Ask an expert - muscles and bones - neck - pain

9 questions

 

There is certainly some good-ish evidence for the treatment of cervical spondylosis with acupuncture. As our factsheet shows

 

 

https://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/4076-neck-pain.html

 

there are several good quality trials which suggest that acupuncture can reduce the neck pain with which it is associated. We have searched the databases for any further and more recent research, but while two studies are in development there is nothing else to report.

 

 

We always tread with caution when advising on the use of acupuncture, though. From a western medicine point of view this is a 'wear and tear' problem for the treatment of which the best that can be achieved is a reduction in the deterioration, getting worse slower, and some reduction in the pain caused by the inflammation. If the pain and discomfort is a recent phenomenon it suggest that the inflammation caused by the problem is not yet too severe, and that there may be some hope of significant reduction.

 

 

From a Chinese medicine perspective pain arises from blockage and stagnation in the flow of energy, and the use of needles is intended to restore normal flow and balance. Physical problems, changes in structure, can have an impact on the flows of energy, especially in the neck, and while acupuncture is never going to correct the changes in physical structure, it can often restore flow and remove pain.We see this quite often with lower back pain associated with crumbling of the lumbar spine, or shall we say attributed to the damage seen on X-ray. We have seen many cases where the X-ray remains unchanged but the pain has reduced.

 

 

As far as cost and frequency of treatment is concerned, that is almost impossible to say. In Greater London the cost of a first session is often in the £50-£70 range with follow up sessions perhaps £40-£60, where in the rest of the UK prices are likely to be £10 lower. There are a number of community based multi-bed clinics where treatment is offered in a group setting at much lower rates, and most members are prepared to discount treatment for those with financial issues. NHS treatment free at point of delivery has become a great deal more difficult to find, and it is a matter of luck whether you have a doctor near you who may be able to offer a number of sessions within GP practice.

 

 

Frequency of treatment is usually more predictable. Unless someone has acute pain treatment tends to be weekly, but with chronic conditions with an underlying physical change of structure you will find that most practitioners will review progress after four or five sessions to see what has happened. At this stage it is worth establishing clearly whether there has been a change and how sustainable any change has been. If the effect has been small and short-lived it may be worth exploring other treatment options.

 

 

The best advice is to contact a local BAcC member and see if they are happy to give up a little time without charge to have a face to face chat and look at the problem. Most do, and this will give you a very clear idea of what may be possible in your specific case. 

 


 

Q: My sister lives in Malta. She has been suffering from debilitating pain from slipped disc at the top of her neck and the second disc is also damaged. Would acupuncture give any pain relief ?

A: As our factsheet on neck pain shows

 http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/4076-neck-pain.html

 there is some evidence that acupuncture treatment can help neck pain. However, the kinds of pain which arise from loss or damage in the discs of the cervical spine are not always that amenable to treatment. There is no doubt that acupuncture treatment will generate some pain relief; this is, after all, what really brought it to the fore in the West after Nixon's visit to China in the 1970s and the picture of people having operations with acupuncture anaesthesia. Pain relief has been researched many thousands of times, and the best one can say is that there is no doubt that acupuncture can relieve pain, but what cannot be predicted is how much relief, and how sustainable the relief is.

 What this may unfortunately come down to is a financial question about how much relief someone can afford. We have seen patients with thriving businesses have treatment weekly for years because it enables them to carry on working and earn far more than the treatments cost, but we have seen many cases where someone does not get enough long term relief to justify the expense. The only way to establish this is to have a course of four or five sessions to see what benefit it can bring.

 What we can say, however, is that we have treated many cases where there has been significant deterioration in the cervical vertebrae where the patient has felt that things haven't got any worse for longer than they expected. Whether this means that the rate of deterioration has actually slowed down or whether it means that the patient is able to handle the pain better is difficult to say. We would rather hope it is both.

 It will certainly do no harm to try acupuncture treatment, however, and may have tangible benefits.


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. 
 

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