Ask an expert - muscles and bones - neck

29 questions

The term 'trapped nerve' usually describes what is more technically called a nerve impingement or nerve compression. A common cause is a bulge in one of the vertebral discs which compresses the nerve root, but there are a number of other fairly frequent causes which do not necessarily involve a structural change in the upper spine.

 

If the problem is structural there may be some value in having some form of manipulation alongside or instead of acupuncture treatment. Osteopaths and chiropractors often treat this problem as one of their 'stock' items for referral. However, a great many problems of this nature are caused either by spasms of the muscles which in turn impinge the nerves or by inflammation of the surrounding tissues. In both cases acupuncture, both in the traditional Chinese form used by BAcC members and in the western medical form used by doctors and physios, is frequently used to good effect, and there is considerable evidence for the successful treatment of inflammation and muscle spasm with acupuncture. Most studies are done on chronic, rather than acute, neck pain, but the results of a very large German study condcted five years ago

 

http://www.ncbi.nlm.nih.gov/pubmed/16781068

 

are typical of the kinds of outcomes reported, although Ernst and White were not quite so positive in their review

 

http://www.ncbi.nlm.nih.gov/pubmed/10342627

 

However, there are significant problems with 'sham' acupuncture, so one has to take their conclusion with some reservations.

 

There is often a significant overlap between the acupuncture points and techniques used by both traditions, but we believe that an advantage of traditional acupuncture is that it looks at the whole system in determining what treatment to offer rather than simply treating the part which hurts. In most cases the treatment will focus on the problem but there are often occasions where the causes, from an Eastern perspective, of this one problem are not simply to do with the area affected, and the skill of Chinese medicine lies in making sure that the symptom does not come back, not simply that it goes away.

 

It may well be worth while contacting a BAcC member local to you to ask if they will give you an honest assessment of whether they can help your specific problem.
 

The use of acupuncture for muscuko-skeletal problems such as this is widespread in both eastern and western versions of the treatment. Chinese medicine speaks of obstruction and blockage, western acupuncture speaks of trigger points in muscles which can cause all sorts of secondary problems. The points which they both use are often the same.

 

 

The one advantage which Chinese medicine has, however, is that it treats people, not simply the conditions which they have, and in this context it is interesting that there is nothing in your case history which suggests itself to you as a probable cause. This doesn't mean there hasn't been one - quite often a series of small injuries reach a critical mass and another small injury can tip the body over into quite a large symptom - but it would certainly interest a Chinese medicine practitioner to establish what the backdrop was against which this injury occurred. There can sometimes be a systemic reason for a problem which simply 'sticking needles in where it hurts' won't change in the long term.

 

Based on what you have said, however, it may well be worth giving acupuncture a go. Although it is not our role to promote other therapies,. it has to be said that you might well benefit from some form of pysiotherapy alongside the acupuncture. Patterns of poor use can establish quite quickly when there is a muscular knot like this, and some form of exercise routine is often very helpful to ensure that the problem gets resolved and stays resolved.

Q. I hav had accupunture done in January on my neck{i have cervical Spondilosis}and i'm also told ny an oestopath that I have a overstretched ligament.When the needle was put in it was really painfully I did tell the accupunturist and was told that how it will be but I feel he may have either gone into a muscal.Since then I have pain in my neck across my neck/back and in the top of my right arm although it is a little easier but still very stiff.I really want to know if this will ease in time or if having accupunture again will correct my pains.I would really appreicate your advise as to ease the pain I am rubbing in Biofreeze which eases it for about half an hour.Many Thanks

 

 

A. Although acupuncture is a very safe form of treatment, there are occasional adverse events. The vast majority are transient - someone might gets a small bruise, or feel a little lightheaded but it would be rare for these to persist for more than a day, two days at most.

 

In your case the fact that the symptom has persisted for over a month is a cause for some concern. In the first instance it is normally best to talk to the practitioner who gave you the treatment to seek their views, but if you feel a little reluctant to go back until you know what the cause is the next step is to see your GP and ask for his or her view. The chances are that there has been bruising fairly deep within the muscle which is taking a long time to heal but in the meantime is putting pressure on a nerve. However, given that you have spondylosis your GP may arrange further tests for you to rule out other possibilities.

 

The BAcC is very keen to gather information on adverse events arising from acupuncture. The last formal surveys, both published in the BMJ a decade ago, were very positive about the safety of treatment, but to remain up to date the BAcC has just launched a pilot scheme based on the GPs' Yellow Card Scheme to collect information on any adverse event brought on by treatment, including ones which are associated with improvement.

 

In the unlikely event that there has been a more substantial injury it is worth reminding everyone that BAcC members are covered by a 'gold standard' professional insurance from Royal Sun Alliance as a part of their membership package, and that the general public can be reassured that their interests are fully protected.

There is a growing body of evidence now being accepted in the West that acupuncture may well be an effective treatment for neck pain. Two studies which reviewed all of the trials they could find were cautiously optimistic about the short term benefits of acupuncture treatment and proposed that further long term studies were needed.

 

 

http://www.ncbi.nlm.nih.gov/pubmed/19216662

 

http://summaries.cochrane.org/CD004870/acupuncture-for-neck-pain

 

That said, you GP is not probably not wrong - by the time that someone is in their 70s or 80s there is often quite a lot of degeneration in the vertebrae in the neck, and if this is causing impingement of some of the nerves emerging at the neck, or tightening of the ligaments and tendons which is itself causing pain, there may be a limit to what acupuncture treatment might be able to achieve. If the restriction of movement is mainly caused by muscles which are guarding to prevent further pain there is a possibility that the treatment may relax them sufficiently to improve the range of movement.

 

If you do choose to have acupuncture treatment it will be important to establish whether the treatment is providing the same kind of relief for a period but no more on each occasion. Although a practitioner will aim to bring about overall improvement there are times when even a guaranteed period of less pain and easier movement is an acceptable outcome for a patient. This has to be an agreed outcome, though, not simply assumed by either party.

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