Article 1: Acupuncture for Neck Pain

What is neck pain?

Neck pain is a common condition — so common, in fact, that the expression "a pain in the neck" is an oft-used figure of speech in English. It can be mild enough so that it is a mere annoyance, or severe enough that it can adversely affect the quality of one's life. Because of its position and range of motion, and because it plays a vital role in the support of the head, the neck is more subject to injury than any other portion of the spine. While it is much less frequent than back pain, neck pain can occasionally be severe enough to warrant attention from a licensed health professional.

Neck pain can have a variety of causes. Keeping your head in an awkward position can cause your neck muscles to fatigue and the joints in your neck to "lock" in place, causing discomfort, stiffness and limited range of motion. Neck pain can also be caused by a sudden force (such as an automobile accident), or a medical condition (swelling, disease, tumors, bleeding, inflammation, etc.). Some neck pain can also cause headaches (see the "Acupuncture for Headaches and Head Pain" section for more information).

Who suffers from neck pain?

Almost everyone will experience some sort of neck pain or stiffness during their lifetime; however, certain occupations appear to be predisposed to neck symptoms. Manual laborers, for instance, have more symptoms than office workers, and the type of work seems to affect the risk. A person's age and a history of twisting and bending during work can also contribute. Workers who have been required to do repetitive tasks with their upper extremities, or who undergo periods of prolonged sitting with their head in a flexed position (such as typing on a keyboard at a desk) are at risk of developing mechanical neck pain.

What can acupuncture do for neck pain?

Studies have shown acupuncture to be effective in relieving certain types of neck pain, particularly those caused by whiplash. Some studies suggest acupuncture can treat degenerative neck disorders such as ankylosing spondylosis and cervical spondylosis; in many cases, acupuncture has worked for patients whose conditions could not be solved using conventional approaches.

Acupressure and herbal medicine are sometimes used in conjunction with acupuncture for neck pain. Applying acupressure to the neck muscles can reduce spasm and lessen pain, leading to a relaxed state and a heightened sense of well-being. Depending on the patient's condition, certain herbal products can be used to improve circulation and blood flow and ease muscle contraction.






Article 2: Treating Chronic Neck Pain Via the Divergent Channels

David L. Boyd, PhD, LAc
Academic Dean, Samra University of Oriental Medicine


Chronic neck pain and tension account for many visits to an acupuncturist's office. Most practitioners are adept at treating acute neck conditions, but they frequently find that their treatments for a more chronic condition, while offering short term relief, do not hold for more than a couple of days. There are many reasons for a patient's lack of response: structural disorders, stress level, improper sitting and posture, and lifestyle choices all can play a role. It is therefore important that patients with chronic neck pain have a complete evaluation, performed or ordered by the acupuncturist or another health care provider, in order to rule out any conditions that might be inappropriate to treat or might respond better to other treatment modalities.

If acupuncture treatment is appropriate, one clinically useful approach to treating chronic neck pain is via the divergent channels, which help circulate the qi and blood of the channels to the face and head. It is also in the neck region that yin divergent channels end and merge with their yang counterparts (lung with large intestine, kidney with urinary bladder) whose pathways continue into the head and neck (the san jiao divergent channel being the exception). Hence, not only does the energy of all the channels pass through the neck; qi and blood of the yin/yang pairs converge there as well and play an important role in maintaining a smooth, balanced flow of qi through this area. Theoretically, it therefore makes much sense that excess, deficiency, or stasis (or a combination of all three) of qi and blood in the channels can contribute to many cases of chronic neck pain, and that treating the divergent channels can help provide some long-term relief.

In order to determine which divergent channels require treatment, specific points need to be examined while palpating the neck that can be used as reflex zones for determining whether a divergent channel treatment is appropriate. These points are all found on the yang channels.



Lung/Large Intestine

Large Intestine 18


Stomach 9 (for palpatory purposes, actually the anterior border of the SCM at the level of Stomach 9)

Heart/Small Intestine

Small Intestine 17

Kidney/Urinary Bladder

Urinary Bladder 10

Pericardium/San Jiao

San Jiao 16


Gallbladder 12

It should be immediately apparent that five of the points are "window of the sky" points, which may be used to balance the flow of qi and blood between head and body. In my experience, however, they are quite useful as reflex point for divergent channel treatment. Gallbladder 12, which is not a window of the sky point, has been determined as a reflex zone through clinical practice.

The assessment protocol is simple but effective. Palpate each point bilaterally to determine which is the most sensitive, making certain that for Stomach 9 you press the anterior border of the SCM laterally, so that you do not occlude the carotid artery. Usually one or two points will respond more to pressure/pain, or the patient will comment that their symptoms seem to be reduced.

Once you have isolated the reflex zones in question, palpate the ipsilateral he-sea point of the yang channel or channels on which the reflex point lies. As you palpate the he-sea point, find the exact area that elicits the most response from the patient, massage this point for a few seconds, then check the reflex on the neck again. If the reflex is less sensitive (at least 30%), then using a divergent channel treatment is appropriate. If there is only a slight reduction in sensitivity, try palpating and massaging the he-sea point of the related yin channel as well (e.g., for Gallbladder 12, try using Liver 8). If there is insufficient response, divergent channel treatment will probably not achieve significant results. Repeat this procedure with all of the sensitive zones.

There are many approaches to treating divergent channels, ranging from simple to esoteric. I prefer a simpler approach. To treat affected divergent channels for chronic neck pain, simply needle the ipsilateral he-sea points of the affected the yin/yang channels. In other words, if the reflex zones indicate that the greatest sensitivity is at Urinary Bladder 10 (left side), and palpating left Urinary Bladder 40 and Kidney 10 reduced the intensity of palpating the zone, needle these two he-sea points. Better results can frequently be achieved by applying draining techniques to the yang channel point and tonifying techniques to the yin channel point. Along with these distal treatments, you may choose to puncture a-shi points on the neck as well or even needle, if appropriate, the points of the reflex zones themselves.

The first few acupuncture treatments may reveal unilateral or bilateral imbalances in many divergent channels. The reflex zones should be rechecked at each treatment. It is important not to overtreat, but focus on the one or two most sensitive channels each time. As the patient improves, the practitioner will notice a concomitant reduction in zone sensitivities as well.

One final note: if there are acute flare-ups during the course of treatment, the practitioner may still continue the divergent channel treatment but may add to the protocol the contralateral jing well point of the reflex zone's yang channel. To take the above example of sensitivity at left Urinary Bladder 10, the practitioner in an acute situation may not only needle left Urinary Bladder 40 and Kidney 10, but also right Urinary Bladder 67 to reduce symptoms. This technique adds a degree of flexibility to the divergent channel protocol and increases its usefulness as a technique for dealing with a common clinical complaint.