Cervical and shoulder syndrome

　　Regarding the main etiology and pathogenesis of cervical and shoulder syndrome, literature reports the following aspects of understanding:
　　(1) Deficiency of Qi and blood, and the camp and defense not being strong enough, allowing wind, cold, and dampness to invade when the body is vulnerable, leading to blockage of Du meridian and obstruction of meridians.
　　(2) Chronic strain, physical weakness, and recurrence of wind, cold, and dampness.
　　(3) Internal deficiency of liver and kidney, external loss of营guard, making the shoulder prone to invasion by wind, cold, and dampness.
　　(4) Local Qi and blood stasis due to blocked meridians and collaterals. These understandings summarize the disease as the original internal Qi and blood or deficiency of the viscera and bowels, leading to weak defense against external pathogens such as wind, cold, and dampness, causing obstruction of Qi flow, deficiency of Qi and blood in the meridians, or Qi stasis locally. However, in clinical practice, how to combine the universality of the above understanding with the particularity of each patient becomes the key to accurate diagnosis and treatment.
　　

　　The complications of cervical and shoulder syndrome include spinal instability, nerve root injury, cervical disc herniation, cervical spondylosis, cervical and shoulder muscle strain, cervical tuberculosis, stiff neck, and spontaneous cervical hemiluxation.

　　1. Spinal Instability: When the stiffness of the spinal segmental movement decreases, it can lead to excessive activity and/or abnormal activity under physiological loads, and it can cause a series of corresponding clinical manifestations and the risk of progressive spinal deformity and nerve damage.

　　2. Nerve Root Injury: A series of diseases caused by nerve injury in related body parts due to factors such as compression, traction, friction, and surgery.

　　3. Cervical Disc Herniation: The cause of cervical spondylosis is mainly due to the degenerative changes of the cervical intervertebral disc, including the prolapse, protrusion, and extrusion of the nucleus pulposus, all indicating different stages of cervical spondylosis. However, in clinical practice, it is common to encounter sudden cervical disc protrusion (extrusion) syndrome, and most cases present with paralysis as the first symptom.

　　4. Cervical Spondylosis: It is a general term for cervical spondylosis, degenerative cervical spondylitis, cervical radiculopathy, and cervical disc herniation, which is a disease based on degenerative pathological changes. It is mainly caused by long-term strain on the cervical spine, bone hyperplasia, or disc herniation, thickening of the ligaments, leading to compression of the cervical spinal cord, nerve roots, or vertebral arteries, and a series of functional disorders.

　　5. Cervical and Shoulder Muscle Strain: This is a condition formed by long-term accumulation, and the treatment of this condition relies not only on medication but also on self-regulation, such as avoiding prolonged neck tilting to keep the neck and shoulders in a tense state, combining work and rest, and doing stretching exercises, etc.

　　6. Cervical tuberculosis: the vast majority of cervical tuberculosis is secondary to the lesions of tuberculosis in the respiratory and digestive systems. It may cause night sweats, low fever, fatigue, sensory disturbance, high fever, difficulty breathing, stiffness of the neck, and short neck.

　　7. Neck stiffness: due to a sudden twist or flash of the head and neck for some reason, the muscles are strongly contracted without preparation or pulled, causing tears in the cervical muscle fibers or ligaments; there are also cases of damage caused by the rapid forward and backward movement of the cervical spine when suddenly braking while riding in a high-speed vehicle; and a few cases are caused by incorrect sleeping positions.

　　The development of neck and shoulder syndrome is roughly divided into three stages: the period of nerve irritation, the period of nerve compression, and the period of nerve compression. Each period has different manifestations, but common symptoms mainly include the following aspects:

　　1. Sensation of tightness in the neck muscles: the patient feels that the muscles around the neck and shoulders are tense, and after a long time, it leads to aching sensation.

　　2. When forcibly moving the neck: the condition of the shoulder and elbow worsens, the patient's soft tissues in the neck, back, and shoulders become tight and painful, and there may be local coldness and numbness. The range of neck movement is limited, there is localized tenderness, and a few patients have intolerable pain and swelling in the neck and shoulders.

　　3. Special abnormal sensations from the shoulder to the tip of the little finger: damage to the lumbar, cervical muscle, and tendons of the hand, accompanied by aching, stiffness, and weakness. The pain in the wrist joint is due to long-term use of the computer, which compresses the nerves in the hand.

　　4. Numbness in the upper limbs: intermittent numbness and tingling in the fingers and palms, some patients have severe numbness in the thumb, index finger, and middle finger. Numbness in the head, neck, shoulders, and arms may occur, and in severe cases, it can lead to weakness and helplessness of the limbs. The sensation of numbness is more common during sleep and upon waking up.

　　5. Some cases may exhibit mild tremors in the upper limbs: due to increased tension in the extensor muscles, the limbs show uniform resistance when actively extending or flexing their joints, which is called lead pipe rigidity. If accompanied by tremors, the resistance has intermittent pauses, known as gear rigidity.

　　6. Pain: After working in front of the computer for a period of time, you may feel pain in the neck and shoulders; there is sometimes a sensation of swelling pain in the palms, wrists, or forearms; when extending the thumb, it is not flexible and there is a feeling of pain, and in severe cases, the fingers and hands become weak and powerless.

　　Nowadays, people's work is becoming more and more busy. Prolonged sedentary work is bound to lead to the occurrence of neck and shoulder syndrome, so we should take early prevention to prevent the occurrence of diseases. The following are some points that need to be paid attention to in daily life:

　　1. Do not use overly soft mattresses to prevent the cervical spine from being in a non-physiological curvature for a long time, and correct inappropriate sleeping positions, adjusting to a reasonable sleeping posture.

　　2. Correct the erroneous view of 'high pillow, no worries'. A person spends at least 1/4 to 1/3 of their life in bed, so it is very important to choose a pillow with strong permeability, conforms to physiological curvature, and has an appropriate height. It is recommended to use a medicine pillow designed according to physiological curvature, which can not only help to restore and maintain physiological curvature, but also bring treatment and health care into the rest time, achieving both treatment and rest without interference.

　　3. Sufficient sleep is essential; only with adequate sleep can neck fatigue be fundamentally eliminated.

　　4. Regularly change the position of the head and neck during work, and perform half a minute to several minutes of activity in the opposite direction, to eliminate fatigue in a timely manner. Regularly look up and far-sight, every time you bow down or work at a desk for a long time, look up and far-sight for several minutes, and massage the head and neck for ten minutes. It is not advisable to read, work, or surf the internet when the neck is too tired, as long-term work in a neck-fatigued state can only lead to more severe neck strain.

　　5. The height of the keyboard and mouse on the computer desk should be slightly lower than the height of your elbow when you are sitting. This can minimize the damage to the lumbar, neck, and hand muscle tendons during computer operation. The display should be slightly lower than the line of sight to ensure smooth blood circulation in the neck, and reduce fatigue caused by tension in the neck and shoulder muscles.

　　6. If your eyes are also tired, it is recommended to do more eye exercises and other eye massages, because eye fatigue can also lead to neck fatigue.

　　7. Master the correct posture for sitting and hand positions. The thighs and waist, and the thighs and calves should maintain a 90-degree bend; the arc of the upper arm and forearm should be kept between 70-135 degrees; the wrist and forearm should form a straight line, avoiding excessive bending and tension of the wrist during work.

　　8. Protect the cervical spine, prevent injury, and do warm-up exercises before labor, exercise, and performance to prevent injury to the cervical spine and other parts.

　　Physical examination

　　Limited neck movement, with significant extension and bending towards the affected side, stiffness in the neck and back, and a decrease in physiological curvature. The tender points are often at the windpool point, spinous process, paravertebral area, and the upper inner angle of the scapula, and they often radiate to distant parts.

　　Auxiliary examination

　　X-ray examination shows changes in the cervical physiological curvature, instability, narrowing of the intervertebral foramen, and hyperplasia of the odontoid joint; electromyography and cerebral blood flow imaging can help with diagnosis and differential diagnosis.

　　Diet is very important for patients with neck and shoulder syndrome, and they should choose food that is delicious and increases appetite, mainly vegetarian, and eat fruits such as apples and grapes after meals. Natural drinks such as juice without any additives are recommended for beverages, and carbonated drinks that can cause stomach acid should be used less. Vegetables and fruits rich in vitamins E, C, A, B, and other nutrients, such as radishes, sprouts, seaweed, onions, kelp, mushrooms, dried fruits (such as chestnuts, walnuts, almonds, sunflower seeds), and strawberries, plums, bananas, as well as tomatoes, oranges, cucumbers containing salicylic acid, should be eaten in moderation.

　　Dietary nutrition for neck and shoulder syndrome should be noted, without avoiding certain foods or having a preference for certain foods. Some foods should be limited, but not avoided.

　　1. It is recommended to reduce the intake of dairy products such as milk and goat milk, peanuts, chocolate, millet, cheese, and sugar, as they can produce mediators such as prostaglandins, leukotrienes, tyrosine kinase autoantibodies, and anti-milk IgE antibodies that can cause allergies and exacerbate, relapse, or worsen arthritis.

　　2. Reduce the intake of fatty meats, high animal fats, and high cholesterol foods, as the ketone bodies, acids, arachidonic acid metabolites, and inflammatory mediators produced can inhibit the function of T lymphocytes, easily causing and exacerbating joint pain, swelling, bone decalcification, and joint destruction.

　　3. Reduce the intake of sweets, as the sugars are easy to cause allergies and can exacerbate the development of joint synovitis, leading to increased joint swelling and pain.

　　4. Reduce alcohol and coffee, tea, and other beverages, and avoid passive smoking as much as possible, as they can all exacerbate the progression of arthritis.

　　5. Eat more animal blood, eggs, fish, shrimp, bean products, potatoes, beef, chicken, and beef tendons, which are rich in histidine, arginine, nucleic acids, and collagen.

　　Cervical and shoulder syndrome has now become a difficult problem困扰ing many people. The conventional methods of Western medicine for the treatment of this disease mainly include manual therapy, medication, traction therapy, and closed therapy, etc. Among them, manual therapy is the most commonly used, with a wide range of application, suitable for any stage of treatment, aiming to improve blood circulation, reduce symptoms, restore function, and promote metabolism. Specifically including:

　　3. Methods to relieve neck pain: Sit or stand, keep the upper body straight, then place the tips of the index, middle, and ring fingers of both hands together on the central line of the neck, and press from top to bottom in turn. Press the fingers forward with force, tilt the head backward, that is, exert relative force. Repeat this 2-3 times, which can quickly eliminate the neck pain and stiffness caused by long-term低头.

　　1. Methods to relieve shoulder stiffness: Stand straight, hang your hands down behind your back, extend your arms straight and interlock your hands, then move your shoulder joints forward and backward, or let your hands hang naturally and rotate your shoulder joints, which can relieve the tension and muscle stiffness of the shoulders.

　　2. Methods to relieve lumbar stiffness: Place one hand on the lower back and the other on the forehead, stand with the lower limbs straight, and tilt the upper body backward. If at home, you can also do the 'Swan Dive': Lie flat on the bed or a flat board, place both hands behind, one hand holding the wrist of the other, then bend both legs upward at the same time, and lift the upper body upward.