Neck Pain: When the Problem Doesn't Stop at the Neck
Neck pain is not always just a pain in the neck. The cervical region is a complex passageway containing the spinal cord, nerve roots, muscles, joints, connective tissues and major blood vessels supplying the brain. A problem in this region can sometimes produce symptoms well beyond the place where pain is actually felt.
That is why an evaluation of neck pain should consider more than simply where it hurts.
The Neck, Shoulder, Arm and Hand Are Connected
Nerves emerging from the cervical spine travel through the shoulder and down the arm toward the hand. When one of these nerve roots becomes irritated or compressed, symptoms may travel along the nerve pathway rather than remaining in the neck. Depending upon the structures involved, symptoms can include:
- Neck or shoulder pain
- Pain extending down an arm
- Tingling or “pins and needles”
- Numbness in the arm, hand or fingers
- Burning or unusual sensations
- Weakness or changes in hand function
This helps explain why someone experiencing tingling or numbness in the fingers may actually have a problem originating in the cervical spine rather than in the hand itself.
Where You Feel the Symptom Isn't Always Where the Problem Begins
Consider someone whose hand is numb. The problem might involve compression of the median nerve at the wrist, as occurs with carpal tunnel syndrome. But similar complaints can also occur when a nerve root is irritated much higher up—in the cervical spine. Likewise, shoulder and arm symptoms may sometimes be connected to the neck even when neck pain isn't the person's primary complaint. This is why simply treating the location of a symptom may not address the complete clinical picture.
Looking for the Pattern
Traditional Chinese Medicine approaches the body as an interconnected system rather than treating every symptom as an isolated event. With more than 50 years of clinical practice, Zhen-Sheng Gao, L.Ac., Dipl. O.M., considers how a patient's symptoms relate to one another.
When evaluating someone with neck pain, he may consider questions such as:
- Where exactly is the pain?
- Does it remain in the neck or travel into the shoulder or arm?
- Which fingers are numb or tingling?
- Does changing the position of the neck alter the symptoms?
- Is movement restricted?
- Did the symptoms begin after an injury?
- Are there headaches, dizziness or other symptoms that require medical evaluation?
These relationships can provide important clues about what may be contributing to a patient's complaint.
The Traditional Chinese Medicine Perspective
In Traditional Chinese Medicine, pain is often described in terms of impaired or obstructed movement of Qi and Blood through the channels and tissues. This is sometimes summarized by the traditional principle that when there is free flow, there is less pain, while obstruction may be associated with pain. This concept of “blockage,” however, should not be confused with the Western medical meaning of a blocked artery or compressed nerve.
Gao combines his Traditional Chinese Medicine assessment with decades of clinical observation to determine an individualized treatment approach. When acupuncture is appropriate, treatment may include points in and around the symptomatic region as well as points elsewhere in the body based upon the patient's presentation. The objective is not simply to put needles where it hurts.