NECK AND SHOULDER PAINS
Neck pain can have profound functional consequences due to the important role of the neck in supporting and moving the head and the associated functions of sight and balance. 11-14% of the working population will annually have some limitation on their activities. 30-50% of the population will have short episodes of neck pain. ( Ref 1) Normally we will develop neck pain from prolonged flexion of the neck when working or a sprain, but whiplash can occur after impact injuries to the head or car accidents. Although the incidence of accidents is low – 300 per 100,000 admissions to A&E hospital departments – most episodes resolve within 3 months after advice and exercise. ( Ref 1). Unfortunately, some patients will experience persistent chronic pain.
Neck pain can be associated with limitation of movement and once examination has excluded that there is an anatomical restriction caused by degenerative changes in the cervical spine, movement can be affected by shortening of muscles due to trigger points in the neck muscles or the muscles between the neck, shoulder and shoulder blade ( Ref 2). Trigger point acupuncture identifies which muscles are affected and treats them alongside the use of exercise, mobilisation and advice on sleeping posture. Benefit can be apparent after 4 weekly sessions.
Shoulder pain is the third most common reported musculoskeletal pain ( ref 1), apart from inflammatory and joint conditions, the soft tissues – ligaments and muscles- are commonly involved and these can respond to trigger point acupuncture, stretches and mobilisation. Examination determines if there are any signs of inflammation , disease or nerve damage and which muscle groups are involved; there are a number of groups around the shoulder blade, shoulder joint, arm pit/axilla and chest. Treatment includes acupuncture needling to the muscle , the technique of using a cold spray and stretching and specific rehabilitation exercises and TENS ( ref 3). Benefit can be apparent after 4 weekly sessions .
References
1. ‘Neck Pain’ , ‘Whiplash’, ‘ Soulder Pain’. in ‘Global Year against Musculoskeletal Pain’ 2009. International Association for the study of Pain
2. ‘Neck pain and Dysfunction following Whiplash’ in Ferguson and Gerwin, 2005;‘Clinical Mastery of the treatment of Myofascial Pain’. Lippincott, Williams and Wilkins. USA
3. ‘Shoulder Dysfunction and frozen Shoulder’ in Ferguson and Gerwin .(ibid)