Acupuncture Continuing Education

Acupuncture Soothes Neck Pain

Acupuncture relieves neck pain, numbness, and weakness caused by intervertebral disc degeneration.

Researchers demonstrate the efficacy of acupuncture point prescriptions for the treatment of pain, numbness, weakness, and electrical shooting sensations in the neck, upper back, and arms due to cervical spondylosis. This condition is caused by soft tissue and spinal degeneration in the neck, which impacts nerve conduction. The cervical spondylosis induced nerve impingement causes radiculopathy, wherein the nerves fail to function properly. This leads to pain, weakness, electric shooting sensations, or numbness. The researchers find acupuncture safe and effective for the restoration of nerve functioning and subsequent alleviation of symptoms.

 

Neck Jiaji points

 

Acupuncture alleviates radiculopathy due to cervical spondylosis. Guangzhou Haizhu District Ruibaojie Community Health Center researchers (Xiao et al.) conclude that conventional acupuncture and balance method acupuncture produce significant positive patient outcomes for the treatment of radiculopathy due to cervical spondylosis. Radiculopathy occurs in approximately 50% – 60% of cervical spondylosis cases.

Cervical spondylosis is caused by a complex combination of factors and often requires extensive treatment. For this reason, prophylactic measures are preferable. The researchers note that lifestyle plays an important role in prophylaxis including proper posture, keeping the neck warm, regular exercise, and supporting general well-being. The researchers determined that acupuncture is a suitable therapy for cervical spondylosis. Both conventional acupuncture and balance method acupuncture achieved similar clinical results.

Xiao et al. implemented a protocolized investigation on the efficacy of balance acupuncture and conventional acupuncture for the treatment of radiculopathy due to cervical spondylosis. Balance method acupuncture achieved a 93.3% total effective rate and conventional acupuncture therapy achieved a 90% total effective rate. In one measure of effectiveness, the McGill Pain Questionnaire indicated that balance method acupuncture produced slightly better results for the relief of pain.

Let’s take a look at acupuncture point selections and their respective results. At the Healthcare Medicine Institute, we present educational materials and translations of international research on acupuncture and herbal medicine. To take a look at our online courses for CEU and PDA credit, visit our acupuncture continuing education section of the website.

A total of sixty subjects with radiculopathy due to cervical spondylosis participated in the study. They were randomly and equally divided into two groups: balance method treatment group, conventional acupuncture control group. This differs from many prior investigations wherein acupuncture demonstrates positive patient outcomes when evaluated against sham-acupuncture, drug therapy, and non-treatment control groups. In this investigation, the researchers focused primarily on which treatment protocol is most effective rather than simply determining whether or not acupuncture is effective. To learn more about prior investigations, browse the HealthCMi.com newsroom to view articles on the treatment of cervical spondylosis with acupuncture. The primary acupoints selected for the treatment group were the following special points:

  • Jiantong – located 2 cun inferiorly and 1 inch laterally from ST36 (Zusanli)
  • Jingtong – patient makes a half-fist, located in the groove just behind the capitulum ossis metacarpalis of the 4th and 5th metacarpal bones

After standard disinfection, a 0.30 mm x 40 mm disposable filiform needle was perpendicularly inserted into the Jiantong acupoint with a high needle entry speed to a depth of 1 – 1.5 inches. The Xie (attenuation) manipulation technique was applied with pulling, pushing, and rotating movements until a deqi sensation arrived. The needling technique focused on eliciting deqi in the patients that was perceived as an electrical sensation transmitting towards the ankles, back, and toes.

For the Jingtong acupoint, another needle was inserted with a slanted orientation at a 30° angle towards the wrist. Similar to Jiantong, the Xie (attenuation) manipulation technique was applied with pulling, pushing, and rotating movements until a deqi sensation arrived. In this case, elicitation of deqi focused on creating a sensation of soreness on the palm. For both acupoints, the needle was removed immediately after the arrival of deqi. No additional needling retention time was applied.

Patients were requested to move their necks during the application of acupuncture treatments. Sessions were administered three times per week for four weeks. The primary acupoints selected for the conventional acupuncture control group were the following:

  • Dazhui (GV14)
  • Tianzhu (BL10)
  • Jiaji (cervical points)

After standard disinfection, a 0.30 mm x 40 mm disposable filiform needle was inserted into the Dazhui acupoint with a slanted orientation and in an upwards direction to a depth of 0.5 – 1 inches. The Ping Bu Ping Xie (mild reinforcement and attenuation) manipulation technique was applied until the patient felt a sensation transmitting towards the neck, shoulder, and arm on the afflicted side. Next, for Tianzhu, another disposable needle was inserted perpendicularly into the acupoint to a depth of 0.5 – 0.8 inches. The Ping Bu Ping Xie technique was applied until the patient felt a sensation transmitting from the needle entry point towards the neck.

Jiaji acupoints were pierced to a depth of 0.8 – 1.2 inches with a perpendicular needle insertion angle. The Ping Bu Ping Xie technique was applied until the patient felt a needle sensation transmitting towards the neck, shoulder, and arm. Following the arrival of a deqi sensation, a needle retention time of 30 minutes was observed. A 30 minute acupuncture session was conducted three times per week for a total duration of 4 weeks. Subjects were evaluated based on a simplified McGill Pain Questionnaire for physical symptoms and physical activity. For each subject, treatment efficacy was categorized into 1 of 4 tiers:

  • Recovery: No symptoms. Neck movement normal. Daily activity and work not affected. McGill pain score ≥95%.
  • Significantly effective: Symptoms mostly ceased. Slight symptoms only present during weather changes or fatigue. Daily activity not affected. McGill pain score 70% – 94%.
  • Effective: Reduction in symptoms. Greater ease in neck movement. McGill pain score 30% – 69%.
  • Not effective: No improvement or worsening of symptoms and/or neck movement. McGill pain score <30%.

The total treatment effective rates for conventional acupuncture and balance acupuncture were determined by calculating the percentage of subjects who achieved a minimum of an “effective” tier of treatment efficacy. The clinical data finds acupuncture effective for the treatment of radiculopathy due to cervical spondylosis, producing a ≥90% total treatment effective rate. In this study, the balance method outperformed the conventional approach administered in the control group.

In a related study, Ma and Li (Beijing Hospital of the Ministry of Health) reviewed journals published on the CNKI journal database and the Wanfang database. They investigated the principles and characteristics of acupoint selections for the treatment of vertebrarterial cervical spondylosis (CSA). This literature review had the aim of standardizing acupuncture therapy for CSA.

CSA comprises 10% – 15% of all cervical spondylosis cases (Shi, M.X.). Research confirms that acupuncture is effective in mitigating related symptoms including dizziness, headaches, neck stiffness, nausea, blurred vision, tinnitus, and balance problems. In CSA treatments, there are several acupuncture point prescriptions used in Traditional Chinese Medicine (TCM). This prompted Ma & Li’s research to investigate an optimized treatment protocol for treating CSA.

Through their research, Ma & Li conclude that acupuncture effectively alleviates cervical vertigo in CSA through a combination of primary and secondary acupoints. They also found that the most frequently used primary acupoint for CSA is Fengchi (GB20), followed by cervical Jiaji acupoints. The most frequently used secondary acupoint is Zusanli (ST36).

The researchers provide the basis for the acupuncture point selections based on their findings. According to TCM theory, Fengchi (GB20) expels wind, improves eyesight, benefits the brain, and relieves vertigo. Administering warm acupuncture on Fengchi dilates blood vessels, increases blood flow, enhances metabolism, minimizes edema, soothes inflammation, reduces soft tissue pressure on vertebral arteries, and reduces vertebral artery spasms. Using the Yang Ci needling technique on Fengchi significantly increases vertebral artery and basilar artery average blood flow velocity. Administration of cervical Jiaji acupoints significantly improves basilar artery blood flow velocity, increases blood vessel elasticity, and reduces muscular spasm.

Secondary acupoint selections for CSA varies according to the condition of each individual patient. Selection often follows the distal acupoint selection principle. As a general rule of thumb, there are some commonly treated acupoints for certain diagnostic considerations:

  • Weak qi and blood circulation: Zusanli, Qihai, Guanyuan, Zhongwan, Pishu, Xuehai
  • Feng Yang Shang Rao (upward disturbance of wind and yang): Fengchi, Quchi, Hegu, Taichong, Yanglingquan, Dazhui
  • Tan Zhuo Shang Meng (upward disturbance of phlegm): Fenglong, Zhongwan, Pishu, Zusanli, Sanyinjiao
  • Weak liver and kidney: Shenshu, Ganshu, Sanyinjiao, Taixi, Yinlingquan

Zusanli promotes spleen health and qi circulation. Fenglong eliminates phlegm and Taichong soothes the liver and regulates the yang element. Taixi, Ganshu, and Shenshu all nourish the liver and kidneys. Acupoints of the gallbladder Shaoyang meridian demonstrate excellent results in alleviating dizziness and headaches in CSA patients.

Primary acupoints for CSA are mainly located along the head and neck. Secondary acupoints are selected on a symptomatic basis, usually following the distal acupoint selection principle. The Wushu acupoints, Yuan acupoints, collateral acupoints, confluent acupoints, and lower confluent acupoints are all common acupoint groups in CSA treatment.

In a related study, researchers from Xindu District Hospital of Traditional Chinese Medicine (Xie et al.) find acupuncture effective for the treatment of cervical spondylosis. Acupuncture achieved a 95.3% total effective rate. Jijia acupoints of the neck were needled with a long needle technique wherein the needles were directed downwardly. Mild reinforcing and reducing acupuncture techniques were employed in the controlled study.

Considering the scientific data from the two aforementioned studies, it is reasonable to conclude that acupuncture is an effective and validated treatment modality for cervical spondylosis patients. Balance method acupuncture proved effective for the treatment of radiculopathy due to cervical spondylosis as did a more conventional approach to acupuncture. Additional research supports refining the acupuncture point selection to a more limited treatment protocol for the treatment of CSA, potentially optimizing the efficacy of this TCM treatment approach to patient care. Given the prevalence of this disorder in society, additional research is warranted.


References:
Xiao XT, Lai XJ & Zhao BB. (2013). Observations on the Therapeutic Effect of Balance Acupuncture on Cervical Spondylotic Radiculopathy. Shanghai Journal of Acupuncture and Moxibustion. 32(7).

Chai XS, Wu WY’Deng H, et al. Treatment of24 cases of chest pain following lung cancer by balancing acupuncture therapy. J Acupunct Tuina Sci. 2008. 6(6): 363-365.

Ma ZB & Li HY. (2013). Acupoints selection of acupuncture in the treatment of cervical spondylosis of vertebroarterial type (CSA). Chinese Journal of Clinical Healthcare. 16(6).

Shi MX. (1992). Practical Surgery. Beijing: People's Medical Publishing House, p 2104.

Xie XY, Qing S, Liao JK, Xiao Y, Liu JQ. (2013). Clinical Efficacy of Long Needle Penetration Acupuncture on Cervical Spondylotic Radiculopathy: A Clinical Observation of 64 Cases. Guiding Journal of Traditional Chinese Medicine and Pharmacology. 7(7).

Yang JX, Yu JC, Zhang JP et al. (2012). Triple Jiao acupuncture in treating cervical spondylotic radiculopathy. Chinese General Practice. 15(25): 2963-2965.


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