Neck and upper back pain

For the stiff neck that will not turn, the knot under the shoulder blade, and the tension that climbs into a headache. The neck and shoulder girdle are assessed together and treated in the same visit.

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Read through

BothWesternClassical

Two lenses, one plan

Wood 木 is the phase it is most often read through. Here the Western lens leads, with the classical lens alongside.

The Western lensAnatomy, physiology, biomechanics

A heavy head on a mobile neck

The neck balances the weight of the head through seven small vertebrae and many layers of muscle. Long hours looking down or forward are thought to load the back of the neck and the upper back, and the shoulder girdle hangs from the same region, so the three are rarely separate problems.

Deep and superficial layers: The upper trapezius and levator scapulae sit near the surface; the suboccipitals, multifidus and scalenes lie deeper. Trigger points in the deep layer can refer pain to the head, the shoulder blade or down the arm.
Joints of the neck: The small facet joints can lock and refer a sharp, one-sided pain, often after sleeping awkwardly. Muscles then guard the joint and keep the neck from turning.
Whiplash: After a car accident, the deep neck muscles and ligaments can stay sensitive long after X-rays are clear. Medical evaluation comes first; the soft-tissue work follows.

The classical lensChannels, patterns, the five phases

Tai Yang, Shao Yang and the wind gate

Pain at the back of the neck follows the Tai Yang channels (Bladder and Small Intestine); pain along the side follows Shao Yang (Gallbladder and Triple Burner). The nape is also where wind and cold are said to enter, and a draft on a tired neck is a classic story for a stiff one.

Fengchi: 風池, GB-20, the Wind Pool, sits in the hollow under the base of the skull. It is a common point for both a stiff neck and the headaches that grow from one.
Constraint in the shoulders: Shoulders that live up by the ears are often read as constrained Liver qi pushing into the Gallbladder channel, with the tension worsening on stressful weeks.

Patterns we often see

Wind-cold lodged in the channels of the neck fēng hán xí luò 風寒襲絡
Qi stagnation and blood stasis qì zhì xuè yū 氣滯血瘀
Liver qi constraint gān qì yù jié 肝氣鬱結

Patterns are examples of how this is often read, never a diagnosis. Yours is read at your visit.

How we work: one plan

The neck and shoulder girdle are screened together. Dry needling and orthopedic acupuncture reach the deep neck and scapular muscles, Active Release Techniques free tissue and nerves at the front of the neck and shoulder, and functional movement corrections rework desk and training posture. Cupping or gua sha across the upper back and distal points finish the visit when they fit.

What neck and upper back pain is

Most neck pain is muscular or comes from the small joints of the neck, and much of it builds slowly: a laptop on the couch, a phone at chest height, a pillow that tips the head. Some arrives at once, after a wrong turn of the head or a car accident. Upper back pain between the shoulder blades often belongs to the same story, since the muscles that hold the head forward anchor there.

Pain that runs down the arm with tingling or weakness may involve a nerve; see pinched nerve. Neck pain with sudden severe headache, dizziness, double vision, slurred speech or weakness needs emergency care first: call 911.

Neck, shoulder and jaw together

The shoulder blade hangs from the neck by muscle, so a shoulder that does not move well makes the neck work harder, and the other way round. Clenching at night adds load from the jaw (see jaw pain). So the screen covers how you turn, look up, reach overhead and hold your head at the desk, whether your complaint sounds like a neck problem, a shoulder problem or both.

How we work with it

The deep layers of the neck, the scalenes, levator scapulae and the muscles under the shoulder blade are hard to reach by hand, and dry needling and orthopedic acupuncture go straight to them. Active Release Techniques work the tissue at the front of the neck and chest that pulls the head forward. Functional movement corrections change the desk, the screen and the pillow. Cupping and gua sha across the upper back are often added, and distal Master Tung's points help on very stiff days.

We track how far you can turn, how long you can work before the ache arrives, and how often headaches follow.

Questions people ask

Can acupuncture help a stiff neck?

Many people come in with a neck that will not turn after sleeping awkwardly or a long week at the screen. Needling of the deep neck muscles, distal points while you turn your head, and hands-on release are often combined in the same visit.

Is it safe to have needles in the neck?

Neck needling is done with careful attention to depth and angle, and the approach is adjusted to your anatomy and any medications, such as blood thinners. If needling the neck itself is too much on a given day, distal points can be used instead.

Can neck tension cause headaches?

Often, yes. Tight suboccipital, upper trapezius and neck muscles can refer pain to the temples, forehead or behind the eye, and treating the neck is often part of headache care.

I was in a car accident. Can I come in?

Please see your physician first to rule out fractures or other injuries. Once you are cleared, the lingering muscle and soft-tissue side of whiplash is something we work with often.

From the journal

This is general wellness information, not medical advice.

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