Neck Pain

Neck covers the area between skull and upper back, its' symtoms involve pain, neural signs and muscle weaknesses.

Neck Region Basic Anatomy

Neck is formed by seven cervical vertebrae, it supports the skull which is approximately about 6-8% of total body weight. Neck is strong but it is also flexible enough for allowing a wide range of motion. The joints in the neck allow six degrees of motions, namely, bending forward, extending backward, bending sideways and turning. Unique and functional sharps of each neck bone allowing fulfilment of different directions of movement. For instance, the first neck bone Atlas looks like a ring sitting on a protrusion sharp structure of the second cervical bone, allowing a wild angle of turning range of motion in the neck area. While the remaining lower neck bones allow mainly side bending motions.

Muscles also play a vital role in neck motion mechanics. Big muscles help to move our neck within the physiological range of motions. As our neck is so flexible, it would also cause problems of poor stability if it lost the small muscles to keep holding bones together.  Muscles in the neck help us to keep a good balance between stability and mobility. 

Nervous systems in the neck are so vulnerable and therefore minor pressure entrapping of nerves could result in arm pins and needles and muscle weaknesses. Nerves in the neck travel through nearby muscles in neck and shoulder, and innervate different muscles in shoulder, elbow, forearm and hands. Differential diagnosis, like skin pin and prick, hot and cold test, help us to make physical diagnoses and formulate corresponding releasing treatment for the patient.  

Neck provides a flexible and stable fixation. Nerves originate from the skull and brain can collect sensation  from the surrounding environment, like vision, smell, noise, etc. Without equal and balanced support , head tilting might result and cause imbalance nerve signals to our brain. For example, imbalance tightness in the upper neck causes unequal signals of head position to our brain. If the position information is contradicted by visual signals, people will easily suffer from dizziness. 

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How the usual neck symptoms look like?  

• Neck stiffness and limited range of motions
• Head tilting and find difficulty keeping an upright posture of neck
• Neck and shoulder blade soreness
• Arm pins and needles or numbness
• Unable to use hands or to maintain lifting up arms

 

 

 

Neck Pain Common Causes

Neck pain conditions generally can be categorized into acute and chronic conditions. Acute neck pain is defined as the condition lasting within 3 to 6 months, and the painful area is usually confined to the affected soft tissue. Chronic neck pain has the wide spreading characteristic and can affect more than one soft tissue simultaneously. Scientists proposed that injuries could lower the sensivity of our bodies, leading to the normal stimulation can now be regarded as painful sensation.

Common acute neck pain illnesses include Muscle Strain, Sport Injuries, Acute Torticollis and Whiplash Injury, etc. Chronic neck pain conditions include Neck Pain Syndrome, Thoracic Outlet Syndrome and Fibromyalgia, etc.

Acute Torticollis

Acute Torticollis is characterised by sudden onset of neck single side tightness, self limited and recover spontaneously within 3-4 days. It is usually caused by Acute Muscle Strain or Fibrositis. However, recurrent torticollis may predispose to chronic neck pain syndrome.

Whiplash Injury

Whiplash injury is one of the injury mechanism that causes spinal trauma. Excessive flexion (hyper-flexion), and excessive extension (hyper-extension) can cause bone damage and tearing of muscle and ligaments, resulting in front and behind side soft tissue injuries. It is common seen in motor-vehicle accidents, and it is complicated by its injury mechanics.

Neck Pain Syndrome

Neck Pain Syndrome refer to cluster of neck pain symptoms, various symptoms are determined by soft tissue affected, limited range of motion, nerve root distribution pins and needles, spinal cord compression symptoms, and sympathetic nervous system symptoms.

Here is the precautions when suffering neck pain syndrome:

• Keep neck region warm.
• Keep good sitting posture, avoid sitting on sofa.
• Do gentle neck mobilisation exercise every hour.
• Avoid weight lifting, or it will cause neck muscle tightness again.
• Avoid using tablet or cell phone, and bending neck forward posture would cause neck tightness.
• Improve office working posture, with ergonomic design table and chair.

Fibromyalgia

Fibromyalgia affects about 2% of the population, and it is a non-arthritic rheumatic disease. According to College of American Rheumatology, diagnostic criteria includes number of painful area in 19 parts of body, and severity of following symptoms, including fatigue, waking un-refreshed, cognitive (memory or thought) problems.
Compare Different Neck Pain Conditions:

	Aetiology	Symptoms	Treatment Focus
Acute Torticollis	Strained Muscle	Opposite side limitation of side bending and turning	Muscle relaxation and pain control
Whiplash Injury	Motor Vehicle Accidents, involve acceleration and deceleration neck motion	Instability of neck, and recurrent neck pain condition	Muscle training to improve instability
Thoracic Outlet Syndrome	Poor posture, neck muscle strained	Nerve or blood vessels compression symptoms	Release compression
Fibromyalgia	Unknown	Multi area pain at the same time	Pain relief, also focus on insomnia and emotional problems

Frequent Asked Questions:

Q1: Could all neck problems be treated by acupuncture?

A1: Acupuncture can effectively relieve neck pain. However, every patients should be assessed according to their individual complaints. Their health care partitioner should prescribe talor made treatment plans which are corresponsing to individual illnesses and diversified needs. Other than acupuncture, we provides Shock Wave, Cupping, Manual Mobilization, Exercising Advice and Chinese Herbal Medicine.

Q2: Is acupuncture painful?

A2: No, the needles we use are usually as thin as hair. It couldn't cause so much unbearble pain to our patients. Instead, they should feel a so called sensation of acupuncture. It should be a mild feeling of deep soreness. 

Reference:

1. Yin, C., Buchheit, T.E., Park J.J.. (2017, October). Acupuncture for chronic pain: an update and critical overview. Current Opinion in Anaesthesiology , 30(5), 583-592. doi:10.1097/ACO.0000000000000501.
2. Saha , F. J., Schumann, S., Cramer, H., Hohmann, C., Choi, K. E., Rolke, R., . . . Lauche, R. (n.d.). The Effects of Cupping Massage in Patients with Chronic Neck Pain - A Randomised Controlled Trial. Complementary Medicine Research, 24(1), 26-32. doi:10.1159/000454872.
3. Nakajima, M., Inoue, M., Itoi, M., & Kitakoji, H. (2013). Clinical effect of acupuncture on cervical spondylotic radiculopathy: Results of a case series. Clinical Trial Acupunct Med, 31(4), 364-367. doi:10.1136/acupmed-2013-010317(Read)
4.  Callejas-Marcos I, Torrijos-Bravo A, Torres-Chica B, Ortiz-Gutiérrez RM. Eficacia de la punción seca en la cervicalgia en comparación con otras técnicas de fisioterapia: una revisión sistemática [Efficacy of dry needling in neck pain compared with other physiotherapy techniques: A systematic review]. Rehabilitacion (Madr). 2019 Jul-Sep;53(3):189-197. Spanish. doi: 10.1016/j.rh.2018.11.004. Epub 2019 Jul 9. PMID: 31370946.(Read)
5. Witt, C. M., Jena, S., Brinkhaus, B., Liecker, B., Wegscheider, K., & Willich, S. N. (2006). Acupuncture for patients with chronic neck pain. Pain, 125(1), 98–106. https://doi.org/10.1016/j.pain.2006.05.013 (Read)
   This was a combined study design, incorporating randomized and cohort studies. 14161 patients with chronic neck pain from German multi-medical centres were enrolled. Usual medical treatment was given as a control group while additional acupuncture for 15 sessions was given as an intervention group. Subjects given acupuncture performed significant improvement in Neck Pain and Disability (NPAD Scale by wheeler) outcome measure. It is believed that acupuncture improves pain relief in addition to conventional medical treatment.
6. Liu, S., Wang, Z., Su, Y., Qi, L., Yang, W., Fu, M., Jing, X., Wang, Y., & Ma, Q. (2021). A neuroanatomical basis for electroacupuncture to drive the vagal–adrenal axis. Nature, 598(7882), 641–645. https://doi.org/10.1038/s41586-021-04001-4

7. Vickers, A. J., Vertosick, E. A., Lewith, G., MacPherson, H., Foster, N. E., Sherman, K. J., Irnich, D., Witt, C. M., & Linde, K. (2018). Acupuncture for chronic pain: Update of an individual patient data meta-analysis. The Journal of Pain, 19(5), 455–474. https://doi.org/10.1016/j.jpain.2017.11.005

    

    

Commonly seen related pain conditions