Not all non-invasive therapy is the same. For successful treatment of neck pain accurate diagnosis is tantamount. This requires knowledge of western anatomical principles, as well as eastern holistic principles. It also requires extensive experience treating many patients that present with different patterns of neck pain. Come to Roots of Eastern Medicine Acupuncture Clinic for an effective, non-invasive treatment to stop your neck pain now.

(1) Treating the neck according to the muscles

Today’s non-invasive therapy for treating the neck (and most parts of the body) often falls short as there is failure to treat the patient as a whole, but rather bits and pieces are viewed as independent from the whole system.

Typical theraputic massage tends to focus on the muscles as the primary source of pain and treatments are focused on relaxing the muscles. Massage therapists with minimal anatomical training and experience usually just massage the neck and shoulders according to a routine that they use on most patients. Little attention is paid to the source of the pain, or to diagnosis.

Therapists that base their therapy more closely on human anatomy tend to do more diagnosis. Different patients will be treated differently according to different diagnoses. But sometimes here strict anatomical adherence can lead to tunnel vision and inflexibility.

A typical rule of thumb is that in muscle pathology pain is elicited when the dysfunctional muscle is either stretched or flexed. So usually pain is felt in only one or two directions, depending on the muscle. So if only turning the head in a certain direction elicits the pain, then it is more likely a muscle/tendon that is involved.

Joint pathology, on the other hand usually involves pain felt in multiple directions, so almost any movement of the joint in question elicits the pain. This rule of thumb is of course an over-simplification, but it nonetheless can provide some clues of joint versus muscle/tendon pathology.

Another test is the compression and distraction test. If there is cervical disk pathology, symptoms will generally be increased when the cervical disks are compressed, and decreased when they are distracted from each other.

Compression means that pressure (usually gentle pressure) is applied to the top of the head down towards the neck and upper torso. This pressure can be applied with the patient facing forward, or to the left or right.

With distraction force is applied in the opposite direction, pulling the head away from the body. If these tests do not present with an increase/ decrease in symptoms then there is greater likelihood that the disease is not related to the cervical disks.

So if joint pathology is ruled out, then muscles that are flexed or stretched when neck pain is elicited are typically implicated, especially if they lie in close proximity with the pain.

If flexing or extending the head elicits pain then usually the splenius, suboccipitals, and trapezius muscles are implicated, as these are flexed or stretched in those movements.

If turning the head elicits pain, then the splenius, sternocleidomastoid (scm), levator scapula, and suboccipitals muscles are suspected.

If tilting the head to the side, then the scalenes are of prime suspect, but there is also a possibility of scm and levator scapula involvement because of their position at the side of the neck. The splenius muscles are also involved in this movement.

So, simply stated, strict anatomical adherence dictates that in the case of muscular pathology of the neck, you need only focus on the muscles directly related to neck movement.

Anatomical knowledge is extremely important in the proper diagnosis and treatment of neck pain, but strict adherence to anatomical principles can sometimes cause tunnel vision in the diagnostician. In these cases important anatomical features may be overlooked, and pathophysiology that can not be explained by gross anatomical knowledge alone will be missed.

Overlooking of anatomical features:

A) The scapula is often an important component of neck pain. The scapula is the bone that makes up the shoulder blade. Traditional anatomical knowledge would say that to treat neck pain with scapular involvement you must consider the levator scapula and the trapezius muscles, both of which connect the scapula to the cervical vertebrae of the neck.

B) This is usually a very effective strategy for treating neck pain with scapular involvement, but unfortunately some patients may not respond to this treatment. In these cases it is important to view things from a more holistic standpoint.

C) Any muscular pathology that distorts the position of the scapula can in turn pull on the trapezius and lavator scapula and indirectly lead to neck pain. The rhomboids are muscles that lie between the shoulder blades and are responsible for some scapular movement. Thus pathology here can indirectly lead to neck pain, especially cases of neck pain that are elicited when the head is bent forwards.

D) The supraspinatus must also be considered. It is a muscle at the top of the scapula which is responsible for abduction of the shoulder. Due to its close proximity to the trapezius and levator scapula it can also indirectly lead to neck pain, especially neck pain that is elicited by raising the arm, as it is responsible for the initial faze of arm abduction.

E) There are many other muscles which can indirectly lead to neck pain but these two are provided as an example of why flexibility in diagnosis is important. Zeroing in on one part of the anatomy can lead to the exclusion of other important areas.

Pathophysiology that can not be explained by gross anatomical knowledge alone

A) One of the most important diagnostic tools for practical medicine (or medicine that works) is palpation. If palpation, or pressing certain areas elicits a patient’s symptoms (pain, for example) then this area is probably related to the disease. If further palpation, or manual stimulation, of the same area then alleviates the symptoms, it is even more likely that this area is related to the disease.

B) Points like these are called Ashi points in traditional Chinese medicine and with stimulation here patients usually say, “Yes, that’s definitely the point,” or “Yeah that’s exactly like the pain I feel.”

C) These points are usually on the same side that the patient subjectively feels the pain. But sometimes (not often, but sometimes) they are on the opposite side. So pain on the left side of the neck will be elicited by pressing on the right side.

D) This doesn’t make sense anatomically because muscles, tendons, and nerves on one side of the body do not typically cross the spinal vertebrae to the other side of the body.

E) But Traditional Chinese Medicine states that meridians, or qi pathways are symmetrical on both sides of the body, and a problem of a meridian on one side of the body can produce symptoms in the symmetrical meridian on the opposite side.

F) Manual stimulation of one side of the body can sometimes elicit pain, numbness, or paresthesia on the opposite side of the body which demonstrates this principle.

There is of course more to neck anatomy and proper treatment than only the muscles. I used the muscles here, however, to illustrate the point that even if therapy is limited to this one area, one still needs to think outside of the box to treat the myriad of patients that present with neck pain.

Tui Na medical massage, acupuncture, and myofascial release therapy practiced at Roots of Eastern Medicine Acupuncture Clinic can effectively treat disorders of the neck muscles through accurate diagnosis and proper employment of these techniques. Make an appointment today to stop your neck pain.

(2) Treating the neck according to the ligaments, tendons, and articular cartilage

One of the most fundamental principles in Traditional Chinese Medicine theory, especially when dealing with the treatment of pain is “Tong ze, bu tong. Bu tong, ze tong.” This means that where there is free flow there is no pain, and where flow is blocked pain arises.

Simply due to anatomical structure alone, certain structures of the body receive less blood flow than others. The ligaments connect the muscles to the bones, the tendons connect the bones to the bones, and the articular cartilage provides cushioning between the bones and provides a smooth surface for the bones to slide across each other.

These three tissues all have significantly fewer blood vessels than the muscles, and therefore receive less nutrients and less waste removal than the muscles. So the muscles heal faster, perhaps within 1 day or 1 week of the original injury. The ligaments, tendons, and articular cartilage, on the other hand can take up to three months to heal, or perhaps longer if the correct therapy is not employed.

Since these three tissues are most plentiful at the joints, and their anatomical structure results in slower healing time, most chronic musculoskeletal pain is due to joint pathology.

If you have chronic neck pain and have been to specialist after specialist, and have exhausted what seems to be every treatment modality, don’t give up. I have seen very few therapists, specialists included, that have an adequate understanding of the tendons, ligaments, and articular cartilage. Most simply do not understand how to treat these tissues effectively. For the remainder of this article I will refer to these tissues collectively as the ‘joint tissues’ for convenience (for joint issues, treat the joint tissues).

To treat these joint tissues and promote faster healing time, the circulation in these tissues must be increased. If blood flow to these tissues is adequate, scar tissue can be remodeled, minor tears can be repaired, and calcium deposits can be carried away. Because of the sparse blood vessels here, most of the nutrient supply to these joint tissues comes by way of diffusion, which is the spontaneous intermingling of two or more particles as a result of random thermal motion. Particles tend to move from areas of high concentration to areas of low concentration.

If that doesn’t make sense, think about it this way. If you put a few drops of food coloring in a glass of water and just wait, eventually the food coloring will spread through the solution uniformly, so the entire glass of water looks like one uniform color. The spreading of the food coloring is diffusion.

Another diffusion example: When gas is passed, it is very potent at first; the smell can be strong enough to compel people to leave the room. Eventually the gaseous vapor spreads. While it offends a larger quantity of people due to increased coverage area, it becomes less and less potent as time goes on, so the magnitude of offense as it is perceived by the individuals is gradually less and less. The spontaneous spreading of the gaseous vapor is diffusion.

Since the joint tissues have fewer blood vessels, they depend largely on diffusion for their nutrient supply and waste removal. Diffusion can sometimes be a painfully slow process, however, if you have ever waited for food coloring to fill a glass of water or the powerfully nauseating aroma of a fart to leave a room you probably understand. But the rate of diffusion can be increased.

When molecules are agitated they will diffuse at a faster rate. Stirring the water in the glass makes the food coloring spread very fast, and a powerful fan can get rid of a strong smell.

Through Connective Tissue Acceleration, practiced solely at Roots of Eastern Medicine Acupuncture Clinic, the rate of diffusion in the joint tissues can be significantly increased. By alternating an increase and decrease in osmotic pressure, connective tissue acceleration acts as a pump for the joint tissues, so that nutrients enter the cells faster and waste products are expelled faster. Make an appointment to turn you chronically painful neck into a healthy pain-free neck.

(3) Neck pain and chiropractic adjustments

If your pain has not subsided since visiting the chiropractor do not despair. Chiropractic adjustments have their place in the scheme of medicine. For simple subluxations (joint displacement) chiropractic adjustments can be very effective. But when complicated by problems with muscle or joint tissue uneven pressure is placed upon the bones.

An uneven pressure is placed on the joints when there are muscle and joint tissue abnormalities. These abnormalities put uneven stress on the bones from within the body. This will pull bones out of place again and again, even when attention is paid to proper posture and body mechanics. So pain may be resolved directly after the adjustment only to return later.

Tui Na medical massage, acupuncture, myofascial release, and connective tissue acceleration, practiced at Roots of Eastern Medicine Acupuncture Clinic can take the uneven pressure off of the bones so that pain relief lasts longer. This is an excellent supplement to your chiropractic visits and will likely increase the efficacy of the time spent with your chiropractor.

4) More on neck anatomy and complications

There is much more to the neck than muscles, tendons, ligaments, and articular cartilage.

Seven cervical vertebrae make up the bones of the neck. Eight cervical nerves extend out from the cervical portion of the spinal cord. Each cervical vertebra is separated from each other by an intervertebral disk. The disks provide cushioning to the vertebrae and flexibility to the neck. Due to the neck’s housing of part of the spinal cord and the cervical nerves, and its position between the head and the rest of the body, neck problems can lead to a whole host of other problems.

These problems include, but are not limited to: headaches, tinnitus, blurry vision, dizziness, unilateral headaches, asthma, numbness of the extremities, paralysis, and more.

Problems of the neck can be related to: osteoarthritis (or bone spur formation), rheumatoid arthritis, cervical disk degeneration, injury, tumor(s), and infection to name a few. Chinese medicine provides excellent treatment methodologies for these conditions but these will be discussed specifically in later articles as they are independent topics which require independent attention.

A great deal of neck conditions can be treated through the muscles and joint tissues using tui na medical massage, acupuncture, connective tissue acceleration, and myofascial release.

Make an appointment at Roots of Eastern Medicine Acupuncture Clinic to accurately locate the source of your neck pain and get you pain free as soon as possible.