupuncture works is from Dr Richard Tan, who developed the Balance Method. His description goes something like this “you can walk to the light bulb, or you can flick the switch. We needle where the switch would be”

If you picture the Qi that travels around our body as a network of rivers and pain as a slow up or blockage of the water flow it becomes easier to see how we can work on a distal area of the body to still have great effect on the flow of Qi and as a result the pain.

The other thing I love about using Distal treatment is the patient’s ability to mobilize the area of discomfort during the treatment while the needles are in place. By gently moving the head and neck around safely as the needles are situated elsewhere, we can monitor the response to the needling and note and decrease in pain immediately and we can encourage fresh blood and oxygen to the area which in turn assists recovery.

TUI NA –

Tui na is a form of Chinese massage and I often use it to compliment Acupuncture and other TCM therapy’s in supporting neck pain Originating in China Tui na is thought to be the oldest system of bodywork. It’s very similar in principle to acupuncture however it targets the acu points with fingers and massage rather than needles.  It can vary from a strong yang dynamic deep tissue treatment with palpating, kneading and pushing motions to a gentle yin more energetic process depending on the individual patient needs. Tui nah massage uses techniques similar to acupressure along with myofascial release and reflexology. It also incorporates joint mobilization and stretching.

As with Acupuncture the main focus of Tui Na is to remove stagnant blocks and achieve optimal Qi movement around the body.

GUA SHA –

Gua Sha an ancient Chinese practice where an angled stone or tool is used to rhythmically and repeatedly rub or scrape the skins surface releasing trapped heat, promoting blood flow, circulation and energy redirection. Treating neck pain is one of the most common applications for Gua Sha although lately the use of facial Gua Sha it is becoming widely known for its cosmetic benefits these days. When performed for the treatment of neck pain it is used locally to promote blood circulation and Qi movement in turn relieving the pain caused by stasis. It is applied with massage oil and the use of a tool, sometimes a spoon shape or curved stone that is blunt. This tool is then used to apply press strokes or scrapes down the area of stagnation.

The treatment is usually brief and used in conjunction with other TCM therapies. This is a great technique that is gentle, and I use on both my paediatric and adult patients. I often show to patients and patients partners ways they can incorporate Gua Sha for home use in between sessions.

Gua Sha can sometimes result in red skin colouration called ‘sha’ that looks like a rash or bruise. The colouring is the where the scraping is helping to release heat toxin, move blood and invigorate Qi. The colour can vary in depth depending on the treatment but tends to last 2-4 day at most.

CUPPING –

Cupping involves a vacuum like suction being created on the skin using a cup. Cups used are either a silicone suction cup or a glass cup heated by fire to create suction. This short period of suction typically applied in the localized area of pain serves to warm the channels and draw out cold. It promotes muscle tension release, improved blood flow, Qi movement and toxin release reducing inflammation and pain. It can be an odd sensation but is not painful and is extremely effective and certainly something I would incorporate for upper back and neck pain.

Much like Gua Sha when the cupping draws out the heat and toxins and moves stagnation the result can sometimes include some skin colouration that resembles bruising where the cups have been placed. This is not painful and fades within 2-4 days.

HERBAL LINEMENT AND PATCHES –

We have several great liniments and patches that I use regularly in clinic when treating pain.

The Hua Tuo brand patches are great for long lasting relief of muscular cramps and spasm. They are infused with herbs and essential oils and provide localized warmth to an affected area for up to 1-2 days.

Trans Wood Lock Liniment is quite a hot liniment that can be very therapeutic for arthritic and muscular pain. It is the warmest of the three liniments that I use and may not be suitable for all patients depending on their presentation.

Zheng Gu Shui Liniment is the ‘liquid gold’ of the liniment selection and most commonly used and purchased. It’s brilliant both as a pre training liniment to encourage blood flow to areas that are prone to injury or discomfort and as a treatment for muscle ache and arthritic pain.

Po Sum On Oil is not only great for sore muscles, sprains and strains but also useful in the treatment of chest soreness from bronchial cough.

These herbal liniments all have different combinations of ingredients meaning that depending on the patient’s overall pattern and presentation one may be more suitable that the other. They bring relief by warming the area of pain and encouraging blood flow to the area which in turn promotes healing and comfort. They are a great way of supporting healing between Acupuncture appointments.

PREVENTATIVE AND LONG-TERM CARE –

Understanding the root cause to your neck pain is essential to optimal recovery and long-term care. In cases where the pain is from an injury or incident and it is dealt with in the acute stage then generally patients will respond well with recovery being straightforward and long lasting.

In cases where an injury has been left to become chronic or lifestyle factors such as stress, sleep, diet and physical activity are playing a role then it becomes critical that all these factors are explored, and the patient is supported to regain balance. When imbalances impact other body systems then for full health to be restored not only the pain needs to be addressed but the root cause and subsequent deficiencies or excesses that are being experienced.

As I have mentioned already there are many therapies that complement Traditional Chinese Medicine in the treatment of pain. I am an avid supporter of Chiropractic care to address structural and mechanical disorders of the musculoskeletal system, Remedial Massage for additional yang body work and muscle release and Exercise Physiology to promote core stability and strength.

Qi needs to move. This means incorporating stretching and gentle movement will also be part of your recovery. This may take the form of home based practice with movements that myself of one of your other health professionals provide you or you may like to explore external yoga, qi gong, tai chi or Pilates with an instructor that can cater to any current or past injuries or weaknesses.

Scott Stepehens

Acupuncturist
03 5973 6886

Scott works on a Wednesday afternoon from 2pm-8pm.

138 Tanti Avenue, Mornington

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