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 are at risk of developing mechanical neck pain.

 

Causes of neck pain

1.                  VETERBRAL:  a. Whiplash. This is a common cause of neck injury in car accidents. The force of bumping on the tail of the car during accident gives an over stretching anteriorly and posteriorly of the neck induce so-called whiplash injury. The injured part of the neck usually was on the ligament, soft tissue, cartilage, or a combination of these. The injured person usually does not feel severe pain or discomfort right after the moment of accident occur, or the pain and discomfort went away in a short time. At this point, X-ray film taken on the neck would not show any abnormality. The real suffers will come on several hours to days later. The symptoms of whiplash can be experienced including stiffness of the neck with limitation of movement, pain over the neck increased by sneezing, numbness of fingers, and diminished the muscle power the upper arm, various depending on if there is spine involvement and the level the involvement. The pain or discomfort of whiplash injury may be mild or intolerable.

            b. Sprain. Sprain of neck commonly caused by sportive activities. Pain over the back of the neck and radiated to both sides of shoulder. Sometimes it accompanied with numbness. Differential from herniation of intervertebral disc should be done. 

            c. Herniation of intervertebral disc. HIVD is a nerve compressed by the slipped disc. Pain over the neck with upper back or upper arm radiation, with or without numbness of the fingers or arm are the subjective symptoms of HIVD.  

            d. Arthritis.

            e. Bony destruction.

            f. Cervical rib: This is due to abnormal development of the 1^st. rib that long to compress the spinal nerve.

2. MUSCLE:  a. Trauma.

             b. Spasm (Facet syndrome). Commonly abruptly developed and noted in the morning when the subject gets up from bed. Usually one side of the neck sustained the attack. Sometimes more on the posterior side of the neck or the whole neck was affected. In Chinese, it called “falling from the pillow”. 

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. Some studies also suggest acupuncture can treat degenerative neck disorders such as cervical spondylosis and ankylosing spondylosis. Acupuncture treatment provides a promptly relieve effect to pain and muscle spasm. Long term effect had been demonstrated clinically and proven by controlled studies. Accompanied with cupping, heat, and massage treatment can add positive effect to the treatment but not necessary is a syneresis.

 

Documentation of acupuncture treatment on neck pain

 

Irnich D, Behrens N, Molzed H, konig A, Gleditsch J, Krauss M, Natalis M, Senn E, Beyer A, Schops P.  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

Department of Anaesthesiology, Ludwig-Masimilian University, Germany

 

OBJECTIVES: To compare the efficacy of acupuncture and conventional massage for the treatment of chronic neck pain, using a prospective, randomized, placebo controlled trial.

PATIENTS: 177 patients aged 18-85 years with chronic pain.

INTERVENTIONS: Patients were randomly allocated to 5 treatments over 3 weeks with acupuncture, massage, or sham laser acupuncture.

MEASUREMENTS: Using 3D ultrasound real time motion analyser, visual analogue scale, pressure algometer, seven point scale and SF-36 to assess the outcome of treatment measured before, during, one week and three months after treatment.

RESULTS: One week after 5 treatments the acupuncture group showed a significantly greater improvement in motion related pain compared with massage (difference 24.22, p=0.0052) but not compared with sham laser (17.28, p=0.327). Differences between acupuncture and massage or sham laser were greater in the subgroup who had had pain for longer than five years )n=75) and in patients with myofascial pain syndrome (n=129). The acupuncture group had the best results in most secondary outcome measures.

CONCLUSION: Acupuncture is an effective short term treatment for patients with chronic neck pain.

 

David J, Modi S, Aluko AA, Robertshaw C, Farebrother J. Chronic neck pain: a comparision of acupuncture treatment and physiotherapy.

Br J Rheumatol 1988 Oct; 37(10):1118-22

Royal Berkshire Hospital

 

OBJECTIVE: To evaluate the effectiveness of acupuncture, as compared with physiotherapy, in the management of chronic neck pain.

PATIENTS: 70 adult patients with non-inflammatory neck pain of more than 6 weeks duration and with no abnormal neurology were randomly assigned to receive either of the treatments. 35 patients were included in each group.

MEASUREMENTS: Pain by visual analogue scale and neck pain questionnaire, improvement in range of movement of neck relative to baseline, and well-being. Measurements were recorded at the beginning of treatment, 6 week, and 6 months.

RESULTS: Both treatment groups improved in all criteria. Acupuncture was slightly more effective in patients who had higher baseline pain scores.

CONCLUSION: Acupuncture showed better result than physiotherapy in more severe cases of neck pain.