I believe that the neck region is one of the most important areas to address in treatment, the reason for this is that it serves as the bridge between the brain and the body. What the mind wills, the body does, and this relationship is linked via the neck region. From an anatomical perspective the neck contains cranial nerves that innervate organs and regulate homeostatic balance, carotid arteries and jugular veins, as well as glands which play a pivotal role in exocrine/endocrine roles in metabolism and homeostasis. From an acupuncture perspective many important meridians pass through this region, including the stomach meridian, large intestine meridian, gall bladder meridian, and san jiao meridian. As well as acupuncture points that relate to the heavenly points, or window of the sky points, ‘wind’ points, and key reflective areas that relate to the constitutional energetics for the individual. Thus for these reasons it is of paramount importance that the neck region remains relaxed, balanced, and pain free.
An acupuncture perspective
In the acupuncture clinic, as always, I first address the constitution of the individual. Carefully palpating the abdomen (hara) I look for tightness or pressure pain in key reflective areas that relate to the state of the organs and meridians. Palpation of the meridians and neck is included in the diagnostic process, and tight or painful areas are noted. This palpatory technique is pivotal in gaining insight into the individuals’ constitutional state and as to what is holding the individual back from being in a state of optimal health.
I would like to note that the majority of the time, addressing the constitution will benefit the symptoms i.e. neck pain, that have brought the individual to treatment. However for the purpose of this page I will highlight areas I would address when dealing with the symptom of neck pain, as well as describe the importance of why these areas need to be resolved if they present with tightness or pressure pain.
Brain (Heavens)... Neck (Man)... Body (Earth)...
As I stated previously the neck is the link between the brain/mind and the body thus when dealing with neck pain, key areas that I palpate include the scalene muscles, sternocleidomastoid, trapezius, splenius capitus region, and cervical vertebral region. If we look at these areas from an acupuncture/anatomical perspective we can see that pressure pain and tightness in these regions can impact the whole organism and not just cause pain in the local region.
Scalene muscles: Can often become tight and painful contributing to neck pain and restricted range of motion. Furthermore as the scalenes originate from the cervical vertebrae and attach to the first and second ribs, tightness can also result in drawing the first rib upwards, compressing the neurovascular bundle against the clavicle, and thus resulting in thoracic outlet signs and symptoms.
Furthermore this region is where the acupuncture point Quepen lies, and it is at this acupuncture point that the stomach, large intestine, small intestine, sanjiao, and gall bladder channels meet at. Thus tightness and pressure pain at this region can relate to a range of meridian pathologies manifesting in a multitude of signs/symptoms.
Sternocleidomastoid muscle (SCM): The SCM can become tight due to emotional repression, physical trauma i.e. car accident, or just poor posture. Regardless, tightness and pressure pain is commonly seen in the acupuncture clinic unilaterally or bilaterally. It is extremely important to release this area from pressure pain as it can cause neck pain and restricted range of motion, as well as for the fact that the vagus nerve passes through this region. Thus a tight SCM can impinge and obstruct the vagus nerve (parasympathetic nerve) and thus impact on many aspects from mood, digestion, respiration, and much more.
Furthermore, the anterior border of the SCM belly is the region of acupuncture point Renying, which translates to ‘Mans Welcome’ and is a key diagnostic area for thyroid imbalance (based on the Kiiko Matsumoto system).
Thus these aspects further highlight the importance of releasing the SCM in cases of neck pain, and in any case where tightness and pressure pain is found by palpation, as the above shows, a tight SCM can impact far more than just the neck region.
Trapezius Muscle: The trapezius muscle especially the upper fibres play a pivotal role in treating neck pain/restricted range of movement, as they are involved in extending the head and neck, as well as unilaterally contracting to laterally flex the head to the same side, and rotate the head and neck to the opposite side. Key acupuncture points I palpate for pressure pain and thus focus on releasing with distal acupuncture points incude: The region of Tianzhu (window of heaven point), Fengchi (‘wind’ point), and Jianjing. I want to stress that when pressure pain is found on reflective areas/acupuncture points like these, I do not needle them directly, but rather use distal points ( i.e. on the arms and legs) to release these areas. Releasing these areas of the trapezius muscle greatly benefits the neck and shoulders and is integral in treating neck pain.
Cervical vertebrae: I find in the clinic that palpating the whole posterior region of the neck, observing tightness/pressure pain on the cervical spine (du mai), region of the cervical intertransversarii (cervical huatuo region), and splenius capitus region (bladder meridian) and releasing these areas through distal acupuncture points, to be extremely beneficial in addressing neck pain or discomfort.
Final thoughts ...
Above I have highlighted some key areas/meridians that I find very important in diagnosing, assessing, and addressing in regards to treating neck pain. Furthermore my intention is to convey that releasing the neck region from tightness and pressure pain through the regulation of the meridians is much more than the structural beneficial effect induced, but rather a systemic regulation that can be far reaching from body to mind.
It is very interesting to note that the classic Chinese Medical text, the Ling shu (Spiritual Pivot) which came to be in the Han dynasty (206BC – 220AD), also highlighted the importance of the neck and the acu-points in this region. It is in scroll one, chapter two that Qi Bo (the emperor’s physician) describes the shu transport/antique points situated from the hands/feet to the elbows/knees. The importance of these acupuncture points is still known today and these are the main acupuncture points used by many acupuncturists in the modern day clinical setting.
Once Qi Bo has described the shu points and trajectory he goes on to mention the ren mai being between Quepen (St 12), he then describes the points in the neck region which western acupuncturists know as 'window of the sky points'. Discussing these 'neck' points in the same chapter entitled "Roots of acupuncture points" and describing them in the same breath as the shu transporting points, further illustrates the importance of the neck region and the acupuncture points in this region.