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Ask an expert - muscles and bones - neck

25 questions

Q: I have struggled with my neck and shoulders for years and have recently started to get tension head aches. Massages have helped in the past but not so much anymore. My posture isn't great so I know this is the main trigger and I also work in an office so sit at a desk for 8 plus hours a day. Would acupuncture help me?   Thanks in advance

A: We often come across people who are pretty much spot on about the causes of their problems - posture, work-related stress and sedentary nature - but are not in a very good position to do much about it. This is a problem for us as acupuncturists in terms of the ''two steps forward, one and half steps backward' of a great deal of the treatment we do. We obviously believe that we can help problems like neck pain and headache, and the evidence supporting this is pretty good, as our factsheets show:

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

https://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/headache.html

It falls a little short of an absolute recommendation but this is more to do with the vagaries of methodological requirements than the treatment itself. These remain some of the more common conditions for which people seek our help.

We suspect that the real issue here is how a practitioner might work with you to manage the causes of your problems. There are a number of exercises and self-help routines which people can use, both within acupuncture and within associated disciplines, and many of our patients find these very beneficial, although we have to be honest and say that it takes a bit of nagging on occasion. We know that employers have statutory duties to offer staff members breaks when they are machine or desk bound, but we know equally well that it is a brave employee these days who insists on this. There are a number of meditation and mindfulness programmes which can be of great help, and other people use NLP as a means of anchoring relaxed states and breaking the cycle of tension.

We think the best thing to do, though, would be to visit a local BAcC member, possibly for a chat or even for a couple of sessions to explore how much change the acupuncture treatment seems able to achieve. If this can be targeted for a time when you have some R and R ahead, like a Bank Holiday weekend or holiday, so much the better. This will give a very clear indication of the possible benefits.

Much of the problem stems from blockage and stagnation of the energy, and acupuncture treatment can be hugely effective in relaxing people. The point, though, is to stop them tensing up again while they do what they have always done.

Q:  My father is 87 and suffered unstable c1c2 neck fracture 8 months ago due to falling. He has no paralysis and has refused most medical interventions (including wearing a collar which he finds too painful) as his desire to live was reduced by recent bereavement. He has severe chronic neck and head pain ever since, with little or no relief even on opiate medicines. Please could l ask if acupuncture might perhaps give him any relief or reduction of pain if it is safe for cc2 fracture?

A: There is no reason of which we are aware why acupuncture would be absolutely contra-indicated for your father's problems. However, there are degrees of relative contraindication, but these depend on the professional judgement of the practitioner and the specific circumstances of the case.

 The one caution of which we are aware is one which mainly appears in the literature of physios who perform acupuncture. We have seen them say that there are rare occasions where the muscles of the back or neck brace themselves to maintain stability, and any treatment which relaxes muscle, even unwittingly, might make the joints of the spine more mobile and thence cause pain. However, we recently put together an acupuncture safety website with the main physio and doctor acupuncture associations www.acupuncturesafety.org.uk and this was 

not thought to be significant enough to warrant mention. Indeed, the fact that your father is wandering around without a neck brace is probably an indicator that while painful the neck is not that close to giving way.

 We do publish a fact sheet on neck pain

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

which quotes a number of encouraging studies, and certainly neck pain is one of the more frequent reasons why people seek treatment. Since the greater majority of referrals are by word of mouth res ipsa loquitur, as solicitors say - we wouldn't get the referrals if it didn't work.

 The best advice, which we invariably give, is to see if your father is willing to drop in to see a local BAcC member who can assess his specific presentation. Most members are happy to give up a little time without charge, and seeing a problem first hand gives a much better idea of what may be possible. We also are very emphatic that we treat the whole person - body, mind and spirit - so it may even be that your father could derive some benefit in other ways to help him deal with what must have been a very painful bereavement for him.


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:  My GP is referring me to have acupuncture treatment for my neck.  I have a partial fear of needles and a low pain threshold . I am suffering with bad headaches and my GP  thinks it's coming from my neck.

A:  The GP may well be correct; a considerable number of headaches arise from problems in the neck, often to do with gradual changes in the vertebrae which can impinge nerves and affect blood flow. There is quite a great deal that acupuncture for both problems, as our factsheets show:

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

http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/1581-headache.html

Obviously we have to qualify these kinds of sheet with the statement that traditional acupuncture treats the person, not the condition, so we treat a person with a headache, not just a headache. This can make a profound difference to the treatment. Twenty different patients with the same presenting symptom might be treated in twenty entirely different ways as the practitioner sought to balance their own specific patterns of energy. This is one reason why we believe that acupuncture can be more successful than some conventional treatment because it is tailored to the unique needs of the patient.

As far as needles are concerned, there is no reason to fear them. The majority of members use needles which are 0.18mm ot 0.25mm and usually only an inch long, of which the top 3mm-5mm is actually inserted. The use of guide tubes helps even more, the pressure of the tube deadening most of the sensation in the area. Most of us have treated people who are needle phobic, and the simple expedient of showing someone what is going on, perhaps on an area where they can see what's happening, and talking through the process is usually more than effective. There are very few cases where the needling itself has stopped people having treatment, and most of us know how to start as gently as possible in order to keep people happy! The best thing to do is to visit a local BAcC member for a pre-commitment chat to be reassured about them, where they work and what needles look like. You will also get the benefit of a straightforward assessment of how well acupuncture may be able to help you.

Q:  I've recently developed sensory nerve discomfort on my shoulder blades .I already have idiopathic peripheral neuropathy so I know what nerve pain is . This is touch related as there is no discomfort when there is no clothing touching my shoulder blades . I did a simple experiment with 3 shirts/t-shirts . The first had a rough/course texture , the second had a gripping texture , the latter was soft & smooth . The first two both caused discomfort , the latter virtually none , I had a friend present & we both agreed on the descriptions regarding the "shirts" .
I would also add that I use a thoracic brace for exercising & the pressure of the brace on the my shoulder blades seems to alleviate the discomfort .
I thus thought , albeit from a very limited understanding of acupuncture : its use of pressure points & the fact that a GP at  my practice has used acupuncture for many years for a variety of maladies for the benefit of practice patients is there any evidence of its efficacy in treating sensory nerve discomfort .

A:We do have a number of fact sheets on our website about neuropathic pain and also a number of answers to earlier queries about diabetic neuropathy, but none really quite addresses the problem which you describe.

We suspect that with your problem it really is a case where going back to first principles may offer the best chance of finding some relief from the problem you have. As you probably already know from background reading, the theories of traditional acupuncture are based on the flow of energy called 'qi' and its rhythms, flow and balance in the body. Understanding how problems occur means being able to identify and understand how the flow might have been disturbed where the problem is and also how this fits against the overall backdrop of someone's health. The practitioner invariably, as with any pain, asks questions about whether the problem area feels hot or cold, responds to hear or cold, responds to pressure, is better or worse at different times of day, and so on. The answers to these questions all point to specific disruptions in the flow of energy and hopefully towards solutions.

There are a number of formula points which can be used as short term palliatives, and on occasion these may provide a permanent solution. The majority of cases like this, though, where there is an area of skin and superficial muscular discomfort, require something more sophisticated by way of treatment. Of course, in saying this, we would ourselves be looking at the other possible environmental factors which might be causing the problem, but we assume that you have probably done an exhaustive check on things which might have affected the area.

The best advice we can offer, since it is an unusual and specific presentation, is to visit a BAcC member local to you for a brief assessment of whether acupuncture might be of benefit. A skilled practitioner could usually elicit in a very few minutes how treatable something is, and most of our colleagues are happy to give up a short amount of time to make this determination

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