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Ask an expert - muscles and bones - neck

14 questions

Q: Good to have this blog to post questions.  My question is we have consulted a physio for neck pain and the physio instructed that it's due to trapezius muscle knot and he has given me acupuncture treatment. The neck pain has reduced but have the  trapezius muscle pain. I am worrying if its due to acupuncture treatment? What are the side effects for trapezius muscle acupuncture?

A:If we understand you correctly, the treatment for the neck involved releasing the trapezius muscle and now that the neck pain has reduced the trapezius is painful instead.

A great deal depends on how long it is since the treatment was given. Many physiotherapists use forms of what is known as 'trigger point' acupuncture. This is a western acupuncture approach which involves locating and treating tight spots in the muscle fibres which cause pain where they are and also cause muscle contraction which can then cause pain further down the line. Trigger point treatment often involves using longer and thicker needles than we would use in traditional acupuncture, and the treatment itself can sometimes leave a painful area for a few days. There is sometimes a little internal bruising after this technique, and this can also take a short while to go. You could normally expect this kind of pain to go after 48-72 hours, although if the treatment has been epecially vigorous this may be as long as a week.

If the pain persists after this the first person you should speak to is the physion himself; he will be in the best position to assess what is happening because he will know exactly what he has done, and may be able to apply further treatment and exercises to help to resolve the problem. If this does not do the trick then the next port of call is your GP. However, we strongly suspect that the problem will have gone long before you reach this stage.

The other possibility to consider is that sometimes a severe pain can overshadow another pain in the same area, and when the primary pain goes, the second one becomes more noticeable. This is very common in feedback when people have multiple problems. Here again the physio is the best person to speak to. If he has managed to reduce the neck pain, then he can probably release the trapezius pain too.

There shouldn't be any especially noticeable side effects from this treatment. Clearly if the treatment is vigorous you may feel a little bruised in the area for up to 48 hours, but if the physio recognises from your first session that you are quite sensitive to the needling he may well reduce the intensity of the treatment to make the after-effects a little less noticeable.

We hope that this reassures you.

Q:  I am suffering from severe neck pain.  Also how do I go into studying acupuncture and go into this field of work?

As far as the neck pain is concerned, there is considerable evidence for the use of acupuncture for a number of problems which can manifest as neck pain. Our factsheets on pain relief, osteoarthritis and so on, which can be found at this location

http://www.acupuncture.org.uk/category/a-to-z-of-conditions/a-to-z-of-conditions.html

all point to encouraging studies which, although far from conclusive, would indicate that you may well get some relief from treatment.

We are a little concerned about the use of the word 'severe', however. The first thing we would ask if your were a patient would be not just a description of all aspects of the pain, but more importantly how it has developed. In modern life there are many reasons why people develop neck pain, in the use of computers for hour after hour, for example, and if their work depends on this they sometimes have to keep soldiering on to the point where a niggling pain may become something far more severe. There are also a number of accidents or near misses which can leave people in this state, and which may or may not have been thoroughly checked out.

We would probably want to be reassured that you had had some conventional medical tests like Xrays or scans to establish where there is a physical cause. Our concern would be that acupuncture treatment might offer pain relief and reduction of some of the inflammation but leave an underlying problem untreated which might deteriorate further. This may sound alarmist but is simply common sense; we believe that patients should get the best of all possible worlds, and if there is structural damage no amount of treatmentis going to change that. Unlikely, it is true, but we would need to check.

The best advice we can give is that you visit a BAcC member local to you and seek a brief face to face assessment of whether they think acupuncture treatment may be of benefit. This will enable them to ask the kinds of question that we might, and to advise you accordingly.

As far as studying acupuncture is concerned, we offer automatic elegibility to graduates of courses accredited by the British Acupuncture Accreditation Board, a list of which can be found here:

http://baab.co.uk/study-acupuncture/accredited-courses.html

There are other courses, but we believe that these have the highest standards of training and enable us to maintain the standards of professionalism which we espouse.

We hope that if you do decide to have acupuncture treatment it works well for you. Nothing could be a greater encouragement to start training!

Q:  I have a badly knotted neck down into my shoulder due, I think, to a lactic acid build up. Can acupuncture help or is massage a better route?

A:  This need not necessarily be an either/or; many of our members are also trained in tui na, which is a form of Chinese massage using the same energetic principles as the acupuncture treatment itself. A large number of members are also trained in forms of conventional massage, and it may well be possible by using a careful google search to find a BAcC member near you who does acupuncture and massage. He or she will be able to use their professional his/her professional judgement about what is the most appropriate way to go forward.
 
As a general principle, though, we would say that the most important thing to establish is whether the problem is a local one involving a specific set of muscles or whether it is the local manifestation of a deeper problem which requires a different treatment strategy. This is the sort of judgement on which we would find it difficult to speculate at a distance. We would want to see where and how the problem manifests, and ask a great many questions about its onset (gradual or sudden), how it manifests, what makes it feel better or worse, and so on, to get an idea of what may be happening.
 
Our best advice is for you to visit a BAcC member local to you to ask their opinion of whether acupuncture treatment may be benefical. If they are dual qualified, as we mentioned, then they will be ideally placed to assess what may be the best option for you. Even if they are not, most will know very quickly whether it lies within their limits of competence and advise you accordingly. 
 

Q:  Can acupuncture get rid of pain that is caused by a bundle of nerve tissue protruding into the 4-5th vertebrae of the neck which is causing the pain.

A:  Acupuncture has a relatively good record as far as pain relief is concerned. As our factsheet shows
 
http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/chronic-pain.html
 
there is now a growing body of evidence that acupuncture treatment can play a useful part in the successfull management of chronic pain.
 
That said, the problem you have is largely a mechanical one, some tissues protruding where it should not be and being impinged. If this is as a consequence of inflammation there is a possibility that the acupuncture treatment may be able to assist in bringing the inflammation under control and breaking the spiral which keeps the pain running - inflammation causes impingement causes further inflammation, and so on. If, however, we are talking about a physical change of a nature which means that certain movements will always create pain, then pain management may be less effective.
 
The question really is not whether acupuncture will relieve pain, but only by how much and how sustainable any improvement is. In some cases this can lead to some rather difficult financial considerations; if someone gets two good days after a treatment it becomes a matter of whether they can afford that frequency of treatment or whether they can come to some continuing and cost effective arrangement with a practitioner.
 
However, without a great deal more detail than we have here about the way in which this has become  a problem, what medical and especially neurological opinion has been sought and given, and the nature of pain itself, we cannot be more specific. The best advice that we can give is that you contact a BAcC member local to you and seek a brief face to face assessment where you can explain in greater depth how this problem troubles you, and its history, and they can look at diagnostic information which will enable them to give an honest and informed opinion of whether they believe that acupuncture treatment would be of benefit to you.     

Q:

Q:  ] I am looking for acupuncture for neck pain but can't find a therapist who has a hole in their couch for me to put my face into when I'm lying on my tummy - my neck won't allow me to lie with my face to one side. I've been told the treatment can be done with me sat up but I want to be able to relax during the treatment - don't you agree?

A:  We always try to make our patient's comfort a central concern, but obviously there are going to be a few circumstances where the equipment needed to do this is not something which we could require all our members to have. The usual reason for having a couch with the hole is for massage therapy, and given that we insure a considerable number of members for massage alongside their acupuncture work, it should be possible to find someone who is suitably dual qualified. We are not able to give out the names of these practitioners because we can only make recommendations for acupuncturists, but a google search for 'massage' and 'acupuncture' in your area is likely to identify someone suitable.
 
Good as it is for the experience of treatment to be relaxing, we are bound to say that it is the treatment of the neck which matters most, so we would tend to take the view that the fact that someone couldn't drift off during a session was less important than getting the neck pain sorted. Although relaxation during the treatment is sometimes necessary, in most cases the treatment will be as effective if the patient is simply comfortable while being administered.
 
We hope, however, that you manage to find someone who can provide exactly what you are looking for.
 

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