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
[ 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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