A 45-year-old woman presented with neck pain that she had been experiencing for 25 years, since being in a car accident. In the accident she had experienced some whiplash, where her car had been rear-ended and her neck was hyperflexed and hyperextended. After the accident she received treatment from both a chiropractor and a physiotherapist, which helped but did not cure her.
She was left with residual pain mostly in the right side of her neck, which when quite severe would radiate into the right side of her head and cause a headache. The headaches would go as far as behind her right eye, and sometimes into both eyes. The neck pain was often dull and achy, and could sometimes be sharp. The headaches she experienced were approximately the same type of pain. Her doctor had diagnosed her with osteoarthritis in her neck, probably around the 3rd and 4th cervical vertebrae, and said that the headaches could be related but may also be considered tension-type headaches.
The patient also complained of some chronic discomfort in her right hypochondriac region, i.e. just below the right side of her rib cage. She claimed to have been experiencing some general distension (i.e. bloating) here for at least 20 years. It usually accompanied a lack of appetite, and some belching as well. The hypochondriac discomfort tended to be worse when she was having her period, at which time she would also tend to experience some mild depression.
Her tongue was fairly pale looking, with some slight redness towards the tip. Her pulse was choppy, especially on the left side.
Diagnosis: Initially a sprain to the patient's neck, which was not treated properly. The patient also exhibited some Liver Blood deficiency, which was probably constitutional in nature, and helped to consequently cause some Qi stagnation in her neck. The sharpness of pain also indicated some occasional Blood stagnation. The headaches were a sign of these same types of stagnation, which seemed to concentrate themselves along the Gall Bladder meridian.
The Liver Blood deficiency could be seen in the patient's hypochondriac pain, as well as her lack of appetite and belching. The Liver Blood deficiency was also apparent in regards to the relationship between the hypochondriac discomfort and her periods, and the accompanying depression. Her tongue and pulse also indicated Liver Blood deficiency.
Treatment Principle: Nourish Blood, soothe the Liver, and move Qi, especially in the patient's neck on the right side.
Acupuncture Points Used: SP 6, ST 36, LR 14, RN 4, LR 8, PC 6, GB 1, GB 8, GB 20
Acupuncture treatments were followed by Tui Na, mostly on the patient's right neck and shoulder. After 2 treatments per week for 3 weeks, she felt free of her headaches, and said that most of the pain in her neck was gone. The hypochondriac discomfort seemed to be gone as well, although she did seem to still be belching. She then continued once a month for treatment, and claimed that her periods were now much easier and she no longer experienced depression with them.
By Richard Lobbenberg, Acupuncturist and TCM Practitioner
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