Traditional Chinese Medicine for Neck Pain

The neck is an amazing structure of the human body that allows for an incredible range of motion while simultaneously supporting the head upright and housing many different anatomical tissues and structures important to human physiology. The necks amazing range of motion and strength is largely due to the architecture complexity of muscle, sinew, bone, disc, lymph and nerve tissue forming its infrastructure; which also makes it vulnerable to injury and degeneration. Common causes of neck pain include poor posture, injury, arthritis, cervical disc pathology, lymph node pathology, problems in associated tissue or adjacent anatomical regions, and dermatological conditions affecting the neck region.

In view of traditional Chinese medicine, the neck, in addition to housing the above mentioned anatomical structures, is also a major thoroughfare of the channels and network vessels. Common events that lead to disturbance of the channels, network vessels, and associated tissues of the neck region and leading to pain include:

• External pathological invasion exposure to wind either for long periods of time, following vigorous exercise, or after sweating allowing for wind invasion.
• Toxic fire which includes both external toxic heat and internal fire. Stagnation of the Liver’s Qi mainly due to stress, frustration, or depression that can affect both the Liver and Gallbladder channels, network vessels, and associated tissues.
• Weak constitution due to weakened Qi, blood, or Kidney essence resulting in poor nourishment of the channels, network vessels, and tissues of the neck.

Wind Cold

Wind cold induced neck pain will present symptoms of exterior wind invasion such as slight fever, chills, headache, runny nose with clear-white snivel along with neck stiffness and an aversion to cold and wind which upon exposure irritates the condition. Pueraria Combination (ge gen tang) is a formula of choice for this pattern of neck pain. It has an excellent effect to relax the muscles of the neck and shoulders as well as to improve blood circulation, relieve pain, release the exterior of the wind cold pathogen.

Wind Heat

Acute neck pain with a burning sensation that is aggravated by heat due to exterior wind heat will present symptoms of exterior pathogenic invasion such as fever, slight chills, headache, runny nose with yellow discharge, body aches, restlessness. Bupleurum and Pueraria Combination (chai ge jie ji tang) is an appropriate herbal formula useful to address this pattern. This formula can release the exterior of pathogenic wind and clear the muscle layers of external pathogenic wind heat, clear internal heat, and regulate the Qi to relieve pain.

Wind Cold Damp

Neck pain that is characterized by soreness and heaviness that is aggravated by wet, windy and cold weather with an aversion to cold and alleviated with warm and massage with symptoms of dampness such as heaviness and a greasy tongue and exterior pathology such as headache. Chiang-huo and Du-huo Combination (qiang huo sheng shi tang> can be dispensed to effectively release the exterior of pathology, expel wind damp and promote Qi and blood circulation to relieve pain.

Liver Yang Rising

When neck pain is due to excessive pathogenic fire and hyperactive Yang Qi of the Liver, the pain is concomitant with muscle and sinew spasms that typically present at the back or the lateral aspects of the neck. Also there may be symptoms of Liver excess such as irritability, headache, dizziness, bad mood associated with repression, and nervous tension. Gastrodia and Uncaria Combination (tian ma gou teng yin) calms the Liver to extinguish wind, clears heat, harmonizes the blood and nourishes the Liver and Kidneys.

Lung and Stomach Fire

Neck pain associated with Lung and Stomach affects the front of the neck and may refer to the sides of the neck as well. Symptoms of neck pain are fever with redness and swelling in the throat with difficulty in swallowing. There may be cough, difficulty with swallowing and possible pus from throat infection or tonsillitis. This pattern differs from the common observation of neck pain associated with the musculoskeletal system at the posterior and lateral aspect of the neck and is associated with the inner aspect of the throat and tonsils that refer pain in the frontal aspect of the neck when afflicted with toxic heat. Arctium Combination (qing yan li ge tang) may be used to clear toxic heat from the lung, stomach and diaphragm, expel exterior toxic heat pathogens, ameliorate pathogen dryness, sooth the throat and relieve pain.

Stagnation of Liver Qi

Neck pain related to Liver Qi stagnation is often associated with pain at the occipital and lateral regions that can either be unilateral or bilateral that is spastic and tense. Also the pain may have a tendency to move about, up and down along the course of the channels, network vessels, and muscle regions associated with the Liver and Gallbladder. Pain associated with Liver Qi stagnation has a tendency to be related to emotional stressors such as frustration, resentment and oppressed emotions and therefore symptoms of Liver Qi stagnation such as chest oppression, hypochondriac discomfort, bitter taste in the mouth, restlessness and irritability will present concomitantly. Bupleurm and Cyperus (chai hu shu gan tang) can be used to sooth and course the Liver’s stagnant Qi, harmonize the Gallbladder to relieve the pain and discomfort. This formula can best be made with an addition of Pueraria (ge gen) to further promote relaxation of spastic and tense muscles in the neck region. Herbs such as Tumeric (jiang huang) or Corydalis (yan hu suo) can also be added to further promote pain relief.

Blood Stagnation

Neck pain associated with neck pain is characterized by localized pain that is sharp typically located at the midline of the neck and back. Pain is typically worse at night and often movement is hampered and the patient will not like any type of pressure on the area of the pain. Often in patterns of blood stasis, there is a history of either physical trauma or surgical intervention. In more sever or chronic cases, the patient may have a darkened, dusky complexion revealing the accumulation of pathogenic blood.

Additionally such patients will also have darkened purple spots on the tongue or on the associated auricular region which may also have a nodular surface in cases of accumulations of blood or spurring of the bones. Myrrh and Aconite Formula (xiao huo lou dan) can be used to disperse stagnant blood, clear phlegm, and warm and unblock the channel and collateral vessels to provide pain relief.

Another commonly used formula for blood stagnation is Persica and Achyranthes Combination (xue fu zhu yu tang) which can effectively dispel blood stagnation, activate blood circulation, promote the flow of Qi, and unblock the channels and collateral to relive pain. For more chronic conditions of neck pain due to blood stagnation that has resulted in an accumulation of other related Yin substances that have become stagnant and turbid such as phlegm and cold, Myrrh and Aconite (xiao huo luo dan) is most appropriate. For cases of blood stagnation that is concomitant with Qi stagnation and impaired circulation, Persica and Achyranthes (xue fu zhu yu tang) is appropriate.

Deficiency of Kidney Essence

In those with a constitutional weakness diagnosed as deficiency of the Kidney essence, neck pain may be slight but become worse following exertion. Other symptoms of Kidney essence deficiency should be observed including: weakness of the neck, tiredness, dizziness, low pitched tinnitus, low back pain, weakness of the knees, poor memory, and thinning hair. The formulas Achyranthes and Rehmannia Formula (zuo gui wan) and Eucommia and Rehmannia Formula (you gui wan) are both excellent formulas available to treat Kidney essence deficiency. Achyranthes and Rehmannia Formula (zuo gui wan) is used to supplement the Liver and Kidney Yin and nourish the blood. In other words it supplements the Kidney’s essence with special support to the Yin and blood aspect of the essence. Eucommia and Rehmannia Formula (you gui wan) is used to warm and supplement the Kidney Yang, nourish the blood and essence. This formula’s focus is on the Yang aspect of the Kidney’s essence. Both formulas utilize deer antler (lu jiao jiao) in addition to various Liver and Kidney nourishing herbs and other additional ingredients that further specify the formulation.