Chinese medicine attributes this condition to an attack of Wind and Cold which enter the channels during sleep. Alternatively, the normal movement of Qi and Blood is disturbed and the muscle channels are strained when the sleeper assumes an awkward position. Treatment centers on those channels which traverse the neck.中醫認為這種情況是因為睡眠時風寒入經所致。另外，當睡眠者採取不正確的姿勢時，氣血的正常運動就會受到干擾，肌肉經絡也會受到拉傷。治療集中在那些穿過頸部的經絡。

Needling

First Set of the Acupuncture Treatment

Principal points 主穴:

M-UE-24 (Luozhen 落枕穴), point(s) of pain 痛點.

M-UE-24 (Luozhen)落枕穴

Approximately 0.5 unit proximal to and between the metacarpophalangeal joints of the 2nd and 3rd metacarpal bones on the back of the hand. 手背第二掌骨和第三掌骨的掌指關節之間近端約 0.5 寸。

Supplementary points 補充穴位:

SI-3 (Houxi 後溪), GB-39 (Xuanzhong 懸鐘).

GB-39 (Xuanzhong) 懸鐘

On the outside of the calf, three units above the tip of the lateral malleolus, in the depression on the front edge of the fibula. Or it is located in the depression between the posterior edge of the fibula and the peroneus longus and brevis muscles. 小腿外側部，外踝尖上三寸，腓骨前緣凹陷處。或定于腓骨後緣與腓骨長、短肌之間凹陷處。
One of the eight meeting points: marrow meeting. 八會穴之一：髓會。
Acupuncture 0.5 to 1 unit straight. Moxibustion with moxa stick lasts for 3 to 5 minutes, and warm moxibustion with moxa stick lasts for 10 to 15 minutes.
直刺0.5～1寸。艾炷灸3～5壯，艾條溫灸10～15分鐘。

【Efficacy 功效】Relieves gallbladder fire, clears marrow heat, and relaxes tendons and meridians. 泄膽火、清髓熱、舒筋脈。

Modern: Stiff neck, migraine, lymphadenitis, foot varus.
現代：落枕、偏頭痛、淋巴結核、足內翻。

Classical symptoms: abdominal fullness, heat in the stomach, lack of appetite for food, inability to sweat due to fever, stranguria, sore throat, patellar pain, aching joints, wind disease and heavy body, stroke, paralysis of the hands and feet, stiff neck, and athlete’s foot.
古典：腹滿、胃中有熱、不嗜食，熱病汗不出，五淋，喉痹，髀樞痛、諸節酸折、風勞身重，中風手足不遂、頸項強、腳氣。

Method:

First needle M-UE-24 (Luozhen) with moderate to strong stimulation. At the same time, ask the patient to exercise his neck by moving it around If the pain is unabated, needle the points of pain. Use the supplementary points in rotation. Moxibustion may be applied to warm the needles at points of tenderness. Cups may be applied after needling. Electro-acupuncture may be used at points on the limbs.
方法：先針落枕穴，中度至強刺激。同時讓患者活動一下頸部，如果疼痛不減輕，則針刺痛點。輪流使用補充穴位。可以用艾灸來溫暖壓痛點的針。針刺後可以使用拔罐。可以在四肢的穴位上使用電針。

Second Set of the Acupuncture Treatment

(1) Acupoint selection 取穴

Commonly used points 常用穴: Xuanzhong 懸鐘, Yanglao 養老, Houxi 後溪.

Alternative points 備用穴: Neiguan 內關, Waiguan外關, Zhongzhu中渚, Yanglingquan 陽陵泉.

(2) Treatment Method 治法

Mainly use commonly used acupoints, and only take one acupoint at a time. If the effect is not good, use additional or alternative acupoints.
以常用穴為主，每次僅取一穴，效欠佳時，加用或改用備用穴。

At the Xuanzhong point, insert needle straightly 1.5 to 1.8 units deep, use strong or medium stimulation, and leave the needle for 15 to 20 minutes after gaining qi;
懸鐘穴，直刺1.5～1.8寸深，用強或中等刺激，得氣後留針15～20分鐘；

At Yanglao point, acupuncture 1.5 units upward with the needle tip, so that the needle sensation can be transmitted to the shoulder;
養老穴，針尖向上斜刺1.5寸，使針感傳至肩部；

Houxi, insert needle straightly 0.5 to 0.8 units straight, twist and operate the needle for 1 to 3 minutes after gaining qi, and also add electroacupuncture stimulation, frequency 40 to 50 times/min, continuous wave.
後溪，直刺0.5～0.8寸，得氣後捻轉運針1～3分鐘，亦可加電針刺激，頻率40～50次/分，連續波。

Use conventional acupuncture methods on the alternative points, and needle deeply to ensure a strong sensation of Qi. When acupuncture is performed on any of the above acupoints, the patient must be required to actively move the neck in a gradually increasing range. The needle is left in place for 15 minutes, once a day.
備用穴，用常規針法，深刺，務求得氣感強烈。在上述任一穴位針刺時，均須要求患者主動活動頸部，範圍由小漸大。留針均為15分鐘，每日1次。

(3) Efficacy evaluation 療效評價

A total of 624 cases were treated with the above method, and all were cured in 1 to 3 times, with the total recovery rate reaching 100% (4 to 8).
以上法共治624例，結果均在1～3次治癒，總痊癒率達100％(4～8)。

Head Acupuncture

About Head Acupuncture

Motor Area 運動區

A line starting from a point 0.5 cm posterior to midpoint of midline and stretching diagonally across the head to a point at the intersection of the zygomatic arch (superior margin) with the hairline at the temple. 中線中點後0.5公分處起，沿對角線穿過頭部，至顴弓（上緣）與太陽穴髮際線交點處的一條線。

Sensory Area感覺區

A line parallel and 1.5 cm. posterior to the Motor line. 感覺區：與運動線平行且位於運動線後 1.5 公分的線。

Lower limb, head and trunk area 下肢、頭部和軀幹區域

Location: Upper fifth of Sensory area line. 感覺區線的上五分之一。

Indications: Low back pain (opposite side), numbness or paresthesia in that area, occipital headache, stiff neck, vertigo 主治：腰痛（對側）、此部位麻木或感覺異常、枕部頭痛、頸部僵硬、眩暈

Cutaneous acupuncture and cupping皮針和拔罐

First Set of the Treatment

Tap along the affected area until there is slight bleeding, then apply cups.
Alternatively, cutaneous acupuncture may be used independent of cupping at the following points沿著患處輕拍至輕微出血，再使用拔罐。或者，在以下部位也可以獨立於拔罐而使用皮針：

Principal points 主穴:

BL-11 (Dazhu), BL-12 (Fengmen), DU-14(Dazhui), DU-16(Fengfu), GB-21 (Jianjing), SI-14(Jianwaishu), and the vertebral points M-BW-35 (Jiaji) from the 1st to the 4th cervical vertebra. 大杼、風門、大椎、風府、肩井、肩外俞以及夾脊第1頸椎到第4頸椎。

BL-11 (Dazhu)大杼

1.5 units lateral to the lower end of the spinous process of the 1st thoracic vertebra.距第一胸椎棘突下端 1.5 寸。

Needling method: Slanted insertion toward the spine, 0. 7-1 unit. Sensation: loca1 distension, soreness and numbness sometimes extending between the ribs. 進針法：向柱斜刺，0.7-1寸。感覺：局部脹痛、酸痛、麻木，有時會延伸到肋骨之間。

GB-21 (Jianjing)肩井

Midway between DU-14 (Dazhui) and the acromion of the shoulder. 大椎與肩峰之間的中點.

Indications: Hemiplegia due to stroke, mastitis, functional uterine bleeding, scrofula, pain in the back of the shoulder. 主治：中風半身不遂、乳房炎、功能性子宮出血、瘰癧、肩背疼痛。
Traditional indications: Vertigo, stiff neck, cough caused by rebellious Qi, aphasia due to apoplexy, breast abscess, difficult labor, scrofula 傳統主治：眩暈，落枕，逆氣咳嗽，中風失語，乳癰，難產，瘰癧。

Needling method: Straight insertion, 0.5-1 unit Sensation: distension and soreness extending to shoulder region. CAUTION: Care should be taken not to insert needle too deeply, to avoid puncturing the lung. 針法：直刺，0.5-1單寸。 感覺：脹痛，延伸至肩膀。注意：應注意不要將針插入太深，以免刺穿肺部。

SI-14(Jianwaishu)肩外俞

3 units lateral to the bottom of the spinous process of the 1 st thoracic vertebra. 第一胸椎棘突底部外開3寸。

Indications: Soreness and pain of the back of the shoulder. 主治：肩背酸痛。

Method: Slanted insertion, 0.5-1 unit. 方式：斜插，0.5-1寸。

M-BW-35 (Jiaji)夾脊

Altogether 48 points distributed on both sides of each of the 24 cervical, thoracic and lumbar vertebrae, 0.5-1 unit lateral to the median line of the spine, at the lower end of the spinous process of each vertebra. 頸、胸、腰24塊椎骨兩側，脊椎正中線旁0.5～1寸，各椎骨棘突下端，共48個穴位。

Needling method進針方法:
(1) Straight insertion, for needling the nerve root, pointed slightly toward the spine, 1.5 units deep for the cervical and thoracic points, 2.5 units deep for the lumbar points. Sensation: local distension and soreness, or an electric, numb sensation extending to the limbs and between the ribs. 直刺，針刺神經根，略向脊柱方向，頸、胸穴深1.5寸，腰穴深2.5寸。感覺：局部脹痛，或有電擊麻木感，延伸至四肢及肋骨間。

(2) Slanted insertion for arthritis of the vertebral joints, pointed into the interspinal ligament, 1-1.5 units; or transverse insertion, joining to another vertebral point below, 2-3 units. Sensation: distension and soreness extending around the point.椎關節關節炎斜插，尖入椎間韌帶，1-1.5寸；或橫向插入，連接到下面的另一個椎點，2-3寸。感覺：穴位周圍有脹痛感。

Supplementary points補助穴:

GB-20 (Fengchi), BL-64 (Jinggu), SI-3 (Houxi), TB-10 (Tianjing). 風池、京骨、後溪、天井。

BL-64 (Jinggu)京骨

In the depression on the lateral side of the tuberosity of the 5th metatarsus.

Needling method進針方法:
Slanted insertion pointed downward and medially, 0.5-1 unit Sensation: local distension and soreness.向下方和內側斜刺，0.5-1寸。 感覺：局部膨脹和酸痛。
Source point of the Bladder channel. 膀胱經的原穴。

Indications適應症:
Headache, stiff neck, myocarditis, meningitis, seizures, pain of the lower back and leg. 頭痛、頸部僵硬、心肌炎、腦膜炎、癲癇、腰腿痛。

TB-10 (Tianjing)天井

With the elbow flexed, this point can be found approximately 1 unit above the olecranon of the elbow in a slight depression. 手肘屈曲時，在手肘尺骨鷹嘴上約一寸處，稍凹陷處即可找到此穴。

Indications適應症:
Diseases of the soft tissues of the elbow, migraine headache, tonsillitis, urticaria, scrofula (use moxibustion).
手肘軟組織疾病，偏頭痛，扁桃體炎，蕁麻疹，瘰癧（艾灸）。

Traditional indications 傳統適應症:
Pain in neck, shoulder and back; pain in the eyes, headache, deafness, throat blockage; tidal fevers, insanity.
頸部、肩部和背部疼痛；眼睛疼痛、頭痛、耳聾、喉嚨阻塞；潮熱，精神錯亂。

Needling method針刺法:
Straight insertion, 0.5-1 unit Sensation: local distension and soreness.
直刺，0.5-1寸。 感覺：局部脹痛。

Uniting point of the Triple Burner channel.三焦經合穴。

Second Set of the Cupping Treatment

(1) Acupoint selection 取穴

Commonly used points: Ashi point (the most obvious point for neck tenderness).
常用穴：阿是穴(頸部壓痛最顯處)。

Alternate points: Fengmen, Jianjing.
備用穴：風門、肩井。

(2)Method 治法

At the Ashi point, rub it hard for a while. After routine disinfection, prick it quickly 3 to 5 places with a three-edged needle, or tap it moderately with a skin needle. The tapping area can be equivalent to the diameter of a cup. Then, use a cup of appropriate caliber to suck and pull out.
阿是穴，用力揉按片刻，常規消毒後，以三棱針快速點刺3～5下，或用皮膚針中等度叩打，叩打面積，可相當於罐具口徑。然後，選用適當口徑之罐具吸拔。

You can select 1 to 2 alternative points. After acupuncture to get Qi, leave the needle and then cup the needle. The suction and extraction time is 10 to 15 minutes. After removing the cup, you can use moxa roll circular moxibustion on Ashi point for 5 to 7 minutes. Once a day, not counting treatment sessions.
備用穴可取1～2個，針刺得氣後，留針，再于針上拔罐。吸拔時間均為10～15分鐘。起罐後，可在阿是穴用艾捲回旋灸5～7分鐘。每日1次，不計療程。

(3) Efficacy evaluation 療效評價

A total of 260 cases were treated with the above methods, and all were cured within 1 to 3 treatments. The total recovery rate was 100% (1 to 3).
以上法共治260例，均在1～3次內治癒，其總痊癒率為100％(1～3)。

Injection therapy穴位注射:

Inject a 25% magnesium sulphate solution combined with 2% procaine hydrochloride into the point( s) of tenderness and affected muscle.
將 25% 硫酸鎂溶液與 2% 鹽酸普魯卡因混合注射到壓痛點和受影響的肌肉中。

Air injection空氣注射：
Point M-UE-24 (Luozhen) on the affected side.
患側落枕穴

PS. Traditional Chinese medicine treatments such as acupoint injection and air injection therapy are not allowed in BC.備註: 穴位注射和空氣注射療法的中醫治療不允許在 BC 省進行。

Ear acupuncture耳針:

Points: Neck, Cervical Vertebrae 穴位：頸部、頸椎
Method: Use strong stimulation, retaining needles for 10-20 minutes.
方法：採用強刺激，留針10-20分鐘。

Hand Acupuncture
Point Neck
Method: Use strong stimulation, retaining needle 3-5 minutes.

Neck on Hand Acupuncture 手針療法的頸部點

Location: At the ulnar margin of 2nd metacarpophalangeal joint on dorsum of hand. 位置：手背第二掌指關節尺側緣處。

Indications: Stiff or sprained neck 適應症：頸部僵硬或扭傷

About Hand and Foot Acupuncture

Foot acupuncture
Point #23
Method: Same as hand acupuncture above
Other prescriptions

1. Immobile, severely painful neck: SI-1 (Shaoze 少澤), SI-2 (Qiangu), SI-3 (Houxi), SI-5 (Yanggu),
   GB-12 (Wangu), B-60 (Kunlun), H-3 (Shaohai), B-2 (Zanzhu). (Source: TDP)
2. Stiff neck: B-64(Jinggu), B-11 (Dazhu), B-37 (Pohu), GB-21 (Jianjing), TB-16(Tianyou), SI3 (Houxi), B-1 0 (Tianzhu). Sore neck that radiates into the back and shoulder: TB-1 0 (Tianjing).
   (Source: CNLAM)
3. Stiff neck: Co-24 (Chengjiang), Gv-16 (Fengfu), SI-3 (Houxi). (Source: OM)
   Remarks

• The effect of acupuncture therapy is enhanced by the use of manipulation and hot packs after needling.

Note: The above text is in English and is from “Acupuncture, A Comprehensive Text, Shanghai College of Traditional Medicine translated and edited by John O’Connor and Dan Bensky, 1981”

Reference:

1. 針灸學，新世紀第四版，主編梁繁榮，王華，2016.8
2. 落枕