Dr Maggie Ju Acupuncture Harley street and Kensington

Neck pain

Neck pain is a common condition with high prevalence. It is strongly linked to office and computer work. Most of the cases are muscular. 

Research has shown that acupuncture has both immediate and long-lasting effect on neck pain. For example, a large sample size German study with more than 14,000 participants evaluated adding acupuncture to usual care for neck pain. They found that participants reported greater pain relief than those who didn’t receive it. 

Muscles at the neck

The neck is the centre of muscle network of the upper body. The cervical spine and the muscles and ligaments are at the back of the neck. The cervical spine is made up of seven vertebraes between which is a disc. Spinal cord is within the spine and protected by the spine. Nerves come out from the cervical spine and innervated the neck and arms.

There are many muscles connect the neck to the head, shoulders and the back.

Trapezius muscle

Trapezius is a large triangular muscle superficially located at the neck and upper back. It connects the neck to the head and shoulders and upper back and middle back. Apart from trapezius there are many muscles connecting the neck to the head and shoulders.

Muscles connect the neck to the head. As mentioned above some muscles connect the neck to the head contributing to the head and neck movement. They are Semispinalis captisis which is deep to the trapezius muscle is originated from the four to seven cervical vertebraes and the upper seven thoracic vertibraes. Beneath this muscle there are five other muscles  including rectus capitis posterior minor,rectus capitis posterior major, rectus capitis anterior, rectus capitis lateralis, obliquus capitis superior. Splenius capitis and Longissimus capitis are originated from lower cervical spine and upper thoracic spine and attach to the head.

Muscles connect the neck to the shoulder blades and the back

Levator scapulae muscle

Levator scapulae muscle is the muscle located at the back and side of the neck. It originates at the transverse process of the first to fourth cervical vertebrae and inserts at the superior corner of the scapula. It rotates and flexes the cervical spine laterally, when one shoulder is fixed. It flexes and extends the cervical spine, if both the shoulders are fixed. It lifts up the shoulder when the spine is fixed. This muscle pain presents a stiff and painful neck. The pain is characterised at the one side of the neck and the upper shoulder and it may go down to the shoulder blade and between shoulder blades. The pain limits the movement of the head.

The rhomboid muscles

The rhomboid muscles include the rhomboid muscle major and the rhomboid muscle minor. They connect the shoulder blades to the vertebras (C7-T5) to adduct the arm and pull the shoulder blades towards to the spine. Cooperating with levator scapulae muscle they lift up the medial border and downwards rotate the shoulder blades. The rhomboid muscle major also holds the shoulder blades onto the ribcage.

The serratus posterior superior

Deep to the rhomboid muscles is the serratus posterior superior. This muscle originates at the C7-T3 vertebras and attaches at the second to the fifth ribs under the shoulder blade.  It elevates the ribs to aid diaphragm for deep breath.

 The splenius cervicis are originated from T3-T6 and inserted to the C1-C3 transverse process. The cervical part of the illiocostalis muscle ends at the cervical transverse processes.

The semispinalis cervicis are originated from the transverse processes of C4-T10 and attach to the spinous processes of C2-C4. They extend, rotate the head and spine.

In the neck there are also some intrinsic muscles such as multifidus, minor deep intrinsic muscles, rotators between and process of the vertebras to stabilise the vertebral column.

Fascia and nuchal ligaments in the neck

Surrounding muscles, blood vessels and nerves, there is a layer of fibrous tissue called fascia. In the neck, there are a few layers of fascia that support the structure of the neck.  Some of the fascia blends in the ligament at the midline of the neck. This ligament is the nuchal ligament in the neck.

Nuchal ligament attaches the bottom of the skull and extends all the way along midline of the neck down to the last cervical spinous process (from the seventh cervical vertebrae, the lowest cervical vertebrae on the neck).  It limits the flexion of the neck and provides sites for attachment of some muscles including trapezius, splenius capitis, rhomboid minor and serratus posterior superior and cervical spinalis. Ossification, fibrosis and inflammation of the ligament result in neck stiffness and pain.


Shoulder pain

Shoulder joint is the most mobile one in the body. It moves the shoulder forward and backward, up and away from the body and also moves the arm circularly. Shoulder consists of  bones, joint, cartilage, muscles, tendons and ligaments.  If something goes wrong with the shoulder, it will cause pain and limit the movement. With aging the soft tissues surrounding the shoulder tend to degenerate, and older people are likely to get shoulder problem. Soft tissues injury around the shoulder is very common and this will cause shoulder pain. The pain can come on gradually or abruptly, and it may range from mild to severe often accompanied with limited motion. The common causes of shoulder pain include

No1: Fronzen shoulder. Known as adhesive capsulitis. It is caused by a thickening and stiffening of the tissues around the shoulder joint. This is is a painful condition in the shoulder.  Typical symptoms are shoulder pain and restricted shoulder movement. It presents a painful persistent stiffness of the shoulder joint that it is difficult to carry out everyday tasks such as dressing, driving and sleeping comfortably. Some people are unable to move their shoulder at all. This is caused when the capsule surrounds the shoulder joint becomes inflamed. The capsule that surrounds the shoulder joint becomes swollen, thickened and tightened This leaves less space for the upper arm bone in the shoulder joint, and makes the movement stiff and painful. The symptoms of frozen shoulder can vary greatly, but tend to get worse slowly over the time. They are usually felt in three stages spread over a number of months or years. This is a common condition affecting about 2% of adults. 

No2: rotator cuff injuries and irritations: due to tears and inflammation of rotator cuff, the symptoms include pain or stiffness in the shoulder when you lift your arm above your head to brush your hair or when you reach behind your back.

No3: Osteoarthritis can affect shoulder as well thigh less common than knee and hip.

Treatment for shoulder pain is aimed at relieving pain and preserving range of motion of the shoulder. Acupuncture is a valuable treatment for shoulder pain.

If you have had acupuncture for this, do you know the effect of acupuncture for shoulder pain is closely related to the acupuncture points chosen?  Some clinical trials showed that the most effective acupuncture points for shoulder pain are Ashi points with a significantly greater recovery rate.