What is back and neck pain?

Back or neck pain is common, with 1 in 3 adults each year suffering with such pain. Acupuncture is widely recognised as an effective solution, so much so that it is one of a handful of therapies recommended by NICE (National Institute for Clinical Excellence), in their guidelines on treatment of back pain issued to GPs.

Acute back or neck pain

Usually starts with either a sprain or cold or wind provoking the pain.

Chronic back or neck pain

Begins simply as long standing tension in the supporting muscle of the neck or back. It may start very subtly and get stronger and stronger – generally worse with stress or tiredness.

The muscles can feel tense and have knotted areas that are particularly tender.

If the tension is held for a long time it can lead to fibrous changes within the muscles, so they lose their ability to fall into a relaxed state, and some of the knotted areas can become permanent fibrous structures that can lead to a hunched posture (generally Spondylosis) or intodegeneration, called osteoarthritis.

Slipped disc or prolapsed/herniated disc

Often, a combination of on-going muscle tension exacerbated by digging, lifting of heavy weights or even coughing! The latter creates pressure within the disc, which can lead to the prolapse/herniation. You will probably have acute pain, perhaps with numbness and definitely weakness.

Sciatic pain

Where pain is referred from the back down the sciatic nerve into the leg.


What causes back and neck pain?

  • Stress
  • A draft: either hot air or cold air
  • Trauma: a fall, heavy lifting, an accident during motion/exercise, etc
  • Bending awkwardly
  • Lifting, carrying, pushing or pulling
  • Slouching: at your desk, or behind the driving wheel
  • Over exercise, or repetitive strain injury

Extra risk factors:

  • Being overweight
  • Smoking
  • Being pregnant
  • Long term use of medications that weaken bones eg. corticosteroids
  • Depression

Conventional treatment for back and neck pain

NICE (National Institute for Clinical Excellence), gives a guideline to doctors to improve the early management of persistent non-specific back pain, which suggests one of the following should be tried before medical intervention:

Physical activity at manageable levels – with a structured exercise programme to improve muscle strength and posture.

Or

Manual therapy – spinal manipulation, mobilisation and massage: chiropractic, osteopaths, manipulative physiotherapists

Or

Acupuncture: up to 10 sessions over a period of 12 weeks

If there is no benefit from one of these then further investigations will be undertaken with an MRI scan or x-ray.  Pain relief may be provided by paracetamol and a NSAID.  In acute cases analgesics and muscle relaxants may be recommended.  In some cases surgery may be required, for example for a very bad slipped disc which will not respond to other treatment.


How do I treat back and neck pain?

Acupuncture for back and neck pain

Is highly effective at pain management. (In China they use acupuncture as the sole anesthetic for operations!  Although I’m not suggesting this... it does demonstrate it’s profound effect on pain control).

Acupuncture both relaxes the muscles, and also clears the pain.

If cold, damp or a draft caused the pain, the acupuncture will be used to “clear Wind”, “clear Damp” or “clear Cold”. If it is more a matter of tension and stress, acupuncture will start to each the build up of pressure and nourish the underlying deficiency.

EFT for pain

EFT is highly effective to resolve pain. This is where points at the beginning or end of acupuncture channels are tapped, while the patient focuses on the pain. The pain will commonly disappear from the beginning to the end of treatment.  It may return, but this just means more tapping is required.  You will be taught the points so you can do this on your own at home too.

Effectiveness?

British Acupuncture Council: Back Pain fact sheet exert:

Research has shown that acupuncture is significantly better than no treatment and at least as good as (if not better than) standard medical care for back pain (Witt 2006; Haake 2007; Cherkin 2009; Sherman 2009a). It appears to be particularly useful as an adjunct to conventional care, for patients with more severe symptoms and for those wishing to avoid analgesic drugs (Sherman 2009a, 2009b; Lewis 2010). It may help back pain in pregnancy (Ee 2008) andwork-related back pain, with fewer work-days lost (Weidenhammer 2007; Sawazaki 2008). Acupuncture has in some meta-analyses been found superior to sham acupuncture (Hopton 2010) while in others the advantage was not statistically significant (Yuan 2008; Ammendolia 2008). The sham interventions are not inactive placebos, but effectively different versions of acupuncture, so their value in evaluating treatment efficacy is highly questionable (Sherman 2009a). (See Table overleaf).

Acupuncture can help back pain by:

  • Providing pain relief - acupuncture leads to release of endorphins ... and changes the processing of pain in the brain and spinal cord (Pomeranz 1987; Zhao 2008).
  • Reducing inflammation - by promoting release of vascular and immunomodulatory factors (Kim 2008, Kavoussi 2007;Zijlstra 2003).
  • Improving muscle stiffness and joint mobility - by increasing local microcirculation (Komori 2009)
  • Reducing the use of medication for back complaints (Thomas 2006).
  • Providing a more cost-effective treatment over a longer period of time (Radcliffe 2006;Witt 2006).
  • Improving the outcome when added to conventional treatments such as rehabilitation exercises (Ammendolia 2008; Yuan 2008).

BBC article: "Acupuncture for low back pain is cost-effective and works". BBC News, September 06

Each case is slightly different, so to discuss your symptoms further call 020 7370 4693 or email.


Case study for back pain

Jessica, 26, lower back pain

Jessica had strong lower back pain. She woke up with it one morning and after 2 months it was getting worse.

I treated locally with acupuncture on her back, around the affected area, and other distal points in her feet. I used a little cupping – where a vacuum is created in a glass cup and it sucks the skin, leaving a red mark. Heat lamps were placed over her back to warm the acupuncture channels. Sometimes we did some tapping.

With each session the pain would diminish – by the seventh session she was completely pain free.


Lifestyle advice for back and neck pain

  • Try putting a hot water bottle on the area or having a hot bath
  • Alternatively place an ice pack on the area
  • With painful neck and shoulders from stress and tension, you will find exercise helps: walking, swimming and yoga are good
  • General levels of good mobility - through stretch or yoga is beneficial
  • Pilates can be of great benefit
  • Change your sleeping position, change your pillow
  • Lose weight if you are over-weight
  • Avoid repetitive actions
  • Don't stand for too long
  • Keep your lower back and neck well protected from drafts
  • Reduce stress levels

Stress reducing tips:

In my experience stress is a big contributor to headaches, so:

  • Get good rest, at least 8 hours a night, the more before midnight the better
  • Take a walk in nature: the countryside or a park
  • Try yoga, Qi Gong or Tai Chi
  • Engage your creativity: painting, playing an instrument, taking pictures, creative writing (start with a journal)
  • Avoid over obsessing about emails, texts and the internet
  • Anything to provide balance to counteract a busy life

Ask yourself, what do I do to relax?  I hope you have an answer!  If so, make time for it.  If not - play and find out.