Neck Pain: Erase It in 10 Min 90% Success Rate. A Magic Wand Making Me Speechless

• "However chronic a disorder may be, there is a way to treat. Those who say 'incurable' simply lacked the skills" (疾虽久，犹可毕也。言不可治者，未得其术也) -- Chinese medicine classic Huangdi Neijing (100-200 BC).

As a health care clinician or a scientific researcher, do you know anything about the Chinese medicine classic Huangdi Neijing which was compiled around 200 BC?

Is There A Magic Wand?

If you have a chance to read this medical classic, you will immediately notice that there are many astonishing statements in it which could make today's clinicians or scientists speechless. Here just cite a few:

"[With acupuncture,] the therapeutic effect should happen like the wind blows away cloud (效之信，若风之吹云)...

"Those who are skilled in using needles will cure an illness easily like plucking out a thorn from the skin, brushing away a dirt, untying a knot, or unclogging a blocked drain (夫善用针者，取其疾也，犹拔刺也，犹雪污也，犹解结也，犹决闭也).

As an acupuncturist, I was speechless when I first time encountered such "overstatement" claims.

When A Neck Pain Patient Came to See You

Neck pain (NP) is one of the most common musculoskeletal disorders, having an age-standardised prevalence rate of 27.0 per 1000 population in 2019 (Somaye Kazeminasab et al, 2022).

Unfortunately, "Neck pain is an extremely common condition that can be difficult to deal with ... so difficult to cope with because there is an abundance of information available at our fingertips, but how do we know if our sources are reliable?" Says Dr Terry Crowder, an American veteran chiropractor from Mckinney Chiropratic. Yes, Dr Crowder is right. Neck pain for us clinicians is tough.

Neck Pain Is Tough

In 2014, a literature review on the efficacy of various treatments of non-specific neck pain (NP) was published in Manipulative Physical Therapy. From the results of 41 randomly controlled trials (RCTs), the review concluded (Roland Bryans et al, 2014) :

• Spinal Manipulation Therapy (SMT): For chronic NP, SMT is not strongly recommended unless used in combination with exercise, massage, stretching, advice, laser therapy, soft tissue therapy, short wave diathermy. For acute NP, SMT is similarly not strongly recommended unless used in combination with advice and exercise.

• Manual therapy: For chronic NP, manual therapy is not recommended unless used in combination with advice, stretching, and exercise.

• Home exercise: For acute NP, home exercise is not recommended unless in combination with advice or training, and for chronic NP, unless with infrared radiation, massage, or other physical therapies.

• Home stretching: Not recommended unless in combination with advice and training.

• Home strengthening & Endurance exercises: Not recommended unless combined with advice, training and supervision.

• Laser: No sufficient evidence that supports a recommendation.

• Massage: No benefit unless combined with self-care, stretching, and/or exercise for chronic NP.

• Transcutaneous nerve stimulation: No sufficient evidence that supports a recommendation.

• Traction: No sufficient evidence that supports a recommendation.

• Trigger point therapy: No sufficient evidence that supports a recommendation.

A 2015 Cochrane Review on manipulation and mobilisation for neck pain by Anita Gross et al (2015) concluded:

• Although support can be found for use of thoracic manipulation versus control for neck pain, function and QoL, results for cervical manipulation and mobilisation versus control are few and diverse. Publication bias cannot be ruled out. Research designed to protect against various biases is needed.

In short, no single technique has been proved to be impressively effective for neck pain with strong evidence or strong confidence. Everything is in uncertainty.

Exercise for Neck Pain: How Much It Work?

In this 21 century, our modern medicine offers no clinically important help for our neck pain patients which may include our parents, siblings, or kids... At one time, requesting patients to do exercise was believed to have benefit for neck pain. Based on the research data up to 2000, an Evidence-Based Guidelines published in Physical Therapy (John Albright, et al, 2001) concluded: For neck pain, exercises were the only intervention with clinically important benefit relative to a control.

Unfortunately, the story changed 15 years later. In 2015, a Cochrane review based on updated data nullified the 2001 Guideline. This review included 27 trials up to May 2014 with 2,485 participants. It concluded:

• For acute neck pain only, no evidence was found.

• For chronic neck pain, "No high quality evidence was found, indicating that there is still uncertainty about the effectiveness of exercise for neck pain" (Anita Gross et al, 2015) .

Patient Education

In modern medicine, among a plethora of unproved anectodal modalities, patient education is another commonly used trick for neck disorders. In 2009, the Spinal Journal published a Cochrane Review on patient education for neck pain, which concluded:

• This review has not shown effectiveness for educational interventions for neck pain of various acuity stages and disorder types and at various follow-up periods, including advice to activate, advice on stress coping skills, and neck school (Ted Haines et al, 2009).

Exercise Homework Actually Work? Patients' Voice

Sometime in 2016, an anonymous patient posted on reddit.com talking about how he or she deals with the homework given by a physiotherapist:

• Every time I have had physio, I have been told something like "you need to do these exercises twice a day for the next 30 days". I nod and agree but I know I will do these exercises once a day for the next one day and then get lazy.

• And when I go back to the physio after 30 days with barely no improvement but I will tell them that it's feeling a little better so they increase the amount of exercises I won't do.

• Giving people homework is not an effective treatment method. But there is no quick fix for a lot of conditions that require physio.

Neck, Head, Trap Pain in Ancient Doctor's Hand

While for a veteran clinician today who is specialized in musculoskeletal disorders, "Neck pain is an extremely common condition that can be difficult to deal with" (Terry Crowder, 2023), a general physician in China millennia ago would say otherwise (Suwen 62 in Huangdi Neijing):

• For pain at back of head, posterior neck or upper traps, needle small toe close to nail root, pain will go away instantly; if not, insert three needles at the area under lateral malleolus, pain will go away within the time for a meal; always prick opposite side of the pain (...头项肩痛，刺足小指爪甲上，与肉交者各一痏，立已，不已，刺外踝下三痏，左取右，右取左，如食顷已).

Speechless. My dear readers.

Ancient Stock-in-Trade, Today's Magic Wand

The ancient acupuncture 2000 years ago in China, if you have learned the "secrets", must be a magic wand in the eyes of today's healthcare practitioners. But for the physicians in that era, it was their stock-in-trade, nothing astonishing, nothing to be shocked speechless.

The therapeutic effect of this ancient healing art is not only immediate but also highly reliable, consistent and predicable for all the disorders with symptoms of any abnormal sensations including pain which is the most commonly seen symptom.

Yes, there is no mistake, for all diseases with symptoms that your brain can perceive (a hint for all musculoskeletal clinicians: muscle/bone/joints can not feel anything without CNS and PNS).

No Patients Have The Same Neck Pain

In terms of neck pain, it can be differentiated into countless types depending on where the pain is localized. No patients have the same neck pain. Right?

Is the pain located between vertebra bodies (disk herniation issues), that is, cervical joint C1/C2, C2/C3, …. or C7/T1? Or between transverse processes or between spinous processes? Even for levator scapulae pain, the pain can be located at the origin, the insertion, the upper body, the middle body and the lower body of it. For SCM, pain can be found at upper, middle, or lower portion of it... The pain can also happen at front of neck...The possibilities of the locations of the neck pain is countless, countless and countless (the same apply to any other disorders not limited to neck pain).

When Neck Pain Is at Cervical Facet Joints

For example, if a neck pain is located at or around cervical facet joints at C5/C6, theorized from the basic principle of Neijing acupuncture, there are countless locations on the body that can be needled to produce a remedial effect, more or less. Among these therapeutic locations, I found that there are at least 10 locations which can produce a miracle effect instantly for C5/C6 neck pain relief with at least 90% success rate.

Among these 10 magic locations, the most convenient one for needle insertion is at the medial-posterior side of the lower 1/4 to 1/3 of tibia bone. In this area of the tibia bone, you can identify a pea-sized spot on the bone which is tender when pressed (suppose the patient complained pain only at the spot on or around C5/C6 facet joints). If the neck pain happened on all of the 7 cervical facet joints, you may find 7 tender spots on the medial side of the lower half of tibia bone (on one side or both side).

The intensity of the tenderness of the spots when pressed is roughly proportional to the severity of the neck pain at the corresponding cervical facet joints.

Be A Sharpshooter

Upon your insertion of one or a few needles on or surrounding such tender spots (you must hit the bone), with 3 – 5 seconds and at least 90% certainty, your patient while rotating his or her neck as you instructed, will feel puzzled: Are you a magician? More amazingly, if the patients also complained shooting pain or numbness on the arm and hands, those symptoms will also subside instantly.

Note usually the instantly relieved pain will come back at a lower intensity in hours or a few days or weeks, depending on how severe or how chronic the initial condition is. The permanent cure of a mild to moderately-severe neck pain at only one or two cervical joints usually needs 2- 6 treatments at 1-2 sessions per week.

If Pain Moves

Often the patient may tell you the pain moved to a different location, for example go one facet up or down, or go to spinous process, .... But no matter where the pain goes, you can always identify a corresponding tender spot somewhere surrounding the lower medial leg, once pricked, will take away or relieve the new pain instantly.

If the initial pain does not go away completely by the first needle, you can add a needle at a tender spot on the opposite lower leg. If after the second needling some pain still remains, you may add further another needle at a tender spot on the opposite small finger. If still some pain remains, go to the same side pinky. There are at least 10 ..."spare tires" for you to use. Keep going this way, you can erase the neck pain completely in 10 minutes.

Remember always identify the tender spot before needling. This is the key to get maximum and consistent effectiveness.

Change the Game: No More Shot in The Dark

In modern medicine particularly in musculoskeletal field, we have so many "uncertainty" but no "confidence". All we can do is just "shot in the dark then pray". Even a simple pain at neck which can plague every one – both patients and clinicians.

No wonder in 2018, the British Journal of Sports Medicine published an editorial titled: "Is it time to reframe how we care for people with non-traumatic musculoskeletal pain?" The editorial loudly voiced:

• "Current Approach to Musculoskeletal Pain Is Failing …

The leading author of the editorial is Professor Jeremy Lewis, who is also a consultant physiotherapist working in the UK-NHS.

With a magic wand which makes us speechless, we can change the game, we can change the status-quo world of medicine.

No more shot in the dark then pray.

References

Anita Gross et al, Manipulation and mobilisation for neck pain contrasted against an inactive control or another active treatment. Cochrane Review 23 September 2015

Anita Gross et al, Exercises for mechanical neck disorders, Cochrane Review 2015

Jeremy Lewis , Peter O'Sullivan, Is it time to reframe how we care for people with non-traumatic musculoskeletal pain? Br J Sports Med 2018 Dec; 52(24):1543-1544

John Albright et al, Philadelphia Panel Evidence-Based Clinical Practice Guidelines on Selected Rehabilitation Interventions for Neck Pain. Physical Therapy, 2001

Somaye Kazeminasab et al, Neck pain: global epidemiology, trends and risk factors. BMC Musculoskelet Disord. 2022; 23: 26

Roland Bryans et al, Evidence-based guidelines for the chiropractic treatment of adults with neck pain, Manipulative Physiol Ther. 2014 Jan;37(1):42-63

Ted Haines MD, Msc et al, A Cochrane review of patient education for neck pain. The Spine Journal Volume 9, Issue 10, October 2009, Pages 859-871

Terry Crowders, Sorting Out Neck Pain Facts from Fiction: Top 3 Myths & Facts. https://mckinneychiropractor.org/neck-pain-facts-fiction-3-myths-facts/ (Accessed on Apr 12, 2023)

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