Acupuncture & Myofascial lines for Neck, Back, & Shoulder Pain
Watch the video below to learn why it is important for acupuncturists
to understand myofascial lines.
Master Tung's Points
There are several groups of Tung's points for neck pain and they each work differently. The tai yang meridians can be very effective for neck pain and tend to get to the deeper levels of the neck muscles. Points on the small intestine meridian include 22.08 & 22.09, while points associated with the UB meridian include 77.01 - 77.04.
Points like 22.03 and 22.06 are often used for neck pain, but work on a more superficial level and are highly effective for acute conditions. Other Tung points for neck pain include the Three Weights (77.05, 77.06, 77.07), the 7 Tigers (77.26), and the points on the palm 22.01 & 22.02.
With so many groups of points to choose from, how do you determine which points will give you the best results? What do you do if your first group of points don't work? Do you know when 22.01 - 22.02 should be used instead of 22.03 and 22.06?
Myofascial lines or chains are similar to the meridians.
While 22.03 and 22.06 are often very good for treating acute neck pain, they are often less effective for chronic conditions. We can see from the image how these points are located on what is known as the Superficial Back Arm Line (SBAL).
Taking a myofascial chain perspective we can see how the points 22.08 and 22.09 are on a deeper level and will effect the levator scapulae and rhomboid muscles. With special needle technique and the addition of a third point distal to 22.08, we can have a good effect on bone related spinal conditions like osteoarthritis and bone spurs.
Neck Pain and the Tai Yang and Shao Yang Meridians
The Superficial Back Line (SBL) from Anatomy Trains by Tom Myers, Elsevier Publishing.
In a meridian systems approach to acupuncture such as practiced in the Balance Method and Tung style acupuncture, we begin our diagnosis by determining what meridians are symptomatic.
If neck pain is present at a point like UB 10, we may then select points on either of the tai yang meridians.
For pain at UB 10 we could use points like SI 3 or 22.08 & 22.09, since the small intestine and bladder meridians are both tai yang channels. This is the system one connection in the Balance Method. For pain at UB 10 we could also use points like UB 59, UB 60, or UB 62 as these are classically indicated for neck pain. In the Tung system the points 77.01 - 77.04 could also be used for pain in the UB 10 region. This approach of using the tai yang connections is very useful for many patterns of spinal pain, cervical spondylosis, and sciatica.
When pain is located at GB 20 rather than UB 10, traditional methods would dictate using san jiao points over small intestine points on the hand. For pain at GB 20 a good point prescription is Luo Zhen (22.03), SJ 3 (22.06) and SJ 5 - needled contralaterally. However, in some cases this will not work. As the triple warmer meridian is on the SBAL, points on this meridian will effect the trapezius. However, people may have pain at gallbladder 20 which is due to a deeper level disharmony.
Understanding the Different Levels
While the tai yang and shao yang connections are essential for acupuncturists to understand, it is also important to consider the myofasical levels when treating neck pain.
The image shows the two back arm lines called the Superficial Back Arm Line (SBAL) and the Deep Back Arm Line (DBAL). The SBAL includes the arm flexors, deltoids and trapezius. When we needle points on the hands and arms like 22.03, 22.06 and Triple Warmer 5, it will have an effect on the SBAL and trapezius muscle. This is likely why TW 5 is often used for neck and shoulder pain at GB 20 and GB 21.
Similarly, the SI meridian is on the DBAL and needling points like SI 3, 22.08 and 22.09 will effect the deeper muscles below the trapezius. We can see from the image that the scapularis, rhomboids and levator scapulae are all located on the DBAL.
The SJ and LI meridians are both located on the SBAL and have many similar effects. Consider how LI 4, Ling Gu, SJ 3, 22.06 and SJ 5 are all very effective for headaches and neck pain. Similarly, SJ 6 and 33.04 - 33.06 are indicated for constipation as are LI 4 and 33.01 - 33.03. The similarity in SJ and LI point functions is likely related to both of these meridians being located on the SBAL.
When treating neck pain it is important to consider which meridians are symptomatic, but it is also necessary to determine what muscles have trigger points, and if the vertebrae, discs or bones are involved in the pathology. When the the deeper levels of the muscles are involved, or if there are spinal disorders present, it is often best to focus on the SI meridian (DBAL) and the UB meridian (SBL). This is because points on these channels and myofascial chains will reach the deeper levels.
Myofascial Lines, Tung's Points & Structural Alignment
There are many advantages to learning the myofascial lines and integrating the knowledge with Tung's points. One benefit is that by understanding the myofascial lines you will be able to treat structural conditions. As acupuncturist, accounting for alignment and structure may be something we are not trained in. However, it is a crucial factor that relates to peoples pain.....especially when it is in the neck, shoulders and upper back.
This also relates to why some people get great results with one group of points, while others with a similar pain pattern don't respond to that same group of points.
Let me explain, you may have needled a point group like 22.03 & 22.06 for neck pain and found that it got great results for many people. However, some people don't respond to that point group. Do you know why?
We've spoke about how 22.03 & 22.06 are on the SBAL, while 22.08 & 22.09 are on the DBAL. However, many cases of shoulder and neck pain are rooted in the feet, legs, hips, or low back. Other doctors like physical therapists, chiropractors and osteopaths understand this but many acupuncturist do not.
As acupuncturists we want to get to the root imbalance. So it's important to at least understand some basics about structure, then we can better choose which Master Tung points to needle.
Traditional Point Groups for Pain at GB 20 - GB 21
SJ 3 & SJ 5
7 Tigers - 77.26
HT 5 - HT 7 (Balance Method)
Knowing how myofascial lines relate to structure, alignment, and meridians will help you to make better point selections.
Master the art & Science of Tung's Points for the Neck, Shoulders and Upper Back
With over 14 point groups for treating the neck, back and shoulders it can be challenging knowing what groups of points to use for each patient. You can use the meridian system connections; however, this does not account for structural issues and key anatomical features.
In my 212 level course I cover all the major Master Tung point groups for treating the neck, upper back, and shoulders. This is all discussed in relation to the myofascial lines, anatomy, traditional point uses, meridian systems, and structural issues.
This course includes:
Over 8 hours of video presentations
A 61 page pdf with extensive anatomical illustrations
Integration of TCM with Master Tung's style
Bio-mechanical discussions relating to Master Tung's points
A solid introduction to structural issues of the neck, back, and shoulders
Special Points that work like the 7 Tigers, but are stronger in many cases
Knowledge & growth that will last a lifetime