About 20% of my patients over the last 30 years have come to the clinic because they have neck pain, but neck pain is a very general term. In order to write a meaningful article about this subject, I need to discuss different conditions that cause pain in the neck and how acupuncture helps each one.
Below is a list of the different types of neck pain patients receive acupuncture for.
Tight Muscles (Cervical Myospasm)
I believe most of us have experienced pain in the neck due to tight muscles at one time or another. It is often very localized in terms of where the pain is felt and can occur as a result of a sporting activity or from working for long hours behind a desk. It can also occur in part because of emotional distress. Often the pain will be worse with movement and the range of motion of the neck will be reduced. It has been my experience that acupuncture is usually very effective at treating this condition and can usually reduce the pain substantially in one treatment and completely eliminate it with a couple more.
Torticollis (Cervical Facet Joint Injury)
Often seen as a sports injury, it can also occur by sleeping in the wrong position. A predisposing cause can be emotional stress or cervical spondylosis, a condition which will be discussed later in this article. The patient will feel pain, but this condition differs from cervical myospasm in terms of its cause and in the degree of limitation in range of motion. Cervical myospasm is caused by tight muscles. Torticollis has its cause in an injury to the facet joints of the cervical spine, usually at the level of C5-C6 in older patients and C2-C4 in younger ones. The loss of movement is quite noticeable, with the neck locked in a position of lateral flexion to the opposite side of the injury. Acupuncture can usually relieve the pain and restore range of motion in 4-6 treatments. Or better said, it can restore the range of motion to the point where it was before the injury.
Whiplash (Cervical Sprain/Strain)
Whiplash describes the motion the neck makes during collisions, whether during car accidents or in contact sports, but what occurs in the neck is a sprain or strain of ligaments and muscles in the neck, as well as compression of facet joints of the vertebrae. The acupuncture treatment for a whiplash injury involves needling points that directly effect the facet joints as well as treating traumatized muscles not only on the back of the neck, but on the front as well. Usually, we see pain relief and increased range of motion within 2-3 treatments with further improvements occurring over the course of 4-8 treatments.
Cervical Spondylosis (Degenerative Joint/Disc disease)
Cervical spondylosis is a progressive condition that involves the facet joints of the vertebrae and the intervertebral discs. It is a natural result of aging, and in some people it will cause local pain, especially in the C5-C7 area, or will refer pain into the shoulder and arm. When the disc is involved, sensations of numbness, tingling, aching and burning can occur along dermatome pathways to the shoulder and arm. There are specific treatment strategies for both facet joint and disc-related pain, and in the case of the latter, there will be a predictable pattern of pain referral depending on which vertebrae are affected. Acupuncture can be very effective at reducing pain in most cases of cervical spondylosis, and on average, 5-10 treatments should suffice, depending on the severity of the condition. In cases where there is a postural imbalance, such as a forward-leaning head or lateral flexion of the neck, acupuncture and corrective exercises will have to be done or the problem might return.
Muscle Tension Headache
This part of my article could just as well appear in my article on headaches. A muscle tension headache is exactly what it is called—a headache that is caused by tense and shortened cervical muscles. Such tightness can occur with repetitive overhead movements at work or playing sports, or from a direct blow to the head that offsets vertebral alignment in the neck. It can also result from poor posture, when a person slouches, which creates a thoracic hyper-kyphosis and a cervical hyper-lordosis. In all of these cases, the tightness of the muscles activates trigger points, and there will be pain at the occiput, and possibly referred pain to the side of the head, behind the eyes, to the forehead, the top of the head, or even down the arm, chest and upper back if the scalene muscles are involved. I’ve treated this kind of headache hundreds of times and can say with confidence that acupuncture is usually very effective in eliminating the pain. Substantial relief can occur after the first treatment, and the pain can completely go away after two or three more.
The headaches will tend to recur if the postural problem mentioned above is not resolved. Acupuncture and manual myofascial release can help, and I am always happy to suggest self-help exercises that can improve the posture, provided the patient is motivated.
Thoracic Outlet Syndrome
This problem often originates in the neck, but it is usually felt in the shoulder and arm. Hence, I am not counting it among the five causes of neck pain described above. Acupuncture can be very effective at relieving the pain and paresthesia of this condition. I have written an article devoted solely to Thoracic Outlet Syndrome if you would like further information.