NECK, SHOULDERS AND UPPER BACK

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NECK, SHOULDERS AND UPPER BACK

Chapter contents

NECK AND SHOULDERS

Stiff neck

Interrogation, Chapter 36

Wind-Damp Painful Obstruction Syndrome

Stiff neck, body aches, a feeling of heaviness of the body.

Liver-Qi stagnation

Stiff neck when tense, tense upper back muscles, hypochondrial or epigastric distension, irritability, moodiness, a feeling of a lump in the throat, premenstrual tension, Wiry pulse.

Liver-Yang rising

Stiff neck, tense upper back muscles, headache, dizziness, tinnitus, irritability, propensity to outbursts of anger, Wiry pulse.

Kidney deficiency

Slightly stiff neck, dizziness, tinnitus, lower backache.

Other symptoms depend on whether there is a Kidney-Yin or Kidney-Yang deficiency.

Invasion of Wind-Cold

Stiff neck with acute onset, aversion to cold, fever, occipital headache, stiff neck, sneezing, body aches, tongue with thin white coating, Floating-Tight pulse.

Liver-Wind

Stiff neck, headaches, tremors, severe dizziness, tinnitus, headache, numbness of the limbs, tics, Stiff, Deviated or Moving tongue, Wiry pulse.

Rigidity of the neck

Observation, Chapter 10

Cold Painful Obstruction Syndrome

Rigidity of the neck with acute onset which may continue for months, neck ache that is aggravated by exposure to cold and damp weather and ameliorated by the application of heat.

Liver-Qi stagnation

Rigidity of the neck which is aggravated by emotional upsets, hypochondrial or epigastric distension, irritability, moodiness, a feeling of a lump in the throat, premenstrual tension, Wiry pulse.

Liver-Yang rising

Rigidity of the neck, headache, dizziness, tinnitus, irritability, propensity to outbursts of anger, Wiry pulse.

Liver-Wind

Rigidity of the neck, stiff neck, tremors, severe dizziness, tinnitus, headache, tics, tremor of limbs, Stiff, Moving or Deviated tongue, Wiry pulse.

Neck pain

Interrogation, Chapter 36

Wind-Damp Painful Obstruction Syndrome

Neck pain, stiff neck, body aches, a feeling of heaviness of the body.

Liver-Qi stagnation

Chronic neck ache, tense upper back muscles, hypochondrial or epigastric distension, irritability, moodiness, a feeling of a lump in the throat, premenstrual tension, Wiry pulse.

Liver-Yang rising

Chronic neck ache, tense upper back muscles, headache, dizziness, tinnitus, irritability, propensity to outbursts of anger, Wiry pulse.

Invasion of Wind

Neck pain, stiff neck, aversion to cold, fever, occipital headache, body aches, Floating pulse.

Other symptoms and signs depend on whether it is Wind-Cold or Wind-Heat.

Liver-Wind

Neck pain, stiff neck, tremors, severe dizziness, tinnitus, headache, numbness of the limbs, tics, Stiff, Deviated or Moving tongue, Wiry pulse.

Soft neck

Observation, Chapter 10

‘Soft neck’ refers not only to a feeling of softness of the neck on palpation but also to a subjective feeling of softness and weakness of the neck, as if the patient found it difficult to keep the head up.

Severe deficiency of Qi and Blood

Soft neck, exhaustion, poor appetite, loose stools, weak voice, tiredness, blurred vision, dizziness, numbness/tingling of limbs, palpitations, dull-pale complexion, Pale tongue, Weak or Choppy pulse.

Kidney-Yang deficiency

Soft neck, lower backache, dizziness, tinnitus, a feeling of cold, weak knees, bright-white complexion, tiredness, abundant clear urination, Pale and wet tongue, Deep-Weak pulse.

Deviated neck

Observation, Chapter 10

‘Deviated neck’ indicates the leaning of the neck to one side.

Kidney-Essence deficiency

Deviated neck, poor constitution, poor bone development in children, softening of the bones in adults, deafness, weakness of the knees and legs, poor memory, loose teeth, falling hair or premature greying of the hair, weakness from sexual activity, lower backache, infertility, sterility, dizziness, tinnitus, normal-coloured tongue and Floating-Empty or Leather pulse if Kidney-Essence deficiency occurs against a background of Kidney-Yin deficiency, or Pale tongue and Deep-Weak pulse if against a background of Kidney-Yang deficiency.

Liver-Qi stagnation

Deviated neck, stiff neck, headache, dizziness, tinnitus, irritability, propensity to outbursts of anger, Wiry pulse.

Wide neck

Observation, Chapter 10

Qi stagnation with Phlegm

Wide neck, a feeling of a lump in the throat, irritability, phlegm in the throat, a feeling of oppression of the chest, abdominal distension, Swollen tongue with sticky coating, Wiry-Slippery pulse.

Phlegm with Blood stasis

Wide neck, a feeling of a lump in the throat, a feeling of oppression of the chest, a feeling of heaviness, dizziness, abdominal pain, chest pain, Purple and Swollen tongue, Wiry-Slippery pulse.

Liver-Fire

Wide neck, headaches, dizziness, tinnitus, irritability, propensity to outbursts of anger, red face, thirst, bitter taste, constipation, dark urine, Red tongue with redder sides and dry yellow coating, Wiry-Rapid pulse.

Thin neck

Observation, Chapter 10

Severe deficiency of Qi and Blood

Thin neck, exhaustion, poor appetite, loose stools, weak voice, tiredness, blurred vision, dizziness, numbness/tingling of limbs, palpitations, dull-pale complexion, Pale tongue, Weak or Choppy pulse.

Chronic Yin deficiency

Thin neck, dizziness, tinnitus, night sweating, dry throat, tongue without coating, Floating-Empty pulse.

Other symptoms and signs depend on the organ involved.

Swollen neck glands

Observation, Chapter 10

Invasion of Wind-Heat with Toxic Heat

Swollen neck glands with acute onset, swollen tonsils, sore throat, aversion to cold, fever, cough, sore throat, stuffed or runny nose with yellow discharge, headache, body aches, slight sweating, slight thirst, tongue slightly Red on the sides in the chest area or on front part, Floating-Rapid pulse.

Toxic Heat with Qi and Yin deficiency

Chronic swelling of neck glands which comes and goes, sore throat that comes and goes, tiredness, breathlessness, weak voice, dry throat, loose stools, night sweating, tongue without coating in the centre, Empty or Floating-Empty pulse.

Residual Damp-Heat with Qi deficiency

Chronic swelling of neck glands which comes and goes, aggravated by periods of overwork and alleviated by periods of rest, chronic sore throat that comes and goes, a feeling of heaviness, muscle ache, tiredness, poor appetite, loose stools, Pale tongue with sticky yellow coating, Soggy pulse.

This condition is very common in postviral fatigue syndrome.

Toxic Heat with Blood stasis

Chronic, swollen neck glands, dark colour on the neck, dark complexion, chest pain, headache, abdominal pain, Purple tongue, Wiry-Rapid or Choppy-Rapid pulse.

Pulsation of the carotid artery

Observation, Chapter 10

‘Pulsation of the carotid artery’ indicates an excessive pulsation of this artery which is clearly visible.

Kidney and Heart-Yang deficiency with Water overflowing to the Heart

Pulsation of the carotid artery, oedema especially of the legs and ankles, a cold feeling in legs and back, fullness and distension of abdomen, soreness of the lower back, a feeling of cold, scanty clear urination, palpitations, breathlessness, vomiting of watery, frothy white fluid, cold hands, Pale and Swollen tongue with a wet white coating, Deep-Wiry or Deep-Fine-Slippery pulse.

Chronic Phlegm in the Lungs

Pulsation of the carotid artery, sputum in the throat, wheezing, breathlessness, inability to lie down, a feeling of oppression of the chest, cough with expectoration of profuse sputum, Swollen tongue with sticky coating, Slippery pulse.

Shoulder ache

Damp-Cold

Ache in the shoulder region that may extend to the scapula region, a feeling of heaviness, numbness, coldness on palpation.

Wind-Cold

Acute pain in the shoulder joint that is aggravated by exposure to cold and application of heat, a feeling of cold.

Stagnation of Qi and stasis of Blood

Pain in the shoulder joint, rigidity of the shoulder, a feeling of distension, Purple tongue.

Frozen shoulder

Cold

Severe pain in the shoulder joint that is aggravated by exposure to cold and alleviated by application of heat, inability to abduct the arm, a feeling of cold.

Damp-Cold

Severe pain in the shoulder joint that is aggravated by exposure to cold and dampness and alleviated by the application of heat, inability to abduct the arm, a feeling of heaviness and numbness of the arm, feeling of cold.

Blood stasis

Severe pain in the shoulder joint that is worse at night, rigidity of the shoulder joint, Purple tongue.

UPPER BACK

Upper backache

Interrogation, Chapter 37

Invasion of Wind-Cold

Upper backache, stiffness of the neck and top of the shoulders, aversion to cold, fever, occipital headache, stiff neck, sneezing, body aches, tongue with thin white coating, Floating-Tight pulse.

Stagnation of Qi and stasis of Blood

Upper backache that may be worse at night, rigidity of the neck, pain relieved by exercise and aggravated by rest, tense muscles, headache, abdominal distension and pain, Purple tongue, Wiry pulse.

Damp-Cold

Severe pain in the upper back that is aggravated by exposure to cold and dampness and alleviated by the application of heat, a feeling of heaviness and numbness of the upper back, a feeling of cold.

Liver-Yang rising

Pain and stiffness of the upper back, stiff neck, tense muscles, headache, dizziness, tinnitus, irritability, propensity to outbursts of anger, Wiry pulse.

Liver-Qi stagnation

Pain and stiffness of the upper back, stiff neck, tense muscles, hypochondrial or epigastric distension, irritability, moodiness, a feeling of lump in the throat, premenstrual tension, Wiry pulse.

Cold upper back

Interrogation, Chapter 37

Invasion of Wind-Cold

A feeling of cold of the upper back, stiff neck and shoulders, aversion to cold, fever, occipital headache, stiff neck, sneezing, body aches, tongue with thin white coating, Floating-Tight pulse.

Yang deficiency

A feeling of cold of the upper back or in general, cold limbs, tiredness, depression, Pale tongue, Deep-Weak pulse.

Hot upper back

Lung-Heat

A feeling of heat of the upper back or in general, cough, slight breathlessness, chest ache, flaring of the nostrils, thirst, red face, Red tongue with yellow coating, Overflowing-Rapid pulse.

Lung-Yin deficiency

A feeling of heat in the upper back that is worse at night, dry cough, weak voice, dry throat with a desire to drink in small sips, hoarse voice, night sweating, tiredness, tongue without coating in the front, Floating-Empty pulse.

Stiffness of the back as if wearing a tight belt

Girdle Vessel pathology

A feeling of stiffness of the back and waist as if wearing a belt which is too tight, backache radiating horizontally to the front or abdominal pain radiating towards the back, a feeling as if sitting in cold water, a feeling of heaviness of the abdomen as if wearing a heavy money-belt (ancient texts describe this symptom as ‘feeling as if wearing a belt with 3000 coins’).

Damp-Heat in the Liver channel

A feeling of stiffness of the back and waist as if wearing a belt which is too tight, a pricking feeling of the skin around the waist, inability to breathe deeply, fullness of the hypochondrium, abdomen or hypogastrium, bitter taste, poor appetite, nausea, a feeling of heaviness of the body, yellow vaginal discharge, mid-cycle bleeding/pain, pain, urinary difficulty, burning on urination, dark urine, Red tongue with redder sides and a sticky-yellow coating, Slippery-Wiry-Rapid pulse.

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