Proper, analytical case history of the patients is the key factor for successful treatment. It is essential to know certain basic facts, such as the location and the condition of the pain, whether it is acute or chronic, the duration of the pain and whether it is due to an accident or a fall. Sometimes, pain can be even due to an infection or increase in weight.

Examination:
A physician must analyze the patient's movements of the neck on both sides, movement of upper limbs, stiffness in both pair of limbs and upper neck, etc. This will give an indication of the extent and location of the pain.

Treatment:

Depending on where the pain is, whether chronic or not, the conditions of the muscles, their flexibility, etc. the treatment needs to be planned. Some of the treatments are suggested below:

a) Acupuncture is very useful in relieving back pain. In this, needles of various sizes are used to relax the muscles. For young children, laser acupuncture, which is painless, is used.

b) Sometimes, the muscles can be relaxed by injecting local anaesthesia like xylocaine (1%). However, this should be adopted only in acute cases. This technique is known as Neural Therapy.

c) Soft massage with specific ayurvedic oil (slightly heated) can greatly relax the muscle and thereby reduce the pain.

d) Careful repositioning by chiropractic can go a long way. However, repositioning should strictly be done under expert guidance only. This technique is also known as Osteopathy.

e) Ozone therapy, wherein ozone is injected.


In very acute cases, when the patient is not in a position to move the neck, and the shoulder muscles are very stiff and painful, adopting a combination of acupuncture, hot oil massage, injection of local anaesthesia and ozone therapy can be of great help. After a day or two, when the muscles have relaxed, repositioning should be done in a very gentle and mild way. Such repositioning will not have any side effects at all, whereas, improper repositioning could lead to complications later on.

The number of sittings a patient has to undergo depends on the extent of the pain and his response to the treatment. Subsequently, as follow-up, a patient is advised to apply suitable, warm ayurvedic oil, with mild massage daily or twice a week