Neck Pain


Sherryl K., Tarzana, California, 2002. Whiplash injury.

Sherryl is a 30 years old female, secretary of a finance firm, suffering from pain in the neck, shoulder and arms for 1.5 years ago. This pain was a consequence of car accident (so called whiplash injury). She had been gone through chiropractic treatment and even epidural injection. X-Ray and MRI examinations revealed nothing particular. She also suffered headache, depression, fatigue, anxiety, insomnia and stress mostly because of the persistent pain.

She started her first 6 acupuncture treatments every other day with better improvement. Two treatments a week after the 7th session and totally 20 treatments had given. She was completely free of symptom and advised to have treatment once every two weeks for three months to keep the high threshold of effect and to prevent recurrence.  

Comment: Acupuncture treatment injury was showed to be very effective for Whiplash. Acupuncture can relieve pain by adjusting the nervous conduction and increase the secretion of neurohormones such as endorphines. Furthermore, acupuncture improves the micro-circulation in the injured areas to relieve the edema and congestion which resulted with an enhancement of the healing process of soft tissues. Application of immobilization to a not fracture area actually could diminish the local circulation. Over use of manipulation would increase tissue damage.

 

Neck pain is a common condition. It can be mild enough so that it is a mere annoyance, or severe enough that it can affect the quality of one’s life. While it is less frequent than back pain, almost everyone will experience some sort of neck pain or stiffness during their lifetime. Workers who have been required to do repetitive tasks with their upper extremities, or who undergo period of prolonged sitting with their head in a flexed position (such as type on the keyboard of a computer) are at risk of developing mechanical neck pain.

Causes of neck pain

1. Vertebral: a. Whiplash. This is a common cause of neck injury in car accidents.

b. Sprain. Sprain of neck commonly caused by sportive activities.

c. Herniation of intervertebral disc. HIVD is a nerve compressed by the slipped disc.

d. Arthritis. Arthritis is chronic inflammation of the intervertebral joints.

e. Bony destruction. Tumor.

f. Cervical rib: This is due to abnormal development of the 1st. rib.

2. Muscle:  a. Trauma.                   b. Spasm (Facet syndrome).

3. Connective tissue: Infection or inflammation

The role of acupuncture in the treatment of neck pain

Studies have shown acupuncture to be effective in relieving certain types of neck pain, especially those caused by whiplash and muscle spasm. Studies also suggest acupuncture can treat degenerative neck disorders such as cervical disc, spondylosis and ankylosing spondylosis. Acupuncture treatment provides a promptly relieve effect to inflammation, pain and muscle spasm. Long term effect had been demonstrated clinically and proven by controlled studies. Accompanied with electric stimulation, heat, cupping, and massage treatment can add positive effect to the treatment.

 What we do

Standard steps we approach to patient with neck pain:

1. Record detail history of illness to sort out the cause of the pain.

2. Review test data and imaging result (X-ray, CT scan, MRI).

3. Perform physical examination and movement test to picture the illness tissues.

4. Propose a treatment plan.

5. Common acupuncture points used include: Ear sympathetic, neck, and liver; para-spinal points according to the level of illness; GB points in the shoulders; and distal analgesic points.

6. Electric stimulation or cupping added as need.

Demography of neck pain patient and treatment results of our clinic

Study data draw from 2003 to 2007. Age: 45 to 80, average 63. Gender: F:M=3:1

 

Diagnosis

% of total pain   patients

% of Improvement

% of marked   improvement

Average treatment

Injury 2.08 91.5 83.4 14
IVDD 4.15 91.6 68.5 19
Spondylosis 1.7 90 50 18

Be noted that the result of treatment relate closely with many factors include age, gender, length of sickness, severity of sickness, treatment that have used and current combined therapy. Unfortunately, in United Stated many choose acupuncture treatment as tier last resource.

Literature Review

Liang Z et al. Assessment of a traditional acupuncture therapy for chronic neck pain: a pilot randomized controlled study. Complement Ther Med. 2011 Jan;19 Suppl 1:S26-32. Epub 2010 Dec 23.

Two-arm, single-blinded, randomized controlled trial. Test number 178.  This study is aimed to assess the efficacy of traditional acupuncture for chronic neck pain in patients by comparing the differences in symptoms, dysfunctions and quality of life. Traditional acupuncture can relieve pain intensity and improve the quality of daily life with a relative long-term clinical efficacy in patients with chronic neck pain.

Irnich D et al. Randomized trial of acupuncture compared with conventional massage and “sham” laser acupuncture for treatment of chronic neck pain. BJ 2001 Jun 30:322(7302):1574-8

Randomized trial. Test number 177. Test group- acupuncture. Control group – massage or sham laser acupuncture. Result – The acupuncture group showed a significantly greater improvement in motion related pain compared with massage but not compared with sham laser. The acupuncture group had the best results in the subgroup who had had pain for longer than 5 years and in patients with myofasial pain syndrome.

Birch S et al. Controlled trial of Japanese acupuncture for chronic myofascial neck pain: Assessment of specific and nonspecific effects of treatment. Clinical Journal of Pain, 1998, 14(3):248-255.

Randomized controlled trial. Test number 46. Test group– Acupuncture at specific sites relevant for neck pain or acupuncture at specific sites not relevant for neck pain. Control group — Nonsteroid anti-inflammatory medication. Result– Relevant acupuncture contributed to modest pain reduction in persons with myofascial neck pain. The relevant acupuncture group had significantly greater pre- and post-treatment differences in pain than the non-relevant acupuncture and medication groups.

David J et al. Chronic neck pain: a comparison of acupuncture treatment and physiotherapy. British Journal of Rheumatology, 1998, 37(10):1118-1132.

Randomized controlled trial. Test number 35. Test group – Acupuncture. Control group Physiotheraphy. Result — Both groups improved in respect of pain and range of movement of neck. Acupuncture was slightly more effective in patients who had higher baseline pain scores.

Coan R et al. The acupuncture treatment of neck pain: a randomized controlled study. American Journal of Chinese Medicine, 1982, 9:326-332.

Randomized controlled trial. Test number 15. Test group — Acupuncture plus electric acupuncture. Control group –No treatment. Result — Mean pain scores were reduced by: 40% in the test group; improvement in 12/15; 2% in the control group; improvement in 2/15.

Loy TT. Treatment of cervical spondylosis: electro-acupuncture versus physiotherapy. Medical Journal of Australia, 1983, 2:32-34.

Randomized controlled trial. Test number 27. Test group — Electric acupuncture. Control group – Physiotherapy. Result– Improvement was observed in: 67.4% of the test group at 3 weeks, 87.2% at 6 weeks; 51.3% of the control group at 3 weeks, 53.9% at 6 weeks.

Petrie JP et al. A controlled study of acupuncture in neck pain. British Journal of Rheumatology, 1986, 25:271-275.

Randomized controlled trial. Test number 13. Test group –Acupuncture. Control group – Mock TENS. Result — At 1-month follow-up, daily pill count and disability scores, respectively: decreased by 23.5% and 24.6% in the test group; increased by 8.4% and 8.4% in control group.

Wu QF. 100 cases of stiff neck treated by contralateral acupuncture. International Journal of Clinical Acupuncture, 1997, 8(4):427-429.

Group comparison. Test number 100. Test group – Acupuncture at Laozhen. Control group — Medication (ibuprofen 0.3 g, 3 times per day). Result –Cure was observed in: 80/100 (80%) in the test group after the first session, 10 after the second, and 4 after the third; 6 did not respond in 3 days; 12/32 (38%) in the control group on the first day, 6 on the second, and 2 on the third; 12 did not respond in 3 days.