Leveraging fascial expansions in treating neck pain represents a potent approach that blends modern understandings of fascia, kinetic chain dynamics, and the fundamental tenets of acupuncture or traditional Chinese medicine. In this article, we will explore how fascial planes intersect with acupuncture points GV20, GV16, SI15, TH17, SI10, and LI4. We'll underscore their capacity to markedly improve treatment outcomes for afflictions like whiplash, chronic neck pain, and more. For optimal results, these interventions should be implemented in conjunction with a robust program of soft tissue therapy, osseous adjustments, and a personalized regimen of functional exercises.
Article Index
Fascia
Fascia is often defined as "one interconnected tensional network that adapts its fiber arrangement and density according to local tensional demands." When fascial tension is in good balance, fascia acts to distribute force throughout the body and allows us to store and release energy for propulsion. When fascial tension is out-of-balance, hypertensive, or restricted, fascia can become the source of various dysfunctions including neck pain. (Image from "Functional Atlas of the Human Fascial System", I highly recommend this text by Carla Stecco. Click on Image for link)
Fascia of the Neck - Layer 1
The deep neck fascia's initial layer wraps the neck with a variable thickness. It partitions around the sternocleidomastoid and trapezius muscles, extending medially to unite with the contralateral fascia. It also fuses with the superficial fascia, creating the cervical linea alba. It attaches at several locations, including the lower border of the mandible, mastoid process, superior nuchal line, and the external occipital protuberance, while forming the angular and stylomandibular ligaments. This layer also links to the spine, acromion, clavicle, and sternum, and connects with the fascia of various major muscles.
Fascia of the Neck – Layer 2
The second layer of the deep neck fascia encompasses four muscles: the splenii, levator scapulae, rhomboids, and serratus posterior superior. These muscles are encased by the neck's middle fascia layer, which merges with the serratus anterior muscle's fascia. Consequently, the neck's middle fascia layer forms a continuous structure with the thorax fascia's middle layer, both in the front and back.
Fascia of the Neck – Layer 3
The third layer of the neck's deep fascia, often termed the prevertebral fascia, primarily shields the anterior vertebral muscles and stretches laterally on the anterior, medius, and posterior scalenus. This deep layer also has a posterior part that covers the longissimus and semispinalis muscles. It additionally encompasses the rectus and longus capitis muscles along with the sympathetic nerves.
Acupuncture
Acupuncture points, also known as acupoints or simply points, are specific locations on the body that have been identified in Traditional Chinese Medicine (TCM) as having therapeutic effects when stimulated. These points are found along meridians or channels, which are believed to be pathways of energy flow called "Qi" (pronounced "chi") throughout the body.
According to TCM, stimulating acupuncture points can help restore balance, regulate the flow of Qi, alleviate pain, and promote healing in the body.
Modern research has revealed that acupuncture points often correspond to areas where there is a high density of nerve endings, blood vessels, and lymphatic vessels, as well as increased electrical conductivity. This suggests that the stimulation of acupuncture points may have physiological effects, such as the release of endorphins, neurotransmitters, and other pain-relieving substances, as well as the regulation of blood flow and the immune system.
Acupuncture Techniques
When acupuncturists treat a patient, acupuncture needles are not just inserted; they are rotated and pulled back and forth until the acupuncturist feels a response in the tissue (sometimes called a tug response). When performing acupressure, we do the same thing: stimulate a region to activate the nervous system and release tension in a fascial network of interconnected tissue.
Specific Acupuncture Points
In Traditional Chinese Medicine (TCM), acupuncture points GV20, GV16, SI15, TH17, SI10, and LI4 are frequently used to alleviate neck pain. These points are typically identified using the Chinese measurement unit "cun," employed in acupuncture to pinpoint locations on the body. One cun is approximately the width of the patient's thumb at the knuckle, 1.5 cun matches the combined width of the index and middle fingers, and 3 cun is equivalent to the width of the patient's four fingers when placed together.
GV20 (Baihui):
Located at the top of the head, about seven cun above the posterior hairline. It's midway along the line connecting the ears. Traditionally used to clear the mind, relieve headaches, and treat various mental disorders due to its calming effect on the nervous system.
GV16 (Fengfu):
Positioned at the base of the skull, in the depression directly below the external occipital protuberance. It's midway between the mastoid processes. This point is often used for relieving neck pain, headaches, and certain eye problems.
SI15 (Jianzhongshu):
Found on the upper back, approximately midway between the spine and the scapular tip. It's two cun lateral to the lower border of the seventh cervical vertebra (C7). This point is typically used to treat upper back pain, shoulder tension, and respiratory issues like asthma.
TE17 (Yifeng):
Located just behind the earlobe, in the depression between the mandible and the mastoid process. It's one cun posterior to the midpoint of the intertragic notch. This point is frequently used for ear and jaw problems, including tinnitus, ear infections, and TMJ disorders.
SI10 (Naoshu):
Positioned on the upper back, directly superior to the scapular spine in the depression about one cun superior to the scapular spine when the arm is raised. This point is often used for relieving pain and tension in the shoulders, neck, and upper back.
LI4 (Hegu):
Found on the back of the hand, between the thumb and index finger. It's in the midpoint of the second metacarpal bone, radially towards the thumb. This point is commonly used for relieving headaches, toothaches, and various types of pain, as well as to induce labor in pregnant women.
Fascial Expansion Demonstration
In this video, Dr. Abelson, the Motion Specific Release (MSR) developer, demonstrates using fascial expansions to treat neck pain. He demonstrates how practitioners can combine this knowledge with Traditional Chinese Medicine (Acupuncture/Acupressure). By understanding the interconnected nature of fascial planes and their effect on jaw function, along with the specific acupuncture points and techniques used in TCM, practitioners can effectively alleviate pain and foster healing for patients dealing with neck pain.
Conclusion
In wrapping up, this article ventured into the realm of fascial expansions for alleviating neck pain, intertwining modern fascia insights, kinetic chain dynamics, and acupuncture or traditional Chinese medicine principles. We scrutinized the interplay between fascial planes and acupuncture points GV20, GV16, SI15, TH17, SI10, and LI4, highlighting their potential to enhance treatment outcomes. Suggested adjunctive treatments include soft tissue therapy, osseous adjustments, and tailored functional exercises to provide a well-rounded approach.
We delved into the fascia as a tensional network, pinpointing imbalances that may lead to dysfunction and pain, with a special focus on the neck region and its three distinct fascial layers. The discourse extended to acupuncture, elucidating the physiological mechanisms possibly driving its therapeutic benefits, alongside specific points targeting neck pain relief.
DR. BRIAN ABELSON DC. - The Author
Dr. Abelson's approach in musculoskeletal health care reflects a deep commitment to evidence-based practices and continuous learning. In his work at Kinetic Health in Calgary, Alberta, he focuses on integrating the latest research with a compassionate understanding of each patient's unique needs. As the developer of the Motion Specific Release (MSR) Treatment Systems, he views his role as both a practitioner and an educator, dedicated to sharing knowledge and techniques that can benefit the wider healthcare community. His ongoing efforts in teaching and practice aim to contribute positively to the field of musculoskeletal health, with a constant emphasis on patient-centered care and the collective advancement of treatment methods.
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