Hi. I have a difficult case of neck pain that I have been treating for the last several weeks (8 sessions). My patient is in his 40's and has had neck pain for many years. About 2 or 3 years ago, he had surgery to fuse C4 to C6 vertabrae and has some metal implants in his neck as a result. He said that the surgery did nothing to help his condition and, in fact, has made things worse. He now gets severe right sided headaches and pain/numbness down his right arm in addition to the neck and upper back pain. He has tried physical therapy, massage therapy, chiropractic, and prolotherapy, and has stated that these have all, in the best cases, done nothing, and, in the worse cases, made his pain worse. This is his second time trying acupuncture. He said he tried acupuncture for 3 sessions before, but the practitioner did some stretching and adjustments to his neck, which made the pain worse. Other than the nexk pain, my patient doesn't appear to be in bad physical health. He does have some digestive/heartburn issues and some anxiety due to work and pain. I have diagnosed him primarily with blood stasis with some liver qi stagnation and stomach heat.
In the 8 sessions of acupuncture, I've tried to be somewhat conservative given that my patient has been adversely affected by overly aggressive treatment. I have done about 6 sessions of local needling in the huatojiaji points of C4, C5, C6 as well as typical neck pain and blood moving points like luo zhen, LI4, SI3, UB60, GB39, UB17. I also needle some ashi points in the upper back/neck area. I do not use electro stim, given the metal he has in his neck region. I've also done tui na, cupping (very light pressure), and gua sha (very light pressure). A couple of times when he was in acute pain with a headache, I tried using more distal points and some Tung's points around LU10, which seemed to work for a few hours, but the pain returned at the same or increased level. It seems at times that he has very mild temporary relief, but overall, his general pain level is about the same and I am at a loss as to whether I can even help him or not given his past surgery and everything else he's tried. He has stated that he wants to give acupuncture at least 10 sessions, so I have about 2 sessions left to make a difference.
Has anyone encountered a similar case and have any insights? Would herbal therapy be helpful?