Diseases of locomotor system


Acupuncture for cervical spondylopathy
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Introduction
Cervical spondylopathy, also known as cervical vertebral syndrome, is a syndrome due to long-term sprain, osseous hyperplasia, protrusion of intervetebral disc and thickening of ligament that compress the cervical spinal cord, nerve roots and blood circulation. The clinical manifestations are pain in the head, neck, shoulder, arm and chest. This disease pertains to obstructive syndrome in TCM. It is usually caused by invasion of pathogenic wind, cold and dampness into the meridians, blocking the flow of qi and blood; or by asthenia of the liver and kidney as well as insufficiency of qi and blood in the aged, leading to malnutrition of the tendons; or by impairment of the tendons and vessels due to long-term strain.

Syndrome Differentiation
1. Exogenous Wind-cold Attack
Stiffness and pain in the neck or involving the arm and shoulder, cold limbs and numbness of hands, or heaviness sensation, aggravation with wind and cold, accompanied by general aching, thin and white tongue fur, floating and tense pulse.

2. Stagnation of Qi and Blood
Aching, distending pain or prickly pain in the neck, shoulder and arm, or swelling and distension, or pain radiating to the arm, accompanied by dizziness and headache, mental depression, aggravation with nervousness, oppression and pain in the chest, dull tongue, thin and white tongue fur, taut and unsmooth pulse, or deep, thin and unsmooth pulse.

3. Insufficiency of the Liver and Kidney
Slow onset, numbness and vague pain in the neck, shoulder and back, prolonged duration, aggravation with overstrain, accompanied by dizziness, blurred vision, tinnitus, deafness, aching and weakness of loins and knees, weakness of lower limbs, tender tongue with thin fur, deep, thin and weak pulse.

Treatment
1. Body acupuncture
Prescription: Cervical Jiaji (EX-B 2), Fengchi (GB 20), Dazhui (BL 11) and Ashi acupoints.

Modification: For exogenous wind-cold attack: Hegu (LI 4), Waiguan (TE 15), Fengmen (BL 12) and Jianjing (GB 21 ) are added; for stagnation of qi and blood, Hegu (LI 4), Quchi (LI 11), Jianyu (LI 15), Geshu (BL 17) and Yanglingquan (GB 34) are added; for insufficiency of liver and kidney, Ganshu (BL 18), Shenshu (BL 23), Zusanli (ST 36), Xuanzhong (GB 39) and Taichong (LR 3) are added.  
Performance: Reinforcing needling technique is used for the treatment of insufficiency of both the liver and kidney. The rest two syndromes are treated with the reducing needling technique. The acupoints on the neck and back are needled with rotating and twirling manipulations. Moxibustion can be used with the addition of cupping.

2. Ear Acupuncture
Prescription: Neck (AH12), Cervical Vertebra (AH13), Shoulder (SF4, 5), Kidney (CO10) and Ear Shenmen (TF4).

Performance: Each time 2 - 3 acupoints are selected and needled with filiform needles and moderate and strong stimulation. The needles are retained for 20 - 30 minutes. The treatment is given once a day or once every other day. Or Wangbuliuxingzi (Semen Vaccariae) is used for ear point pressing.
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