A sore neck and sore shoulders-these are demons that seem to inevitably plague office workers.

Generally speaking, modern people don't exercise enough, and their shoulder and neck muscles tend to be weak and unable to support the weight of their bones. As a result there is excessive pressure on the joints between the cervical vertebrae, causing pain. Moreover, when a person becomes tense then the shoulders will also tense up, and the muscles are stuck in a contracted position for a long period. They lose flexibility, contributing to shoulder and neck pain.

In addition, improper posture when using a computer or looking at a screen can lead to problems with various parts of the body. For example, the habit of resting one's elbows on the desktop or on the arms of one's chair can lead to pressure on the ulnar nerve. People who customarily talk on the phone with the receiver pinned between shoulder and jaw put the nerves of the cervical vertebrae under pressure. Long periods of sitting down but without keeping the back propped against the back of the chair can lead to accumulated stress on the lower back.

A number of therapies, including tuina ("manipulative therapy"), massage, and chiropractic all claim to be able to alleviate the shoulder and neck pain and muscular fatigue suffered by modern people who exercise too little and have poor posture.

Shawn Lin, chief of the physiotherapy department at National Taiwan University Hospital, says that the approach of Western medicine is to find the organ or tissue in which a problem is located and then to treat the problem area. Treatment can be done with a variety of techniques, from massage and exercise to ultrasound and hydrotherapy.

Shawn Lin says that physical therapy has been used in Taiwan for about 30 years, but has become quite widely known among the general public only in the last decade. In the days before physiotherapy was generally accepted, it was very normal for people to seek out a "bonesetter" or tuina therapist in Chinese martial arts studios. He believes that many bonesetters are skilled, but he has also heard stories of people being injured in such treatment, and there is too large a gray area in popular tuina. "Five years ago, 80% of my patients would have first consulted a freelance tuina therapist before coming to the department of rehabilitative medicine. These days the number is down to about 50%," he says.

Chinese medicine, in contrast to Western medicine, emphasizes keeping the meridians open to a smooth flow of qi and bodily fluids. In most cases heat and tuina massage are applied to promote increased circulation of bodily fluids and relaxation of muscles. Chen Chao-jung, a trauma specialist at the Taipei Municipal Hospital of Traditional Chinese Medicine points out that acupuncture can stimulate certain acupuncture points and effectively relieve pain. If the injury is recent, both tuina massage and medicated plasters can bring alleviation.

Both Western and Chinese medicine state that neck or shoulder pain or muscular discomfort can be relieved through heat or massage. But many people who complete their therapy are right back at the doctor's office again a few days or weeks later, or even become dependent on Western or Chinese medicine or tuina for an extended period. If one does not correct one's long-term posture problems, and does not get any exercise or strengthen one's muscles, then the relapse rate for neck and back pain is extremely high.

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(photo by Hsueh Chi-kuang)