At a Glance
Problem: Persistent neck and upper-back pain after an injury while practicing Brazilian jiu-jitsu. Pain reached 8/10 in the morning, limited neck movement, and repeatedly disrupted sleep.
Treatment: Acupuncture, electroacupuncture, cupping, and soft-tissue treatment focused on the neck and upper spine while also addressing broader muscular tension and recovery.
Key Change: By the third visit, pain had decreased to approximately 3/10 and the patient was sleeping through the night.
Outcome: By the seventh visit, the patient was returning to Brazilian jiu-jitsu and regular training.
Presentation
A Brazilian jiu-jitsu practitioner presented with persistent neck, shoulder, and upper-back pain.
The symptoms began while rolling during a Brazilian jiu-jitsu class and had remained persistent for approximately two months.
Pain was worst in the morning, reaching approximately 8/10.
Turning the head and pressure on the area aggravated the symptoms. Lifting the arms overhead had also become difficult.
Lying down and taking ibuprofen provided some relief, although the patient preferred not to rely on medication regularly.
The pain was severe enough to repeatedly wake the patient during sleep.
The patient trained Brazilian jiu-jitsu up to 5 times per week. They had already seen a physician and were arranging physical therapy.
Examination & Assessment
Palpation found significant muscle tension through the neck and upper back.
The most notable tension and sensitivity were closer to the spine and around the upper back and shoulder blade. The upper trapezius was comparatively less involved.
During Brazilian jiu-jitsu, the neck and upper back can be subjected to significant force as the head and body are pulled, twisted, compressed, or driven into positions that heavily load the neck and upper spine.
This can happen during a guillotine or front-headlock position when the athlete is trying to maintain posture or pull the head back out. It can also happen while being folded or compressed, during a scramble, or while rolling over the neck and shoulder with their own body weight—or an opponent’s weight.
In these situations, the neck muscles may be working hard to resist movement while simultaneously being stretched, twisted, or loaded. If the force comes on quickly or is sustained under pressure, the deeper muscles around the neck and upper spine can become strained or irritated.
In this case, the pattern was consistent with a training-related strain or irritation involving the paraspinal and surrounding neck musculature. The injury was followed by persistent muscle tension and sensitivity that interfered with neck movement, lifting the arms comfortably, and sleeping through the night.
Treatment focused on reducing pain and excessive muscle tension, restoring comfortable movement, and helping the patient return to regular training.
Treatment
Acupuncture was focused on the neck, upper back, and the muscles running alongside the upper spine and shoulder blade. Treatment was adjusted from visit to visit based on where the greatest tension and sensitivity remained.
Electroacupuncture was used through some of the more persistent areas of muscle tension.
Additional acupuncture points were used to reduce overall muscular tension, calm the nervous system, and support recovery from the physical demands of training.
A Theragun was used primarily through the upper back and surrounding back musculature to reduce broader muscular tension from training, daily activity, and the protective tightening that can develop around an injured area.
Cupping was used through the back and upper-back region to further reduce muscle tension and support recovery.
Response
After the first treatment, the patient reported a substantial decrease in pain.
By the third visit, pain had decreased to approximately 3/10, and the patient was sleeping through the night rather than repeatedly waking because of the neck pain.
Range of motion continued to improve over the following visits, although some residual tightness remained.
As the more severe pain settled, the symptoms shifted from persistent pain to intermittent tightness that tended to build with prolonged standing, walking, and physical activity.
By the seventh visit, the patient was returning to Brazilian jiu-jitsu and regular training.
Some clinical details have been generalized to protect patient privacy. Individual results vary.