Neck and Shoulder Pain: 15 Tried-and-True Tips from Top TCM Practitioners of Today

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John Chen, Pharm.D., Ph.D., O.M.D., L.Ac.

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Neck and Shoulder Pain
15 Tried-and-True Tips from Top TCM Practitioners of Today

Compiled by John Chen, Pharm.D., Ph.D., O.M.D., L.Ac.
Editors: Cheri Levine, RN, L.Ac., Britta Becker-Thomas, L.Ac., Donna Chow Sanchez, DACM, L.Ac., Dipl.O.M.

If you'd like to earn continuing education credits for this article, click here to purchase the course and get CEUs!

INTRODUCTION

A successful TCM practitioner will have at his or her disposal a variety of diagnostic and treatment methods, particularly for very commonly encountered problems like neck and shoulder pain. Such skills are invaluable because, as we all know, not all patients respond alike to the same treatment. In this article we present a multitude of procedures used and taught by master practitioners. No matter how seasoned a practitioner you are, mastering some of these protocols can help you immensely in your clinical practice, ensuring successful outcomes.

We begin by exploring the diagnostic techniques of Dr. Jimmy Chang’s pulse diagnosis and Dr. Li-Chun Huang’s auricular medicine. The next section describes acupuncture protocols taught by master practitioners, beginning with Master Tung and contemporary students of his. Next, protocols by the late Dr. Richard Tan and his disciples are presented. Both Master Tung and Dr. Richard Tan were two of the most valued teachers of our recent past. In addition, auricular, traditional and abdominal acupuncture protocols are discussed. The article continues with Dr. John Chen’s detailed information on effective herbs and formulas, including modern research to corroborate the effectiveness of Chinese herbs in treating painful neck conditions. Cautions and contraindications, as well as nutritional and lifestyle recommendations are given in conclusion.

If you enjoy this article, please make sure you check out the article on treating back pain. The information compiled here comes from books and various lectures given by eLotus.org speakers.

TYPES OF NECK PAIN

Musculoskeletal and connective tissue injuries lead to over 10 million clinic visits per year in the United States. Causes of these injuries may be external (sports injuries, car accidents, trauma), internal (chronic wear and tear of muscles, ligaments and tendons; bones weakened by osteoporosis), or both.

Acute injuries are characterized by severe pain, swelling, inflammation, and in some cases, internal bleeding. Treatment of acute injuries should focus on relieving pain, reducing swelling and inflammation, and stopping any bleeding. Chronic injuries are characterized by dull pain, stiffness and numbness, as well as decreased muscle mass and strength. Treatment of chronic injuries should focus on relieving pain and restoring physical and physiological functions.
The types of neck pain that are discussed in this article include:

  • Acute neck and shoulder pain due to sports injuries, car accidents, prolonged body posture in a fixed position (such as working in front of a computer or sleeping in a poor position)
  • Limited movement of the neck and shoulders, due to pain and stiffness
  • Whiplash, muscle tightness, and spasms
  • Acute flare-ups of chronic neck and shoulder problems
  • Pain associated with a slipped or bulging disk of the neck

DIAGNOSIS OF NECK PAIN

Did you know that a diagnosis of neck pain can be made using accurate pulse taking skills and/or auricular medicine, even if the patient does not reveal this complaint to you?

Diagnosing Neck Pain using the Pulse Method taught by Dr. Jimmy Wei-Yen Chang:

Jimmy Chang, L.Ac., the Master and creator of Pulsynergy, has found that the right chi position reveals disorders of the neck and shoulders. In his pulse system, the locations of the cun, guan, and chi positions are half a finger proximal to the usual TCM pulse taking positions. In other words, the styloid process is the demarcation line between the cun and guan positions whereas traditionally, the styloid process is the location of the guan position.
To diagnose neck and shoulder pain, use your index finger to feel the right chi position, and then feel if the pulse extends proximally from this position. Any pulse detected proximally to the right chi position indicates neck and shoulder discomfort and/or pain. The more forceful the pulse, the more inflammation and pain the patient is experiencing. The farther the pulse extends proximally towards the elbow, the bigger the area of pain (for example when neck pain extends down into the shoulders or upper back).

To further diagnose the specific cause of pain, a comparison is made to the other pulse positions. If the vessel feels thick and rounded on top (like a marble), the cause of pain is likely due to a soft tissue injury. If the vessel feels thin and forceful (like a wire), the condition is either disc related or due to a bone spur. Blurry vessel borders indicate blood stasis, most likely the result of a physical injury such as whiplash. A tip on improving your pulse diagnosis is to use the pads instead of the tips of your fingers to feel the pulse. This enables you to feel the shape and force of the pulse more accurately.
One of the reasons Dr. Chang is so successful in his clinical practice is that he never asks his patients to describe the reason for their visit. Dr. Chang simply has his patients sit down for a pulse reading and proceeds to tell them what conditions/issues they have. This deep insight on the practitioner’s behalf gives patients a tremendous psychological boost in their confidence, both in the practitioner as well as their treatment, thereby enhancing their recovery significantly.
If you detect any pulse signs beyond the right chi position in your patients, let them know you think they suffer from neck pain. You will see for yourself how your patients react to your skills and how much more confidence they will have in you, your treatment, and your recommendations.

Click here to learn more about Dr. Chang’s pulse diagnostic techniques.

Diagnosing Neck Pain using Dr. Li-Chun Huang’s auricular medicine:

Dr. Li-Chun Huang is the top expert of Auricular Medicine and has treated the presidents of China, Italy, and Cuba. According to her system, the auricular neck area is located at the base of the antihelix. Dr. Huang utilizes visual inspection, palpation, and electrical detection for diagnosis. The integrity of the cartilage represents the health of the vertebrae. If the cartilage in this particular area looks crooked, bumpy, or depressed upon visual inspection, it is an indication that cervical vertebrae abnormalities or deformities are causing the neck pain. When this area looks red and/or swollen, most likely muscle tension and/ or inflammation is causing the pain. Extreme pain upon palpation with a steel probe is also an indication of neck pain. In addition, a positive reaction with an electric auricular detector in this area is a further indication of neck pain. If you study Dr. Li-Chun Huang’s method closely you can even diagnose what cervical vertebrae are affected, and whether or not the problem is limited to soft tissue or if vertebrae or discs are involved.

Click here to learn more about Auricular medicine by Dr. Huang. Additionally, more information on auricular diagnosis and their points location can be found on the LCH Auricular Medicine section on eLotus CORE.

The pictures below are taken from her book Auricular Diagnosis with Color Photos which is available here.

This is a normal ear with no problems in the neck:

  
In all four pictures below there are positive indications of neck pain. The area of deformity or vessel protrusion denotes the location of a neck disorder. In general, red vessels indicate acute pain with inflammation, purple indicates a past injury, and cartilage protrusions are an indication of structural deformities of the neck.

VARIOUS ACUPUNCTURE STYLES FOR FAST NECK PAIN RELIEF

Selecting correct points and using the fewest points possible has always been the goal of Master acupuncturists. Below is a compilation of the best points for treating neck pain arrived at through years of experience by seasoned practitioners. You may notice that many Masters have arrived at the same conclusions. The explanation for this is due to the holographic nature of the body. Many parts of the body can image one another, thus treating one particular point can have thousands of effects. An understanding of the most basic imaging, such as the hand or foot representing the head; the wrist or ankle imaging the neck; the elbow, the knee; the shoulder, the hip; and so on will help you greatly understand WHY the Masters below chose the distal points they used.

Besides body acupuncture, Auricular and Abdominal acupuncture are also discussed, following the same principles. The key to obtaining exceptional results with acupuncture comes down to using the most appropriate imaging.
Learn more on the distal needling concept through Richard Tan’s book Acupuncture 1, 2, 3.

Traditional TCM Acupuncture:

Traditional points such as the ones listed below are commonly taught in school for neck pain. Some are local and some are distal points.

  • Houxi (SI 3), Shugu (BL 65), Hegu (LI 4), Shousanli (LI 10), Jianliao (TH 14), Chize (LU 5), Waiguan (TH 5), Quchi (LI 11), Fengchi (GB 20), Dazhui (GV 14)

All traditional acupuncture points listed can be found on the eLotus CORE website under TCM Acupuncture. This site includes more than 300+ traditional points for your reference for FREE.

Master Tung’s Acupuncture:

Master Tung’s Acupuncture is becoming increasingly famous in the Western world. Known for its simplicity, ease of use, and exceptional clinical efficacy, Master Tung’s Acupuncture was originally passed down exclusively within the family until the first disciple was accepted in 1964. As a complete system of its own and separate from the traditional TCM acupuncture system, Master Tung’s Acupuncture is known for its unique set of “magic” points, its own acupuncture channels, diagnostic methods, and needling techniques that have been expanded and refined with over 300,000+ clinical cases by Master Tung Ching-Chang.

Various English-speaking teachers and authors for Master Tung’s Acupuncture include Drs. Richard Tan, Chuan-Min Wang, Young Wei Chieh, Esther Su, Robert Chu, Henry McCann, Brad Whisnant, Susan Johnson, James Maher, Jeffrey Russell, and many more. Some of these practitioners are eLotus speakers and have lectured on the topic of neck pain and presented their favorite Tung points they found to be most effective. Below is a summary:

All Master Tung’s acupuncture points listed below can be found on the eLotus CORE website. This site includes more than 300+ Master Tung points for your reference for FREE.

Master Tung’s Points by Dr. Chuan-Min Wang:

  • Acute neck, shoulder pain: Bleed trigger points of levator scapula muscle or upper trapezius muscle. Needle bilaterally Shangbai (T 22.03).
  • Chronic neck, shoulder pain: Needle bilaterally Shangbai (T 22.03).

Dr. Chuan-Min Wang is a direct disciple of Master Tung and has contributed greatly by translating his work into English as well as teaching courses for eLotus. Together, we produced free videos on how to locate and needle the most popular 100 Master Tung points on Youtube, available in Chinese, English, German, French, Spanish and Portuguese. Click here for books and courses by Dr. Wang.

Master Tung’s Points by Esther Su:

  • Chengjiang (CV 24), Baihui (GV 20) to Qianding (GV 21), Xuanzhong (GB 39), Jugu (LI 16), Zuwujin (T 77.25), Zuqianjin (T 77.24), Zhengjin (T 77.01), Zhengzong (T 77.02).

In this system, the selection of points is subject to seasonal changes. In addition, the decision as to which side of the body to needle and/or the exact locations of these points must be determined by the practitioner according to his or her judgment of the patients’ condition at the time of treatment, and by the patient’s response to each needle after it is inserted. In other words, acupuncture points are determined at the time of treatment based on the situation and response to each insertion. In this system, a good rule of thumb is to palpate both sides of the body and to needle the side that is more responsive/tender (ah shi point).

Esther Su learned Master Tung points from Miriam Lee, one of the pioneer acupuncturists in the U.S., and from Dr. Young Wei-Chieh. She has been practicing Tung style acupuncture since 1987 and is retired now. Click here for courses by Esther Su.

Master Tung’s Points by Dr. Robert Chu:

  • Waiguan (TH 5), Chize (LU 5), Yangxi (LI 5), Yizhong (T 77.05), Erzhong (T 77.06), Sanzhong (T 77.07), Qihu (T 77.26), Tianhuangfu[shenguan] (T 77.18). Needle ah shi points on either the opposite side or both sides.

Dr. Robert Chu is a Wing Chun Master and a licensed acupuncturist and herbalist specializing in Master Tung Acupuncture methods. With his bilingual skills, he is able to teach Master Tung’s techniques in the most accurate and precise way. Click here for books and courses by Dr. Chu.

Master Tung’s Points by Dr. Henry McCann:

  • Bleeding for neck pain: Inspect for dark veins or vessels and skin changes, and bleed that area – (1) the region of Weizhong (BL 40) which images the occipital zone, (2) Chong Xiao Xue 沖霄穴(over the sacrum), (3) head and neck zone 後頭頸項區 behind the neck, (4) area around Tianzong (SI 11) (i.e., side of shoulder zone). Bleed the same side as the pain. Inspect for the best area to bleed based on how each patient presents. Detailed information can be found in Dr. McCann’s bloodletting book, Pricking the Vessels: Bloodletting Therapy in Chinese Medicine, and his bloodletting class, Master Tung’s Bloodletting Therapy.
  • Acute neck pain: Area of Sanyinjiao (SP 6), Sizhi (T 77.20), Wanshunyi (T 22.08), Wanshuner (T 22.09), Feixin (T 11.11).
  • Chronic neck pain, especially if it radiates into the head, or is associated with migraines, or if there are cervical bone spurs: Shangjiuli (T 88.26), Xiajiuli (T 88.27), Zhongjiuli (T 88.25).
  • Shoulder pain: Tianhuangfu[shenguan] (T 77.18), Yanglingquan (GB 34), Zhongjiuli (T 88.25), Shangjiuli (T 88.26), Xiajiuli (T 88.27), Zuwujin (T 77.25), Zuqianjin (T 77.24).
  • Aside from the above for shoulder pain, do direct thread/rice grain moxa at Jianliao (TH 14). This recommendation comes from the Zhen Jiu Zi Sheng Jing針灸資生經. If the pain is stubborn, apply fire needle(s)火針 locally (this is a rare occasion).
  • Needle the opposite side of the pain and bilateral if the pain is on both sides.

Dr. Henry McCann is an avid practitioner and author of many Master Tung method acupuncture books. He is currently a faculty member at PCOM, OCOM, and ACTCM. He has also been involved in martial arts for over 30 years and is a 12th generation lineage disciple of the Chen-style Taijiquan. Click here for books and courses by Dr. McCann. Click here to subscribe to his blog.

Master Tung’s Points by Dr. Brad Whisnant:

  • Primary points: Chongzi (T 22.01), Chongxian (T 22.02), Shangbai (T 22.03), Zhengjin (T 77.01), Zhengzong (T 77.02), Zhengshi (T 77.03), Yizhong (T 77.05), Erzhong (T 77.06), Sanzhong (T 77.07), Qihu (T 77.26), Sojingdian (T 22.19)*, Fanhoujue (T 22.12)*.
  • Secondary points: Feixin (T 11.11), Zhishen (T 11.15), Fuyuan (T 11.22), Shangbai (T 22.03), Huochuan (T 33.04), Sanchayi (T 22.15)*, Sanchaer (T 22.16)*, Sanchasan (T 22.17)*, Zhongjiuli (T 88.25).

Dr. Brad Whisnant learned Master Tung’s acupuncture techniques from various Masters and is now one of the most active teachers of the system. Click here for books and courses by Dr. Whisnant. Click here for hands-on training with him personally.

Master Tung’s Points for Neck Pain compiled from various Chinese References:

  • Needle contralateral to the pain. If the pain is in the center, needle bilaterally or the side with more ah shi points. If the pain is on both sides, needle bilaterally.
  • Neck pain (bone spur): Wanshunyi (T 22.08), Wanshuner (T 22.09), Huochuan (T 33.04), Tianhuang (T 88.13), Sizhi (T 77.20), Minghuang (T 88.12), Qihuang (T 88.14), Guciyi (T 44.21)*, Gucier (T 44.22)*, Gucisan (T 44.23)*, Huofu (T 88.41)*, Huoliang (T 88.42)*, Huochang (T 88.43)*, Sojingdian (T 22.19)*.
  • Neck stiffness: Zhengjin (T 77.01), Zhengzong (T 77.02), Renhuang (T 77.21), Sojingdian (T 22.19)*.
  • Fallen pillow syndrome: Waisanguan (T 77.27), Tianhuang (T 88.13), Qihu (T 77.26), Wanshunyi (T 22.08), Wanshuner (T 22.09), Yanglao (SI 6), Sojingdian (T 22.19)*.
  • Shoulder pain: Tianhuang (T 88.13), Waisanguan (T 77.27), Fanhoujue (T 22.12)*, Renzong (T 44.08), Dizong (T 44.09), Tianzong (T 44.10).
  • Frozen shoulder: Linggu (T 22.05), Dabai (T 22.04), Fanhoujue (T 22.12)*, Tianhuangfu [Shenguan] (T 77.18), Minghuang (T 88.12), Tianhuang (T 88.13), Qihuang (T 88.14), Quchi (LI 11), Xiyan, Huantiao (GB 30), Renhuang (T 77.21), Sihuashang (T 77.08), Waisanguan (T 77.27), Sizhi (T 77.20), ah shi points around the second metacarpal phalangeal joint, Baguansan (T 11.30)*, Baguansi (T 11.31)*. Bleed the affected area with cupping. For best results, bleed before needling.

Balance Method by Dr. Richard Tan:

  • Needle the following points contralateral to the pain: Lingdao (HT 4), Tongli (HT 5), Shenmen (HT 7), Xuanzhong (GB 39), and Shugu (BL 65).
  • Needle the following points ipsilateral to the pain: Houxi (SI 3), Zhongzhu (TH 3), Sanyinjiao (SP 6) or ashi points nearby.
  • After the needles are inserted, the patient should move his or her neck to loosen up the joints and muscles, and then assess if the pain has decreased.

The late Dr. Richard Tan was a leading authority in our profession. His skills represented the culmination of years of study and treating thousands of patients during his 20 years of practice. His mission was to teach his Balance Method, which so effectively explained WHY TCM points are used the way they are.

Dr. Tan’s “Acupuncture 1, 2, 3” is a 3-step strategy providing logical and precise guidance toward needling a minimal number of distal points. His method effectively avoids aggravating pain which often occurs with local needling. Click here to view books and courses by Dr. Tan.

Eileen Han Acupuncture:

  • Contralateral points:
    • Houxi (SI 3), Zhongzhu (TH 3), Sanjian (LI 3). Make sure the tip of needle touches the bone.
  • Ipsilateral points: Shenmen (HT 7) to Tongli (HT 5) ah shi, Taiyuan (LU 9) to Lieque (LU 7) ah shi points. The pain should be gone by now.
  • For any residual pain or if the patient wants more needles:
    • Contralateral: Zhongfeng (LR 4) to Ligou (LR 5), Rangu (KI 2) to Fuliu (KI 7) ah shi.
    • Ipsilateral: Yangfu (GB 38) to Qiuxu (GB 40).
  • For cervical spine pain: Oblique insertion on Xinhui (GV 22), Shangxing (GV 23).

Eileen Han was one of Dr. Richard Tan’s top disciples for over 10 years. She now shares her rich, hands-on experience by teaching her understanding of her sifu’s Balance Method worldwide. Click here to watch some of her videos. Click here to intern with Eileen Han or to attend her live workshops.

Distal Needling Acupuncture (DNA) by Robert Doane:

  • Pain around the entire neck and shoulder area:
    • Left side - 2 needles on each of the following: the knuckles on the yin channels of the palm, Jiexi (ST 41), Qiuxu (GB 40), Kunlun (BL 60), and Pushen (BL 61).
    • Right side - Wangu (SI 4), Waiguan (TH 5), Yangxi (LI 5), Sanyinjiao (SP 6), Fuliu (KI 7), Ligou (LR 5).
    • Left and right sides can be alternated from treatment to treatment. Needle into the tendons.
  • Upper neck pain: Bilateral - one needle on each intermetacarpal joint from Houxi (SI 3) to Yuji (LU 10). If the pain is at C1, needle Weizhong (BL 40) deep into the bone and at the middle of the distal joints of both index fingers on the palmar side.
  • Lower neck pain (base of the neck): Bilateral - 1 needle on each yin and yang channel on the wrists and ankles, until you hit the bone. Yangxi (LI 5), Yangchi (TH 4), Yanggu (SI 5), Shenmen (HT 7), Daling (PC 7), Taiyuan (LU 9), Shenmai (BL 62), Qiuxu (GB 40), Jiexi (ST 41), Zhongfeng (LR 4), Shangqiu (SP 5), Zhaohai (KI 6). You can spread the image proximally and distally from the wrist and ankles, needling more points for a better result.
  • Pain on the spine (GV Channel): T1-T12 has an image from the mid frontal hairline to Baihui (GV 20). T12 to the tailbone is mirrored from Baihui (GV 20) to the occipital protuberance. Find the correct corresponding image area and place 2-3 needles on the ah shi point.
  • Neck pain (Trapezius/BL Channel): Bilateral - 4 needles evenly spaced from Qiangu (SI 2) to Xiaohai (SI 8), Weizhong (BL 40) to Zutonggu (BL 66), Rangu (KI 2) to Yingu (KI 10), Chize (LU 5) to Yuji (LU 10).
  • Neck pain (Levator Scapulae/SI Channel): Bilateral - 3 needles evenly spaced from Xingjian (LR 2) to Ququan (LR 8), Qiangu (SI 2) to Xiaohai (SI 8), Dadu (SP 2) to Yinlingquan (SP 9), Shaohai (HT 3) to Shaofu (HT 8).
  • Neck pain (Erector Spinae/KI Channel): Bilateral - Zhaohai (KI 6), 3 needles evenly spaced from Weizhong (BL 40) to Zutonggu (BL 66), Erjian (LI 2) to Zhouliao (LI 12), Yemen (TH 2) to Tianjing (TH 10), Rangu (KI 2) to Yingu (KI 10).
  • Neck pain (Scalenus Posterior/TH Channel): Bilateral - 3 needles evenly spaced from Yemen (TH 2) to Tianjing (TH 10), Quze (PC 3) to Laogong (PC 8), Rangu (KI 2) to Yingu (KI 10), Yanglingquan (GB 34) to Zuqiaoyin (GB 44).
  • Neck pain (Scalenus Medius/LI Channel): Bilateral - 3 needles evenly spaced from Erjian (LI 2) to Shousanli (LI 10), Dubi (ST 35) to Neiting (ST 44), Xingjian (LR 2) to Ququan (LR 8), Chize (LU 5) to Yuji (LU 10).
  • Neck pain (Scalenus Anterior/GB Channel): Bilateral - 3 needles evenly spaced from Yangjiao (GB 35) to Zuqiaoyin (GB 44), Yemen (TH 2) to Tianjing (TH 10), Shaohai (HT 3) to Shaofu (HT 8), Xingjian (LR 2) to Ququan (LR 8).
  • Neck pain (Sternocleidomastoid/BL Channel): Bilateral - 3 needles evenly spaced from Qiangu (SI 2) to Xiaohai (SI 8), Weizhong (BL 40) to Zutonggu (BL 66), Rangu (KI 2) to Yingu (KI 10), Chize (LU 5) to Yuji (LU 10).
  • Neck pain (Upper Part of the Rhomboid Minor/LI Channel): Bilateral - 3 needles evenly spaced from Hegu (LI 4) to Zhouliao (LI 12), Zusanli (ST 36) to Chongyang (ST 42), Chize (LU 5) to Yuji (LU 10), Zhongfeng (LR 4) to Ququan (LR 8).
  • Neck pain (Rectus Capitis Posterior Major, Longus Capitis, Longus Colli, Semispinalis Cervicis/KI Channel): Bilateral - Rangu (KI 2) to Fuliu (KI 7), Feiyang (BL 58) to Shugu (BL 65), Lingdao (HT 4) to Shaofu (HT 8), Hegu (LI 4) to Wenliu (LI 7), Zhongzhu (TH 3) to Waiguan (TH 5).

Robert Doane runs one of the most successful acupuncture clinics in the U.S. seeing over 120 patients a day. He studied with Drs. Richard Tan and Donald Kendall and has perfected his own technique, Distal Needling Acupuncture (DNA). His point prescriptions are based on Dr. Tan’s Balance Method as well as the Muscle Tendon theories from Dr. Kendall’s book, Dao of Chinese Medicine, where specific muscles are paired with TCM channels. Click here for hands-on training with Robert Doane personally.

Bodymapping Acupuncture by Cole Magbanua:

  • General points include: Needle from Lieque (LU 7) into Jingqu (LU 8) or Taiyuan (LU 9), Shangqiu (SP 5), Lingdao (HT 4) to Shenmen (HT 7), Daling (PC 7), Xuanzhong (GB 39), Ligou (LR 5). Palpate and needle ah shi points on opposite or both sides.
  • Dazhui (GV 14) to Fengfu (GV 16) area pain: needle Tiantu (CV 22) to Chengjiang (CV 24).
  • Renying (ST 9) to Quepen (ST 12) area pain: needle Daling (PC 7).
  • Tianzhu (BL 10) to Dashu (BL 11) area pain or base of skull to T1 pain: needle Lieque (LU 7) to Taiyuan (LU 9).
  • GB channel neck pain, base of skull to T1 pain: needle Lingdao (HT 4) to Shenmen (HT 7) from lateral side of ulnar tendon.
  • Tianrong (SI 17) or Tianyou (TH 16) to Yifeng (TH 17) area pain at the corner of the jaw, scalene muscle pain at the TH or SI channel, or ear pain at the neck level, ear infection: needle Shangqiu (SP 5) and Zhongfeng (LR 4).
  • Sternocleidomastoid pain, scalene muscle pain at LI channel, thoracic outlet syndrome at LI channel: Needle Taixi (KI 3) to Fuliu (KI 7).
  • Cervical pain or spinal fractures: Zhengjin (T 77.01), Zhengzong (T 77.02), Zhengshi (T 77.03), Boqiu (T 77.04), two or more needles through the Achilles tendon to tap on the posterior tibia.
  • Anterior neck pain or throat pain
    • Pain on the ST and LI channels: Yangxi (LI 5).
    • Swollen lymph and tonsillitis: Taixi (KI 3).
    • ANY sore throat: Yangxi (LI 5).
    • Sore throat on the ST channel: Daling (PC 7).
  • Thoracic outlet syndrome
    • Thumb/LU: Shangqiu (SP 5)
    • Index finger/LI: Taixi (KI 3) to Fuliu (KI 7)
    • Middle finger/GB: Lingdao (HT 4) to Yinxi (HT 6)
    • 4thfinger/TH: Shangqiu (SP 5) to Sanyinjiao (SP 6)
    • 5thfinger/ SI and HT: Ligou (LR 5)

Cole started learning holistic medicine in 1991 with doctors from a variety of medical traditions, including Chinese, Korean, Ayurvedic, and Himalayan medicine. His primary TCM teacher was Dr. Richard Tan. Throughout his 20 years of practice, Cole discovered that channels are not linear lines but rather are reflected in zones. Thus, he created BodyMapping Acupuncture. In his classes, books, and charts, each channel is specifically color-coded so practitioners can pinpoint specific channel(s) that are diseased and pick the correct points. Click here for books and courses by Cole Magbanua.

TCM Auricular Acupuncture:

  • Neck pain: Cervical Vertebrae, Neck, Shoulder, Shoulder Blades, Kidney. Embed ear seeds and instruct the patient to massage the points three to four times daily for two minutes each time. Switch ears every five days. Five treatments equal one course.
  • Frozen shoulder: Shoulder, Shoulder Joint, Adrenal Gland; or Shoulder, Clavicle, Adrenal Gland, Liver, Spleen and Subcortex.
  • Torticollis or fallen pillow syndrome: Neck, Cervical Vertebrae and all the tender points around the area. Strong stimulation for 60 minutes. Needle once a day. Most patients will experience relief once the needles are inserted. If the pain is along the Liver and Gallbladder channels, needle Liver and Gallbladder as well. Similarly, if the pain is on the taiyang Urinary Bladder or Small Intestine channel, needle the corresponding points accordingly.

Auricular Medicine by Li-Chun Huang:

  • Neck pain, acute sprain, contusion, fallen pillow syndrome: Occiput, Lesser Occiput Nerve, Large Auricular Nerve, Shenmen, Triangle Area of Cervical Vertebrae on the front and back of the ear. Bleed Ear Apex.
  • Periarthritis of shoulder: Shoulder, Shoulder Joint, Clavicle, Large Auricular Nerve. Bleed Ear Apex.
    • For pain of the shoulder upon abduction, use Clavicle, Shoulder (front and back of ear), Arm Pit.
    • For anterior shoulder pain, use Shoulder Joint (front of ear), Coronary Vascular Subcortex, Large Auricular Nerve.
    • For posterior shoulder pain, use Shoulder Joint (back of ear), Clavicle, Large Auricular Nerve.

Dr. Li-Chun Huang uses ear seeds instead of needles for her auricular treatments as she feels it reduces the possibility of infection and the patient can achieve longer lasting treatment effects; for 7+ days. She uses two seeds per tape to provide stronger stimulation.

To learn more on all the auricular points used here, visit our LCH Auricular Medicine section on eLotus CORE.

Click here to buy tools for point detection and treatment.

To watch a demonstration on how to bleed the ear, Click here.

For a color chart of the ear, Click here.

Click here for books and courses by Dr. Huang.

Abdominal Acupuncture by Dave Shipsey:

Abdominal Acupuncture, created by Dr. Zhiyun Bo, is an easy modality to learn and apply. It is not only gentle and relaxing, but also very effective because it works with the qi in the core of the body. In addition, it directly benefits the digestive system.
The following overview to Abdominal Acupuncture is compiled from the online courses by Dave Shipsey (in English), and online resources by Dr. Zhiyun Bo (in Chinese).

Abdominal Acupuncture utilizes a hologram of the abdomen of a tortoise on its back. Abdominal point prescriptions follow the same concept found in herbal prescriptions employing Jun, Chen, Zuo, Shi (Chief, Deputy, Assistant, Envoy) points, each playing an important and essential function.

  • Chief points treat the patient’s chief complaints, and regulate and harmonize the organs. Usually 1-2 points are selected.
  • Deputy points enhance the organ regulating effects of the Chief points.
  • Assistant points enhance Chief and Deputy functions, as well as regulate affected channels.
  • Envoy points provide symptomatic relief. They often image the corresponding pain areas, and can also be guiding points.

There is no set number of points to use for each category; however, usually more Envoy points than Chief points are used. Depending on the condition, some point prescriptions may only contain points from one or two of the categories.
Point locations and needling depths are the keys to successful treatment outcomes. For courses in English by Dave Shipsey, Click here.

Point Locations with Corresponding Imaging Areas

The Ren (conception) channel images the spine. Therefore, the CV points on the abdomen correspond to the vertebra and GV points.

  • Zhongwan (CV 12) = Head – Treats head, brain, and sensory organs
  • Jianli (CV 11) = C1 or Fengfu (GV 16) – Used for brain problems and treats C1 vertebra area
  • Xiawan (CV 10) = C7 or Dazhui (GV 14) – Helps Zhongwan (CV 12) for SP and ST problems, and treats C7 vertebra area
  • Shuifen (CV 9) = T7 – Reduces swelling during the acute stages of back/neck pain
  • Shenque (CV 8) or navel = T12; this is the center
  • Qihai (CV 6) = L1 – Treats all kinds of chronic qi diseases
  • Guanyuan (CV 4) = L4 & L5 or Yaoyangguan (GV 3)
  • Zhongji (CV 3) = Sacrum

In addition to the CV points above, there are also points on the abdomen that image the upper and lower extremities.

  • Huaroumen (ST 24) = Shoulder point – Use for any arm/hand issues. Strengthens the upper back.
  • Elbow point (AB1) is ½ cun superolateral to the Shoulder point. This point is also the Upper Rheumatism Point.
  • Wrist point (AB2) is 1 cun lateral to the Shoulder point, or ½ cun inferolateral to the Elbow point. This point is also the Upper Lateral Rheumatism Point.
  • Thumb point (AB3) is 1 cun superior to the Wrist point. This point is also the Upper Rheumatism Point.
  • Wailing (ST 26) = Hip point – Use for any back/leg issues. Strengthens the lower back.
  • Knee point (AB4) is ½ cun inferolateral to the Hip point. This point is also the Lower Rheumatism Point.
  • Medial Knee point (AB5) is ½ cun inferomedial to the Hip point.
  • Ankle point (AB6) is ½ cun inferolateral to the Knee point (AB4). This point is also the Lower Rheumatism Point.
  • Foot/Toes point (AB7) is ½ cun inferomedial to the Ankle point (AB6).

Abdominal Prescription for Neck Pain:

  • Zhongwan (CV 12), Xiawan (CV 10), Qihai (CV 6), Guanyuan (CV 4)
  • Healthy side: Ashi points around Shangqu (KI 17)
  • Affected side: Ashi points around Huaroumen (ST 24) and Xiawan (CV 10)

Korean Hand Acupuncture by Dr. Dan Lobash:

Dr. Dan Lobash has dedicated his career to the practice and teaching of Korean Hand Therapy (KHT). He has over two decades of clinical and teaching experience. Below is a summary of his method of treating neck pain using the Korean Hand Hologram. The holographic imaging is very similar to the concepts used in Auricular Medicine and the Balance Method. A steel probe is necessary to precisely locate the problem and then either a needle is inserted or a pellet is applied to that point. Click here for courses by Dr. Lobash.

Steps for Korean Hand Acupuncture treatment:

  1. Identify the location of the neck pain through palpation.
  2. Determine the correspondence on the middle finger.
  3. Roll over the area and then identify the precise point that elicits a motor reflex.
  4. Mark the reflex points discovered with a surgical marking pen.
  5. Check immediately for pain reduction and range of motion changes.
  6. Search for additional reflex points, stimulate, and request client feedback.
  7. Apply stimulators (hand needles, moxa, and pellets, in this sequence).
  8. Instruct and provide the client with self-treatment supplies to do at home.

The base of the neck is in the sternal notch, which corresponds to A-20 (CV 22).

The base of the chin corresponds to A-24 (CV 23) or to the distal joint.

The nose is half the length from the distal crease to the tip of the middle finger. (It corresponds to the bridge of the nose.)

The eyebrow center is 2/5th of the distance from the nose point, A-28, to the tip of the finger, A-33 (DU 20).

Conclusion on Acupuncture Styles:

The holographic nature of body becomes clear to anybody who has studied all the points used successfully in various styles of acupuncture. Mastering the selection of the most effective images is a life-long practice. Hence the saying that a medical practice is called a ‘practice’ because one is constantly practicing! While one can get close, there is no ONE method that can duplicate results or be successful 100% of the time on all patients. Therefore, it behooves us to use multiple strategies and have a thorough understanding on HOW to pick the points. We hope that the above recommendations from various styles of acupuncture will help you find your own, unique, and effective point prescriptions. Should you discover any new methods or have clinical breakthroughs, please share with your peers and post on the comment section of this article or on our eLotus Facebook group, Acupuncturist Online.

HERBAL TREATMENT FOR FAST NECK PAIN RELIEF

Herbal treatment for neck pain requires making a differential zang fu diagnosis and an 8 principle pattern differentiation. Some of the most popular herbal formulas for neck pain are described below. Theoretically, as most of us learned in school, there is one herbal formula for each diagnosis. Clinically however, mixed syndromes present themselves every day. Patients may have a combination of heat and cold, deficiency and excess, or all of the above. Therefore, it is not unusual to combine several formulas when using extract capsules or powder/granules. The same applies if you prescribe raw herbal formulas.

Click here to watch a video of how to mix extract formulas and the logic behind it.

Popular Formulas for Neck Pain:

  • Ge Gen Tang (Kudzu Decoction) or Ge Gen (Radix Puerariae Lobatae) is generally a go-to formula no matter the cause of the neck pain, whether it is due to external wind or internal disharmony. Other herbs can be combined depending on the cause of the neck pain. See “Supplementary Herbs and Formulas” for more details.
  • Qiang Huo Sheng Shi Tang (Notopterygium Decoction to Overcome Dampness) is designed for neck and body aches if the predominant diagnosis is damp accumulation. Patients will display a heavy white coating on the tongue and complain of body aches in addition to neck pain.
  • Shu Jing Huo Xue Tang (Relax the Channels and Invigorate the Blood Decoction) is best for neck pain in patients with blood stasis or for those who are on the phone or in front of a monitor or TV for too long.
  • Zheng Gu Zi Jin Dan (Purple and Gold Pill for Righteous Bones) was originally designed for trauma and bone fractures. However, this formula can be used effectively to treat whiplash or post-operative pain. It contains many herbs to relieve pain as well as promote strong bones.

Popular Single Herbs for Neck Pain:

  • Ge Gen (Radix Puerariae Lobatae)
  • Yan Hu Suo (Rhizoma Corydalis)
  • Bai Shao (Radix Paeoniae Alba)
  • Dang Gui (Radix Angelicae Sinensis)
  • Wei Ling Xian (Radix et Rhizoma Clematidis)
  • Qiang Huo (Rhizoma et Radix Notopterygii)
  • Gan Cao (Radix et Rhizoma Glycyrrhizae)
  • Chuan Xiong (Rhizoma Chuanxiong)

Supplementary Herbs and Formulas

  • To enhance pain relief, add Yan Hu Suo (Rhizoma Corydalis), Ru Xiang (Gummi Olibanum), Mo Yao (Myrrha).
  • For recent trauma or bone fractures, combine with Xu Duan (Radix Dipsaci), Xue Jie (Sanguis Draconis), Yan Hu Suo (Rhizoma Corydalis), Ru Xiang (Gummi Olibanum), Mo Yao (Myrrha), Su Mu (Lignum Sappan), Er Cha (Catechu).
  • For old injuries or stubborn pain due to chronic blood stagnation, add Shu Jing Huo Xue Tang (Relax the Channels and Invigorate the Blood Decoction).
  • With bone spurs or calcification, add Po Bu Zi Ye (Folium Cordia Dichotoma).
  • For shooting pain radiating down the arms, add Gui Zhi (Ramulus Cinnamomi), Sang Zhi (Ramulus Mori).
  • For severe spasms, combine with Shao Yao Gan Cao Tang (Peony and Licorice Decoction).
  • With hypertension, combine with Tian Ma (Rhizoma Gastrodiae), Gou Teng (Ramulus Uncariae cum Uncis).
  • With headache, add Chuan Xiong Cha Tiao San (Cnidium & Tea Formula).
  • For stress-related neck pain, add Xiao Yao San (Rambling Powder).
  • For osteoporosis, add Gui Lu Er Xian Jiao (Tortoise Shell and Deer Antler Syrup).
  • For degeneration of muscles, tendons, ligaments, and cartilage, add Shen Jin Cao (Herba Lycopodii), Bai Shao (Radix Paeoniae Alba), Wu Jia Pi (Cortex Acanthopanacis).

Pharmacological and Clinical Research

Yan Hu Suo (Rhizoma Corydalis) is one of the strongest and most potent herbs for treating pain. Its effects are well documented in both historical references and modern research studies. According to classical texts, Yan Hu Suo (Rhizoma Corydalis) has been used to treat chest and hypochondriac pain, epigastric and abdominal pain, hernia pain, amenorrhea or menstrual pain, and pain of the extremities. According to laboratory studies, the extract of Yan Hu Suo (Rhizoma Corydalis) has been found to be effective in both acute and chronic phases of inflammation. The mechanism of its anti-inflammatory effect is attributed to its inhibitory activities on the release of histamine and pro-inflammatory mediators. Furthermore, it has a strong analgesic effect. With adjustment in dosage, the potency of Yan Hu Suo (Rhizoma Corydalis) has been compared to that of morphine. In fact, the analgesic effect of Yan Hu Suo (Rhizoma Corydalis) is so strong and reliable that it showed a satisfactory anesthetic effect in 98 out of 105 patients (93.4%) who underwent surgery. The analgesic effect can be potentiated further with concurrent acupuncture therapy. In one research study, it demonstrated that the analgesic effect is increased significantly with concurrent treatments using Yan Hu Suo (Rhizoma Corydalis) and electro-acupuncture, when compared to a control group, which received electro-acupuncture only. Overall, it is well understood that Yan Hu Suo (Rhizoma Corydalis) has a marked effect to treat pain. Though the maximum analgesic effect of Yan Hu Suo (Rhizoma Corydalis) is not as strong as morphine, it has been determined that the herb is much safer, with significantly fewer side effects, less risk of developing tolerance, and no evidence of physical dependence even with long-term use.

Ge Gen (Radix Puerariae Lobatae) contains many isoflavonoid compounds that have significant analgesic and muscle-relaxant effects. Qiang Huo (Rhizoma et Radix Notopterygii) has an analgesic action, relieving muscle aches and pain. Dang Gui (Radix Angelicae Sinensis) exerts both analgesic and anti-inflammatory effects through the inhibition of pro-inflammatory mediators, including nitric oxide and prostaglandin E2 in peritoneal macrophages. In comparison with acetylsalicylic acid, the anti-inflammatory effect of Dang Gui (Radix Angelicae Sinensis) is approximately 1.1 times stronger, and its analgesic effect is approximately 1.7 times stronger. Lastly, the combination of Bai Shao (Radix Paeoniae Alba) and Gan Cao (Radix et Rhizoma Glycyrrhizae) also provides marked analgesic properties. The effectiveness is increased significantly when combined with acupuncture. Clinically, these two herbs have been used successfully to treat conditions such as pain, neuralgia, trigeminal neuralgia, neck pain, acute back pain, heel pain, pain in the lower back and legs, sciatica, gastric and abdominal pain, and dysmenorrhea.

Qiang Huo (Rhizoma et Radix Notopterygii) exerts its anti-inflammatory effect of reducing swelling and inflammation via inhibition of 5-lipoxygenase and cyclo-oxygenase. Chuan Xiong’s (Rhizoma Chuanxiong) anti-inflammatory mechanism is through inhibition of TNF-α production and TNF-α bioactivity, and shows promising results in the treatment of inflammatory diseases. Wei Ling Xian (Radix et Rhizoma Clematidis) has significant anti-inflammatory properties and works by blocking production of the pro-inflammatory mediators nitric oxide and prostaglandin E(2). Bai Shao (Radix Paeoniae Alba) has an excellent anti-inflammatory effect for treating arthritis by modulating the pro-inflammatory mediators’ production from macrophage-like synoviocytes. Lastly, Gan Cao (Radix et Rhizoma Glycyrrhizae) has demonstrated marked anti-inflammatory action by enhancing the effect of glucocorticoids through increased production and secretion as well as decreasing metabolism of glucocorticoids in the liver. By comparison the anti-inflammatory properties of cortisone to glycyrrhizin and glycyrrhetinic acid, two compounds found in Gan Cao (Radix et Rhizoma Glycyrrhizae), is approximately 10:1. Clinical applications of Gan Cao (Radix et Rhizoma Glycyrrhizae) include pain, inflammation, edema, arthritis, spasms, cramps and more.

Bai Shao (Radix Paeoniae Alba) and Gan Cao (Radix et Rhizoma Glycyrrhizae) are used for their excellent muscle-relaxant effect on both smooth and skeletal muscles, which are common sequelae to injury. Clinically, these two herbs have been used successfully to treat conditions such as leg cramps in the calves, muscle cramps in hemodialysis patients, restless leg syndrome, intestinal spasms, facial spasms and twitching, and menstrual cramps and pain.

Dang Gui (Radix Angelicae Sinensis) is an effective herb to promote generation of bones. According to one study, water extract of Dang Gui (Radix Angelicae Sinensis) was found to contribute to new bone formation and to be effective in the treatment of bone injuries. It directly stimulates the proliferation, alkaline phosphatase activity, protein secretion and particularly type I collagen synthesis of human osteoprecursor cells in a dose-dependent manner.

Wei Ling Xian (Radix et Rhizoma Clematidis) has excellent chondroprotective properites. One study showed that the saponin fraction of Wei Ling Xian (Radix et Rhizoma Clematidis) is effective in ameliorating joint destruction and cartilage erosion in subjects with osteoarthritis. The mechanisms of action for protecting articular cartilage are through prevention of extracellular matrix degradation and chondrocyte injury. Another study demonstrated that the acetone extract of Wei Ling Xian (Radix et Rhizoma Clematidis) had significant and dose-dependent inhibitory effects of the pro-inflammatory and degradative mediators associated with inflammatory arthritis. Wei Ling Xian (Radix et Rhizoma Clematidis) has also been shown to inhibit prostaglandin E(2), metalloproteinase (MMP-3 and -13) and cyclo-oxygenase-2 (COX-2) production by primary human chondrocytes stimulated by lipopolysaccharides. Lastly, Wei Ling Xian (Radix et Rhizoma Clematidis) also showed a beneficial effect on treating osteoarthritis by preventing apoptosis in primary cultured articular chondrocytes induced by adenoviral TNF-related apoptosis inducing ligand.

Comparative Analysis of Herbs vs Prescription Drug

Pain is a basic bodily sensation induced by a noxious stimulus that causes physical discomfort (such as pricking, throbbing, or aching). Pain may be an acute or chronic state. For acute neck and shoulder pain, the two classes of drugs commonly prescribed are non-steroidal anti-inflammatory agents (NSAID) and opioid analgesics. NSAIDs [such as Motrin (ibuprofen) and Voltaren (diclofenac)] are generally used for mild to moderate pain, and are most effective to reduce inflammation and swelling. Though effective, they may cause side effects such as gastric ulcers, duodenal ulcers, gastrointestinal bleeding, tinnitus, blurred vision, dizziness and headache. Furthermore, the newer NSAIDs, also known as COX-2 inhibitors [such as Celebrex (celecoxib)], are associated with significantly higher risk of cardiovascular events, including heart attack and stroke. Opioid analgesics [such as Vicodin (APAP/hydrocodone) and morphine] are usually prescribed for severe to excruciating pain. While they may be the most potent agents for pain, they may also have very serious risks and side effects, including, but not limited to, dizziness, lightheadedness, drowsiness, upset stomach, vomiting, constipation, stomach pain, rash, difficult urination, and respiratory depression resulting in difficulty breathing. Furthermore, long-term use of these drugs leads to tolerance and addiction. In brief, it is important to remember that while drugs offer reliable and potent symptomatic pain relief, they should only be used if and when needed. Frequent use leads to abuse and unnecessary side effects and complications.

Treatment of pain is a sophisticated balance between art and science. Proper treatment of pain requires a careful evaluation of the type of disharmony (excess or deficiency, cold or heat, exterior or interior), characteristics (qi and/or blood stagnation), and location (upper body, lower body, extremities, or internal organs). Optimal treatment requires integrative use of herbs, acupuncture and tui-na therapies. These therapies work synergistically to tonify underlying deficiencies, strengthen the body, and facilitate recovery from chronic or acute pain. TCM pain management targets both symptoms and the underlying cause of pain, and as such, often achieves immediate and long-lasting results. Furthermore, TCM pain management is often associated with few or no side effects.
For treatment of mild to severe pain due to various causes, TCM pain management offers similar treatment effects with significantly fewer side effects.

Cautions & Contraindications

  • Acute neck and shoulder pain, such as in whiplash, may be accompanied by spinal or anatomical injuries. The patient should be checked for structural and anatomical abnormalities if the overall condition does not improve after taking herbal prescriptions for one to two weeks.
  • Most herbs used to treat pain contain blood movers and are contraindicated during pregnancy and nursing.
  • Most herbs used to treat pain move blood, therefore, patients who are on anticoagulant or antiplatelet therapies, such as Coumadin (warfarin), should use these herbs with caution, or not at all, as this may result in a higher risk of bleeding and bruising.

Nutrition

  • Eat plenty of whole grains, seafood, dark green vegetables, and nuts. These foods are rich in vitamin B complex and magnesium, which are essential for nerve health and relaxation of tense muscles.
  • Adequate intake of minerals, such as calcium and potassium, are essential for pain management. Deficiency of these minerals will lead to spasms, cramps, and tense muscles.

Lifestyle Instructions

  • Patients should avoid exposing affected areas to cold or drafts. Scarves, turtlenecks or similar clothing should be worn to protect the neck and avoid exposing the shoulders.
  • Patients with frozen shoulders should be encouraged to exercise their shoulders as much as possible.
  • Patients should also be advised to check their pillow to make sure it is not too high or too low. Mattresses should also be assessed for firmness.
  • Hot baths with Epsom salts help to relax tense muscles and withdraw toxins from the tissues. Rest and relax in the bath for about 30 minutes.
  • Denneroll is a simple pillow-like orthotic device to restore normal curvature of the neck. Patients can be encouraged to do this at home.

We would like to thank all the contributors for submitting their tried-and-true treatment strategies. We hope this article helps you yield better results when treating neck and shoulder pain. Please share this with your colleagues if you find it helpful.

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