bubble_chart Concept

Neck pain refers to the subjective symptom of pain occurring in the neck area. The ancients divided the neck into two parts: the front part is called the neck, and the back part is called the nape. Due to their close connection, they are often mentioned together. For example, Suwen. Gukong Lun states: "Strong wind causing neck pain, puncture Fengfu."

Neck pain and neck stiffness often occur simultaneously, but they are different. Although neck stiffness may be accompanied by pain, it is mainly characterized by stiffness and discomfort in the muscles and tendons of the nape. Although neck pain may also involve stiffness in the nape, it is primarily characterized by pain. For those primarily experiencing neck stiffness, please refer to the entry on "neck stiffness."

bubble_chart Pattern Analysis

1. Wind-dampness in the Exterior︰Its main clinical manifestations are stiffness and pain in the neck, accompanied by aversion to cold with fever, sweating without resolution of fever, headache and heaviness of the head, generalized body pain, white tongue coating, and floating pulse. Neck pain accompanied by stiffness manifests the characteristics of the biao pattern of wind-dampness attacking the exterior, with sweating without resolution of fever, heaviness of the head and body, and normal appearance of the neck. Treatment should focus on wind-dispelling and dampness-overcoming, as well as unblocking the meridians. The formula selected is Notopterygium Overcoming Dampness Decoction with modifications. For neck pain due to wind-dampness complicated by phlegm, treatment should aim to clear heat, dispel wind, resolve phlegm, and unblock the collaterals. The formula selected is Burdock Muscle-Relieving Decoction with modifications.
2. Wind-heat with Phlegm︰It often manifests as neck pain, fever and chills, sore throat, thirst, multiple subcutaneous nodules on the side of the neck that are white, firm, and swollen, or even red, swollen, and ulcerated, a red tongue with yellow coating, and a wiry and rapid pulse. Although both involve neck pain and an exterior pattern, they are not accompanied by neck stiffness. The characteristics resemble a pattern of common cold due to wind and heat, with severe fever and mild aversion to cold, sore throat, thirst, and multiple subcutaneous nodules on the side of the neck that may even become red, swollen, and ulcerated. Therefore, clinical differentiation should focus on three aspects: the presence of neck stiffness, exterior-defense symptoms, and the appearance of the neck.
3. Sprain︰It manifests as unilateral neck pain with a heavy sensation, radiating pain to the back, aggravated by neck movement, and even worsened by deep breathing, coughing, or sneezing. This condition is caused by sudden neck hyperextension, prolonged forward bending, or sudden upward movement of both arms, leading to muscle injury, stagnation of qi and blood, and obstruction of meridians. Tuina therapy is highly effective, and taking relaxing sinew and activating collaterals remedies such as Major Collaterals-Activating Pill is also recommended.
4. Stiff Neck︰Pain in one or both sides of the neck, aggravated by turning, and the pain may radiate to the back or shoulder. You can also take wind-dispersing and collaterals-dredging remedies, such as Pueraria Decoction with modifications.

Sprain and stiff neck have different disease causes, but their clinical manifestations are similar, both presenting with head and neck pain, aggravated pain upon movement, and pain that may radiate to the back or shoulders. The main differentiation lies in the cause of onset.

Neck pain can be seen in various internal and surgical diseases, with the common mechanism of disease being local meridian obstruction. Treatment should focus on "unblocking," with releasing exterior to expel pathogens for those with external pathogens, and resolving phlegm to eliminate dampness for those with phlegm-dampness. Tuina therapy is recommended for neck pain caused by sprain and stiff neck.

bubble_chart Documentation

1. Huangdi Suwen Xuanming Lunfang．"Cold extremities syndrome": "Swelling in the chest and neck, fullness in the chest, abdominal distension and fullness, upper excess and lower deficiency, qi syncope and reversal, excess yang qi, stagnated in the chest, should not be treated with acupuncture or moxibustion, it is advisable to take Shunqi Tang and Xiao Fuling Tang as the main treatment."