Category Archives: Neck Pain
Our neck must support our head, itself about a tenth of our overall body weight. It must also though, be flexible, and our quite amazing flexibility has been achieved by compromising somewhat on strength. The neck muscles are also at the mercy of our emotional state. All in all, neck pain is thus a common reason for seeking treatment. Indeed it now represents the fourth largest cause of disability worldwide (1), and is the second most common musculoskeletal condition treated by professional acupuncturists in the UK (2). My own experience is that acupuncture can be of significant help, particularly as Chinese medicine readily recognises and deals with, any emotional factors which are affecting the physical body.
The first distinction I need to make when you come, is whether the problem is chronic or acute. Taking chronic cases first, these will have persisted for months or years, and may be due to long-term postural problems, occupational factors, old untreated injuries such as whiplash, or degenerative conditions such as osteoarthritis. They may be accompanied by restrictions in your range of movement, making reversing a car difficult. There may be headaches, pain referred to the shoulders or arms, or sensations such as pins and needles in your fingers. A comfortable sleeping position can be hard to find, and if you have been lucky enough to find just the right pillow, then you will be keen not to part with it! I will interview you so that we can together establish all the finer details of these and any other symptoms.
Treatment is usually weekly for a few sessions, with the aim of reaching a more comfortable and settled state, before we start to space the appointments out more. If a degenerative condition has been at work for some time, then although treatment is unable to reverse changes which have already taken place, it may however, slow the rate of further deterioration, and leave you feeling that the condition is less burdensome.
Turning to acute neck problems, these have often arisen in the 24 to 48 hour period prior to someone contacting me: perhaps they may have slept in the wrong position, or suffered whiplash, and found that their neck starts to seize up, and is painful when turning the head to look over the shoulder. I find these patients benefit significantly from one or two treatments spread over just a few days. Some of these patients will report that this is a problem which flares up every few months, perhaps triggered by stress, getting angry, being exposed to a cold wind, or even sleeping in a draught; if this is the case, we need to look more closely at how these relapses might be avoided.
Whatever the type of neck problem, you can expect me to take a look at your posture, check your range of movement, get to understand any occupational factors, examine also your upper back and shoulders, and discuss your health in the widest sense. My preferred treatment is frequently a combination of acupuncture, massage and lifestyle advice. I might give you some stretches or Chinese qi gong exercises to practise. You will also notice I am very keen on keeping the neck warm and protected from the elements, so if you do not already do so, start wearing a scarf whenever you are out in cold or windy weather.
If you would like to discuss your particular symptoms in more detail, you are always welcome to call me.
(1) The global burden of neck pain: estimates from the Global Burden of Disease 2010 study. Annals of the Rheumatic Diseases, July 2014.
(2) Acupuncture in practice: mapping the providers, the patients and the settings in a national cross-sectional survey. BMJ Open, January 2012.
British researchers have found that the wide-ranging lifestyle advice given by acupuncturists to patients with chronic neck pain, is associated with reduced pain and disability. In a three-arm trial, 517 patients were randomly allocated to receive acupuncture (up to 12 sessions), Alexander treatment or usual care. Acupuncturists were encouraged to provide their usual lifestyle advice, tailored to each patient, and covering such matters as exercise, relaxation, diet, rest and work. Advice was found to be provided to 84% of patients.
Compared with those in the usual care group, acupuncture patients made more lifestyle changes and improved their ability to reduce their neck pain without resorting to medication. This behaviour was associated with significant reductions in pain and disability scores after 12 months. The authors conclude that lifestyle advice based on acupuncture theory leads to active patient engagement, and this in turn makes an important contribution to treatment benefits.
(Lifestyle Advice and Self-Care Integral to Acupuncture Treatment for Patients with Chronic Neck Pain: Secondary Analysis of Outcomes Within a Randomized Controlled Trial. Journal of Alternative & Complementary Medicine, March 2017.)
Researchers from the Department of Health Sciences at the University of York, have concluded that both acupuncture and Alexander technique significantly reduce neck pain and associated disability over a 12 month period when compared with usual care alone.
The study recruited 517 patients from GP practices in Leeds, Manchester, Sheffield and York. Participants were randomly placed in one of three groups: one group was offered up to 20 half-hour lessons with an Alexander teacher plus usual care; another received up to 12 sessions of 50 minutes of acupuncture based on traditional Chinese medical theory with practitioners of the British Acupuncture Council plus usual care; and the third group received usual care alone. In all three groups, usual care included prescribed medications and visits to GPs, physiotherapists and other healthcare professionals.
After 12 months, pain was reduced by 32% for those receiving acupuncture and 31% for those having Alexander lessons. When comparing Alexander lessons or acupuncture with usual care alone, these reductions were statistically significant. Moreover, patients in these two groups were found to be better able to cope without resorting to medication. Dr Hugh MacPherson, a Senior Research Fellow in the Department of Health Sciences, said that we now have clear evidence that these two interventions provide longer-term benefits for chronic neck pain.
(Annals of Internal Medicine, 2 November 2015.)
A study undertaken in Brazil has shown acupuncture to be effective in reducing neck pain and improving range of neck motion in women with local myofascial pain. A total of 60 such women, aged 18 to 40, who had been experiencing head or neck pain for six months or more, were randomised to receive either acupuncture, electroacupuncture or sham treatment. Eight treatment sessions were given, and patients followed up 28 days later.
Both acupuncture groups reported a significant reduction in pain levels, compared with the sham group, and both acupuncture treatments also resulted in small increases in cervical (neck) range of motion.
(Pain intensity and cervical range of motion in women with myofascial pain treated with acupuncture and electroacupuncture: a double-blinded, randomized clinical trial. Brazilian Journal of Physical Therapy, 28 November 2014, on-line.)
Researchers in Belgium have found that just one session of acupuncture can already start to ease the discomfort of whiplash injuries. In a randomised, crossover, pilot trial, a total of 39 patients with chronic whiplash-associated disorders, received two treatment sessions of twenty minutes duration, of acupuncture and relaxation therapy randomly crossed over. Acupuncture was given by professional practitioners with at least 15 years experience in traditional Chinese treatment.
Pressure pain sensitivity in the neck was found to decrease more significantly following acupuncture than following relaxation. Sensitivity at a painful region in the calf, also improved, from which the researchers deduce acupuncture may be activating the body’s own pain-killing mechanisms.
(Does Acupuncture Activate Endogenous Analgesia in Chronic Whiplash-Associated Disorders? A Randomised Crossover Trial. European Journal of Pain, February 2013.)