CLINICAL APPLICATIONS
[
Chronic pain of the neck and
shoulders, including numbness and discomfort
[
Limited movement of the neck and shoulders
due to pain and stiffness
[
Long-term neck and shoulder injuries
with a slow recovery or continuing deterioration
[
Injuries of the neck and shoulder
muscles commonly caused by over-exertion
[
Repetitive stress syndrome of the
neck and shoulders (i.e., prolonged upright sitting position, or working in
front of a computer)
[
Arthritis of the neck
WESTERN THERAPEUTIC ACTIONS
[
Anti-inflammatory effect to reduce inflammation and swelling
[
Analgesic action to alleviate muscle pain
[
Muscle-relaxant effect
to relieve muscle cramps and spasms
[
Nourishes the muscles and the
tendons to speed up recovery
CHINESE THERAPEUTIC ACTIONS
[
Disperses painful obstruction,
strengthens sinews and tendons
[
Disperses residual qi and blood
stagnation in the channels and collaterals
[
Relieves pain and muscle spasms due
to chronic bi zheng (painful obstruction syndrome) of the neck and
shoulders
FORMULA EXPLANATION
As the name implies, Neck Support is designed to treat chronic neck and shoulder pain.
Chronic neck and shoulder problems are characterized by pain, numbness, stiffness, discomfort, limited mobility, slow recovery or continuing
deterioration. Effective treatment must focus on activating qi and blood
circulation, opening the channels and collaterals, and nourishing the muscles
and tendons.
Qiang Huo (Rhizoma et Radix Notopterygii) treats soreness, pain and
numbness in the neck, upper back and shoulders due to wind-damp obstruction.
Sang
Ji Sheng (Herba Taxilli), Chuan Niu Xi (Radix Cyathulae), Sheng
Di Huang (Radix Rehmanniae) and Xu Duan (Radix Dipsaci) are used
together to tonify the Kidney and the Liver, strengthen the tendons, and
alleviate pain, stiffness and soreness of the muscles.
Mu Gua (Fructus
Chaenomelis) and Qin Jiao (Radix Gentianae Macrophyllae) dispel painful
obstruction and cramping, relax the sinews and unblock the channels.
Wu Jia
Pi (Cortex Acanthopanacis) treats painful obstruction due to Liver and
Kidney yin deficiencies.
Yan Hu Suo (Rhizoma Corydalis) invigorates
blood, activates qi and alleviates pain. Tao Ren (Semen Persicae), Hong
Hua (Flos Carthami), Ru Xiang (Gummi Olibanum), Mo Yao
(Myrrha), Chuan Xiong (Rhizoma Ligustici Chuanxiong), and Dang Gui
Wei (Extremitas Radicis Angelicae Sinensis) invigorate blood and remove
residual stasis in the channels and collaterals.
Bai Shao (Radix
Paeoniae Alba) and Ge Gen (Radix Puerariae) contain daisein and
paenoniflorin and have strong antispasmodic effects to alleviate muscle spasm,
cramps and pain.
Aside from its anti-inflammatory effects, Gan Cao
(Radix Glycyrrhizae) harmonizes the formula and alleviates muscle pain and
spasms.
Sheng Di Huang (Radix Rehmanniae) and Di Gu Pi (Cortex
Lycii) tonify yin, clear deficient heat and keep the temperature of this
formula cool.
CLINICAL NOTES
[
Dr. Alex Chen, a master of
traditional Chinese medicine with over 30 years of clinical experience,
formulated Neck Support specifically to relieve pain, reduce inflammation and stop
muscle cramps. Herbs in this formula are routinely used in the trauma
department of hospitals in China.
NUTRITION
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Eat plenty of whole grains,
seafoods, dark green vegetables, and nuts. These foods are rich in vitamin B
complex and magnesium, which are essential for nerve health and relaxation of
tense muscles.
[
Adequate intake of minerals, such as
calcium and potassium, are essential for pain management. Deficiency of these
minerals will lead to spasms, cramps, and tense muscles.
LIFESTYLE INSTRUCTIONS
[
Patients should avoid exposing
affected areas to cold temperatures or drafts. Adequate clothing such as
turtlenecks should be worn to cover the neck and shoulder areas.
[
Patients with frozen shoulders
should be encouraged to exercise the shoulders as much as possible. Increase
the range of motion for the shoulder will help to prevent adhesions of the
tendons and ligaments.
[
Patients should also be advised to
check their pillow height to make sure it is not too high or too low.
Mattresses should also be assessed for firmness.
[
Hot baths with Epsom salts help to
relax tense muscles and withdraw toxins from the tissues. Rest and relax in the
bath for about 30 minutes.
CAUTIONS
[
Chronic neck and shoulder pain may
be accompanied by spinal or anatomical injuries. The patient should be checked
for structural and anatomical abnormalities, especially if the overall
condition does not improve after two to three weeks of herbal treatment.
[
Patients who are on anticoagulant or
antiplatelet therapies, such as Coumadin (Warfarin), should use this formula
with caution as there may be a slightly higher risk of bleeding and bruising.
MODERN RESEARCH
Neck Support contains
herbs with strong analgesic, anti-inflammatory and muscle-relaxant functions.
Yan Hu Suo (Rhizoma Corydalis), containing corydaline, exerts strong
anti-inflammatory activity and is effective in both the acute and chronic
phases of inflammation. It
also possesses strong analgesic components that act directly on the central
nervous system. Because of
this action, Yan Hu Suo (Rhizoma Corydalis) works synergistically with
acupuncture to relieve pain. It was demonstrated in one study that when
combined with Yan Hu Suo (Rhizoma Corydalis), the analgesic effect of
electro-acupuncture increased significantly when compared with the control
group, that received electro-acupuncture only.
In addition, Bai Shao (Radix
Paeoniae Alba) and Ge Gen (Radix Puerariae) contain daisein and
paenoniflorin, which have strong antispasmodic effects to alleviate muscle
spasms and cramps. Lastly,
to specifically address the chronic nature of neck and shoulder injuries, many
herbs are added in this formula to strengthen the muscles and tendons and speed
up the overall recovery process.
PHARMACEUTICAL DRUGS & CHINESE MEDICINE: A
COMPARATIVE ANALYSIS
Western Medical Approach: Pain is a basic bodily sensation induced by a noxious
stimulus that causes physical discomfort (as pricking, throbbing, or aching).
Pain may be of acute or chronic state, and may be of nociceptive, neuropathic,
or psychogenic type. For acute pain, use of non-steroidal anti-inflammatory
agents (NSAID) and opioid analgesics offer immediate and reliable effects to
relieve pain. Though these drugs have serious side effects, short-term use can
be justified because the benefits often outweigh the risks. For chronic pain,
on the other hand, use of NSAID’s and opioid analgesics are usually not the
desired treatment options, as they symptomatically relieve pain, but do not
change the underlying course of illness. Unfortunately, the convenience of
these drugs contributes to the vicious cycle of pain, followed by continuous
and repetitive use of drugs to symptomatically relieve pain. When the effect of
the drugs dissipates, patients are often left with nothing but more pain and
more complications from side effects. Therefore, it is important to understand
that while these drugs may be beneficial for acute pain, they do not adequately
address most cases of chronic pain. Additional treatment modalities must be
incorporated to ensure effective and complete recovery from chronic pain
conditions. [Note: Common side effects of NSAID’s include gastric ulcer, duodenal
ulcer, gastrointestinal bleeding, tinnitus, blurred vision, dizziness and
headache. Serious side effects of newer NSAID’s, also known as Cox-2 inhibitors
[such as Celebrex (Celecoxib)], include significantly higher risk of
cardiovascular events, including heart attack and stroke. Side effects of
opioid analgesics [such as Vicodin (APAP/Hydrocodone) and morphine] include dizziness,
lightheadedness, drowsiness, upset stomach, vomiting, constipation, stomach
pain, rash, difficult urination, and respiratory depression resulting in
difficult breathing. Furthermore, long-term use of these drugs leads to
tolerance and addiction.]
Traditional Chinese Medicine
Approach: Treatment of chronic pain is a
sophisticated balance of art and science. Proper treatment of pain requires a
careful evaluation of the type of disharmony (excess or deficiency, cold or
heat, exterior or interior), characteristics (qi and/or blood stagnations), and
locations (upper body, lower body, extremities, or internal organs). Furthermore,
optimal treatment requires integrative use of herbs, acupuncture and Tui-Na
therapies. All these therapies work together to tonify underlying deficiencies,
strengthen the body, and facilitate recovery from chronic pain. TCM pain
management targets both the symptoms and causes of pain, and as such, often
achieves immediate and long-term success. Furthermore, TCM pain management is
often associated with few or no side effects.
Summation: For treatment of mild to severe pain due to various
causes, TCM pain management offers similar treatment effects with significantly
fewer side effects. Though TCM therapies may not be as potent as drugs for
acute pain management, they are often superior [better effects with fewer side
effects] for chronic pain management.
CASE STUDIES
A 46-year-old female presented with
left sided pain which originated at the C2 to C7 cervical region followed by a
tingling sensation on the lateral side of the left forearm and hand. The
practitioner had treated the patient for several years for the same condition.
Initially, the pain was only isolated around the neck region with slight
radiation towards the middle and lower trapezium. The patient was subsequently
diagnosed with hypothyroidism accompanied by intermittent pain, which appeared
usually after a couple of days. Administration of the Neck Support formula had provided the patient
with great relief as well as making the recurrence less severe and not as
abrupt. Consequently, she was able to discontinue taking Motrin (Ibuprofen).
The practitioner concluded that Neck
Support was an excellent formula for degenerative disc disease.
C.H., San Jose, California
A 44-year-old female, who works as
an accountant’s assistant, presented with tightness to her neck and shoulders.
She also complained of stress, depression and had a history of multiple
surgeries. Her western diagnosis was spinal stenosis. Her TCM practitioner
diagnosed her condition as bi zheng (painful obstruction syndrome) of
the neck and shoulders. Prior to taking Neck Support, the practitioner prescribed Ge Gen (Radix
Puerariae) with little result. Neck Support was the only herbal formula to which the patient responded
to favorably.
D.M.,
Raton, New Mexico
A 22-year-old female presented with
pain, tightness and tension in her neck, shoulders and upper back regions. The
patient had been living with the condition for about the last 6 years.
Initially her problems were due to stress; however, a severe car accident about
2½ years ago made the pain worse and constant. Symptoms exacerbated if under
stress or when sick (sinus and head congestion). The pain on the right side of
her back and neck was worse than her left. In particular, a point in her upper
back where energy had been blocked since the car accident appeared quite weak.
She had sought treatments from various physicians, chiropractors, physical
therapists and massage therapists, which included shiatsu. Some of the
treatments provided temporary relief but none had long-lasting effects. The
patient was also taking birth control pills, zinc, echinacea, vitamin C, and
Claritin (Loratadin). Additionally, she was given antibiotics for her sinus
infection, Prevacid (Lansoprazole) for acid reflux, and a nasal spray
prescription for her allergies. Her history and clinical picture directed the
practitioner to diagnose the condition as qi and blood stagnation with bi
zheng (painful obstruction syndrome) due to damp-cold. She was treated with
acupuncture and began taking Neck Support. The patient’s neck muscles gradually became unconstrained
over a period of 3 ½ months.
J.M.,
Baltimore, Maryland
A 40-year-old female presented with
neck tension and pain. There was decreased range of motion in her cervical
spine but all reflexes and DTR’s were within normal limits bilaterally. Upon
taking Neck
Support, the patient immediately noticed a diminished stiffness in
her trapezius region.
G.P.,
Lawndale, California
A 47-year-old female presented with
localized pinpoint pain situated 3 cun lateral to Shendao (GV 11)
within the region of Shentang (BL 44). The patient also complained of
insomnia, poor night vision, dry, itchy and flaky skin patches, ridged nails
and clumps of falling hair. Her menstruation was regular at 28-days with no
clots. Her tongue had teeth marks, a crack in the middle jiao and a
white tongue coat. Her pulse was thin, wiry and rapid but slippery in the Spleen
position. The western diagnosis of her condition was reflex sympathetic
dystrophy syndrome. The TCM diagnosis was qi and blood stagnation, Liver blood
deficiency, and Kidney/Liver yin deficiency. After taking Neck Support, her qi and
blood stagnation subsided and her pain intensity decreased, as evident upon
deep palpation. Her tongue cracks in the Spleen area also dwindled in size.
Additionally, the patient reported improvement in sleep patterns because of
pain relief.
M.D.P.,
Estes Park, Colorado
A male presented with pain and
decreased range of motion in the right shoulder. There was pain upon palpation
of the Large Intestine and Small Intestine channels. The practitioner diagnosed
the condition as bi zheng (painful obstruction syndrome) due to
stagnation of qi and blood. The patient was instructed to take Neck Support. Acupuncture treatments using Dr. Tan’s Balance Method and Tui
Na massage using Dr. Alex Chen’s techniques were also applied. After six
acupuncture and herbal treatments, he regained full shoulder range of motion
and no pain. After the pain was completely resolved, the practitioner switched
the prescription to Neck Support
at 3 capsules per day intended for maintenance care. Upon recurrence of pain,
the patient was instructed to increase the dosage, which in turn resolved the
pain sensation.
K.S., Encinitas, California
A 50-year-old retired male presented
with severe neck and shoulder pain and stiffness, which is worse at night and
disturbs sleep. The western diagnosis included degenerative disk disease at C5
to C7. The diagnosis was blood stagnation, bi zheng (painful obstruction
syndrome), and deficiencies of Spleen yang and Kidney jing (essence).
The patient was instructed to take Neck Support (6
capsules three times daily). Upon
return, the patient commented that Neck Support was effective for relieving pain. In fact, it was the only
treatment that clearly helped. The patient remained under the care of an
acupuncturist and a chiropractor, and continued to take the herbs.
J.B., Camarillo, California
A 41-year-old female housewife
presented with neck and shoulder pain and occipital headaches. Severe muscle
spasms bilateral to C4 to C7 were found as well as neck and shoulder tightness.
The patient also reported anxiety and insomnia due to pain and depression. Her
pulse was wiry and her tongue was purple. Past histories include eight
surgeries to correct her condition. The practitioner diagnosed the presentation
as blood and qi stagnation. After taking Neck Support, a reduction in the severity of her neck and shoulder pain
was noted. The patient also came to the realization that she was now less
affected by damp and cold weather conditions. The practitioner also observed an
improvement in the patient’s neck range of motion.
Anonymous
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