A great majority of my clients, regardless of what their main complaint is, have neck pain. Why is neck pain so prevalent? What causes neck pain? Western doctors continue to be perplexed by neck pain, thankfully we have the experience of chinese medicine to help guide us. The anatomy of the neck is one of the most complexed areas of the body. We see that there are many muscles running in the neck that connect to many more muscles in the head, shoulders and back. The places that are tight on people with neck pain varies from person to person forming an individual picture for each one. On some people almost all of the muscles can be super tight, even rock hard. In these cases many times the person has frequent headaches or migraines, or vice versa, people with headaches have super tight necks.
In chinese medicine all 6 yang meridians run through the neck as well as the Du and the Ren, the two central meridians that split us down the middle. All 6 of those yang meridians have a yin meridian partner, that if deficient in energy, can often be the reason why the paired yang meridian is causing pain. Even when one pinpoints the trigger points on the neck that appear to be the most active, the pain is often secondary to another underlying cause. All this is to say that finding the reason for someones neck pain can be tricky business. The benefit of the shiatsu style of massage is that even if the masseuse does not have an accurate diagnosis to start off with, if we address all of the meridians on the body and carefully check for kyo and jitsu (deficiency or excess) in the channels and use the bladder meridian as well, then when we arrive at the neck 7 out of 10 people will feel better by carefully releasing each of the muscles on the neck. This can take quite a long time if someone is really bound up and may add up to a whole extra hour to the massage, but with careful attention to detail and much patience and breathing even old injuries 30 or 40 years old can be helped. This is not an easy task and sometimes it can be quite daunting. Working on peoples necks made me believe that there really is something akin to possession. That moment when you get to a really important point on the neck, begin to hold it with pressure and the person starts writhing on the table, breathing and moaning with the eyes rolled back in the head like Linda Blair in the exorcist, and even their breath changes to a putrid smell. This is when we hope we remembered to leave a window open as we keep hold of that point, praying for a release so the demon can leave and the treatment will be over.
Neck pain and headaches frequently go together. We must be careful not to release the stagnated qi in the neck in such a way that the qi rises into the head and thus cause a headache. In some cases the stagnation can be intense and come from the back and the arms. This is why we have to clear the channels that are causing the qi to rise in the neck and stagnate in the first place. However, even if we move the stagnated qi, if we do not address the underlying deficiencies causing the imbalance the treatment may only be effective temporarily or not at all.
Through proper diagnosis we can often help the same problem with much less time and effort. However, some problems no matter how attentive we are and how good the diagnosis is just take time. When we look at balancing the yin and the yang in the body, this is when we have the best chance of ridding the problem altogether. In order to do this with problems in the neck where all the yang meridians flow, we often have to look elsewhere to bring the yin balance. Many times that balance lies in the feet or in the arms, but how do we know where it is? There are many methods of investigation that can lead us to the correct places. We can use observation, questioning, palpation of the body, emotions, and many other methods but most importantly we can palpate the pulse. When one doesn't yet have the pulse diagnosis learned as a tool, we can also turn to palpation of the back shu points on the bladder channel as well as abdominal diagnosis. Here we will discuss further the back shu points.
The back shu points correspond to each of the other channels. In addition when we palpate the trapezius and the latissimus dorsi on the back, we will find that where the knots are, if we look laterally from the knot, to the corresponding back shu point, we can see where there is underlying weakness. By addressing these weaknesses we can balance the excess/deficiency cycle of the yin and yang paired meridians for a longer lasting treatment that sets the body on a path of true healing.
When the imbalance is more excess and little deficiency, the problem can be fixed, or, the painful state can be moved into a painless state with relative ease, especially when the yin is addressed as well as the yang. When deficiency is greater, things take much longer and can disguise themselves as severe excess such as very hard knots. However, the treatment principle is to tonify the deficiency which can take great patience as it takes longer to tonify deficiency, xu in chinese, than to disperse the excess, or shi. In cases of severe xu (deficiency) we can actually do damage by dispersing too much of the muscle knots. If we do this we can contribute more to the deficiency causing more harm than good. In learning to recognize when neck pain comes more from weakness or excess is when we can do the most good.
Things to check for:
Are they wearing a bra?
Over the years I have noticed that nearly every woman that comes in complaining of headaches, shoulder pain, back pain, or neck pain, is wearing a bra and the area surrounding the strap is usually one of the tightest. Until recently I have felt like a weirdo telling women they may consider an alternative to a tight bra. Luckily for me, yet unluckily for the ladies, there have been many facebook posts this year proclaiming studies that correspond bras with back pain and headaches confirming my suspicions. The same goes for purses, backpacks, belts, or straps of any kind.
Guarding around the lungs.
A high percentage of neck pain clients are smokers. The corresponding meridians of the lung and large intestine are painful to palpation, as well as the back shu point bladder 13, corresponding to the lungs. Especially once we get much of the tight knots to loosen up and begin to see what the upper back is really like, we can see that the bl-13 point is very deficient. The points in the neck, large Intestine 17 and 18 are also usually tender. In these cases all of the typical gall bladder points and areas of headache may also be tender. This is because in the 5 element cycle, metal, the element of the lungs and large intestine, is in charge of keeping the element wood, the element for liver and gallbladder, in check. This can make us misguidedly suspect the gall bladder as it too has a large share of responsibility in neck pain clients. Often being the culprit. When the lungs are implicated, the client may also notice an abundance of grief or may start sobbing during point releasing.
Guarding around the heart
A possibility that often goes hand in hand with the the lungs but can be the source of the problem on its own is deficient heart qi. All of that thick ropey blockage under the shoulder blades and around Bl-14 and Bl-15 the pericardium and heart points can mean that we need to give qi to the heart. We can check the heart and pericardium points on the arm, as well as the small intestine and tripple burner points on the back of the arm and on the neck to help us correspond our suspicion. If the person is feeling a lack of joy, any mental confusion, or possibly a blockage in the center of the chest. They may be in need of attention to the heart.
Upper mid-back pain and the liver
When the region between the lower part of the shoulder blades, as well as tightness in the ribs and chest are present we may be dealing with the liver/gallbladder pair. The gall bladder channel has many points on the neck and are often the cause of neck pain and headaches. When someone is having issues in the wood element of the liver/gallbladder they may be irritable or angry frequently and be indecisive.
Mid-back pain and the spleen
When we find pain and tenderness around where the end of the trapezius and the latissimus dorsi cross, around where the last ribs are as we palpate down the spine. We may find that bl-20 and bl-21 are also tender with bl-20 feeling rather deficient. In this case we may also find tightness or tenderness on stomach 12 on the neck as well as under the jaw in the front. In these cases we may find people with occasional TMJ or headaches. We can check the spleen and stomach meridians as well we may consider abdominal massage to further confirm what we are suspecting. If someone has pain from a spleen deficiency, they may be experiencing worry, over-giving, resentment, or insomnia from over thinking.
Low back weakness corresponding to upper back/neck tightness and the kidneys
Many times clients may come in for neck pain, but have been living with lower back pain for so long that they fail to mention it because it didn't occur to them. When we palpate the lower back and our fingers or thumb just fall into the depression between the end of the ribs and the top of the iliac crest on the hip along the bladder channel. We most likely are looking at an underlying weakness of kidney qi. Warming and giving energy to the lower back especially on the point bladder-23 we can help correct this. Also, checking the bladder and kidney meridians as well as the bladder points around the neck, we may come to the conclusion that the kidney qi is what we are looking to balance. Often if the bladder is excess from the kidney yin pair being deficient the entire back along the bladder meridian can be knotted and hard. Low back pain as wel as possibly hip pain, or sciatica pain may also be present.
Of course this is an over simplified description of how to diagnose with the bladder meridian. We offer shiatsu training to any one interested in learning shiatsu or just getting better at the type of massage they do in order to be more effective with their clients. The true purpose of our treatments is to bring balance so people can get through their healing crisis and eventually come to connect their heart to their will (kidney) and find their life path. The 5 element system affords us a way to help with this. While this may sound like a lofty endeavor, while we contemplate the meaning of this, we can still help the neck pain with great success.
Just for fun, I've included a photo of a client that has severe stagnation. After 4 years of taking heavey medication including opiates for constant headaches and migraines, it took tow months of shiatsu, then acupuncture, then gua sha and cupping to get to a pain free state. One of the hardest clients I have ever had. In my opinion, the situation was exaserbated by a tight bra.
One may notice the indentation around her sides from the bra.