A 48-year-old patient with a one-year history of severe neck pain accompanied by reflex nausea, vomiting, and dizziness was successfully managed using a Liver and Kidney-warming herbal strategy combined with spinal adjustment.

Case ID: CHC-0062

Case Summary

This case describes a 48-year-old patient who presented with a one-year history of chronic neck pain driven by long-term desk work. Unlike typical cervical spondylosis that merely causes arm numbness, this patient’s structural neck degeneration reflexively triggered severe autonomic nervous system symptoms, including nausea, vomiting, sweating, and dizziness. The original report documented a conventional diagnosis of sympathetic cervical spondylosis and a TCM assessment of Bone Impediment (Gu Bi) driven by Qi Stagnation, Blood Stasis, and Liver/Kidney Insufficiency. The patient was managed through a highly integrative approach utilizing “Zhao’s Balanced Spinal Adjustment” to mechanically relieve the sympathetic nerve irritation, alongside acupuncture, acupoint injections, and a targeted herbal decoction to warm the root and unblock the meridians.

Patient Presentation

• Patient: 48-year-old (Surname: Huang).
• Main Complaint: Stiff and painful neck with restricted movement, accompanied by occasional nausea, vomiting, sweating, dizziness, and poor sleep.
• History: The patient sought consultation on February 3, 2014. One year prior, due to prolonged desk work and fatigue, the patient developed frequent neck pain. Without receiving systematic specialized treatment, the condition progressed. Whenever the patient was tired or worked at a desk, reflex symptoms of nausea, vomiting, and chest tightness would appear. A previous diagnosis at another hospital confirmed sympathetic cervical spondylosis, and cervical traction provided temporary relief. One month ago, the neck pain severely worsened, accompanied by intense nausea, vomiting, and sweating that did not respond to various treatments.
• Physical Exam: The neck was stiff with restricted mobility. Crucially, specific nerve tests—including the brachial plexus tension test, intervertebral foramen compression test (Spurling’s test), and Hoffman’s sign—were all negative (-), ruling out direct nerve root or spinal cord compression.

Examination and Diagnosis

• Imaging (X-ray): Showed disappearance and reversal of the normal cervical physiological curvature (anti-bowing), narrowed C4-C5 and C5-C6 intervertebral spaces, C3-C4 segmental instability, and overall cervical degenerative changes.
• Conventional Diagnosis: Sympathetic cervical spondylosis.
• TCM Tongue and Pulse: The tongue body was pale and dark (舌质淡暗) with a thin, white coating. The pulse was sunken and choppy (脉沉涩).

TCM Assessment

The original practitioner interpreted the presentation as Bone Impediment driven by Qi Stagnation and Blood Stasis, with Liver and Kidney Insufficiency (骨痹 – 气滞血瘀，肝肾不足).

According to the holistic principles of yin and yang Chinese Medicine the Kidneys govern the bones and the Liver governs the sinews. Long-term desk work severely depleted the patient’s foundational Liver and Kidney essence, leading to the structural degeneration (instability and narrowing) of the cervical spine seen on the X-ray.

Because the structural foundation was weak, local Qi and blood stagnated around the neck. This localized stasis trapped the meridians, causing severe pain and stiffness. Furthermore, this deep stagnation disrupted the body’s autonomic Qi mechanics. The trapped turbid Qi rebelled upward (causing dizziness and sweating) and interfered with the Stomach’s natural descent (causing nausea and vomiting). The pale-dark tongue and sunken-choppy pulse provided objective confirmation of this combination of deep foundational deficiency and localized blood stasis.

Treatment Approach

The primary treatment principle was to warm and tonify the Liver and Kidneys, regulate Qi and invigorate blood, unblock impediment and stop pain (温补肝肾，理气活血，通痹止痛). The strategy required a dual approach: manually adjusting the spine to immediately relieve the physical irritation on the sympathetic nerves, while internally warming the body’s essence and aggressively clearing the blood stasis.

Interventions and Herbal Formulas

• Zhao’s Balanced Spinal Adjustment (Manipulative Therapy):
  • Muscle Relaxation: The practitioner first applied a 5-line, 10-point thumb-pressing myofascial release technique, pushing down along the muscle fibers to restore biomechanical balance to the cervical muscles.
  • Spinal Adjustment: With the patient seated, the practitioner applied upward traction from the jaw and occiput. At maximum traction, a slow rotational manipulation (1-2 times) was applied, followed by targeted thumb pressure to realign the deviated spinous processes until the pain points disappeared.
• Acupuncture & Acupoint Injection:
  • Acupuncture: Applied to Dazhui (GV14), Cervical Jiaji points, Baihui (GV20), Shenting (GV24), Yintang (EX-HN3), Fengchi (GB20), and Houxi (SI3).
  • Acupoint Injection: Every two days, 2ml of bone-strengthening solution and Rhodiola injection were administered into the affected Cervical Jiaji points to directly nourish the local tissues.
• Internal Herbal Formula (February 3, 2014): A 13-herb decoction designed to warm the Kidneys, unblock the collaterals, and stop the reflex dizziness and pain.
  • Warming the Kidneys and Boosting Qi: Lu Jiao Shuang (Degelatined Deer Antler, 15g), Rou Gui (Cinnamon Bark, 5g), and Huang Qi (Astragalus, 10g) deeply warmed the Kidney Yang and boosted the central Qi to rebuild the structural foundation.
  • Dispersing Wind and Calming Dizziness: Tian Ma (Gastrodia, 6g) and Gou Teng (Uncaria, 12g) are a classic pairing used specifically to extinguish internal wind, calm the Liver, and immediately stop dizziness and vertigo.
  • Moving Blood and Relieving Spasms: Ge Gen (Pueraria, 12g) specifically directs fluids to the neck to relieve stiffness. Yan Hu Suo (Corydalis, 10g) and Chuan Xiong (Ligusticum, 10g) aggressively move blood to stop pain. Bai Shao (10g) and Mu Gua (Papaya, 10g) soften the tense sinews and relieve muscle spasms.
  • Unblocking Collaterals: Du Huo (10g), Gui Zhi (Cinnamon Twig, 10g), and Xi Xin (Asarum, 3g) warm the meridians and drive out deep-seated cold-dampness.
  • Administration: 3 doses prescribed, water decocted, taken warm twice daily.

Follow-Up

• Three Days Later: The patient’s severe nausea and vomiting were noticeably reduced. Manual therapy was continued to consolidate the effect.
• Outcome: After a total of 5 sessions, the patient’s symptoms were basically resolved. She was instructed to continue functional neck exercises. A two-year follow-up confirmed that she experienced no relapses.

Why This Case Is Interesting (Clinical Reasoning)

The notable feature of this case is addressing the systemic, “mimicking” symptoms of sympathetic cervical spondylosis.

As the original commentary points out, when cervical degeneration, instability, or trauma irritates the nearby sympathetic nervous system, it triggers a cascade of autonomic dysfunctions. This can cause severe headaches, blurry vision, or even “pseudo-angina” (rapid heartbeat and chest pain) and “pseudo-pharyngitis” (a lump in the throat). If a doctor only treats the stomach (for nausea) or the heart (for chest tightness) without checking the neck, the treatment will fail. By correctly identifying the cervical spine as the root trigger, Professor Zhao utilized targeted bone-setting to remove the nerve irritation and Tian Ma / Gou Teng to settle the resulting neurological storm, achieving a rapid cure for what appeared to be a complex systemic illness.

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Source Original source: Zhanjiang Second Hospital of Traditional Chinese Medicine / Guangdong Provincial Administration of Traditional Chinese Medicine Original title: 【以案说医】招仕富：温补肝肾，理气活血，通痹止痛法治疗交感型颈椎病案 Practitioner: Professor Zhao Shifu (招仕富) Publication date: 2024-09-01 Original language: Chinese ChineseHerb.org version: English translation and editorial adaptation