Fallen pillow (stiff neck) mostly due to improper pillow height, poor posture or overwork caused by neck muscles, ligaments and joints strain, resulting in spasm of the neck muscles, muscle incoordination, or sleep, wind, cold and damp, resulting in neck meridians and channels, qi and blood running poorly caused by the clinical manifestations of the cervical neck in the morning, neck straightening, activity is limited. Mostly in young adults, occupation-related, more men than women, winter and spring. Belongs to the Chinese medicine “pillow wind”, “lost pillow” category. Pathogenesis and pathology Chinese medicine believes that the pillow is often due to neck tendon frustration, stagnation of blood stasis, not through the pain, or the body of the liver and kidney deficiency, tendon and bone weakness, poor qi and blood operation, coupled with nighttime sleep, neck and shoulder exposure, feel the wind and cold, qi and blood paralysis, meridians and collaterals can not be blocked, thus resulting in this disease. Modern medicine believes that the occurrence of pillow fall with the patient sleeping in poor posture, pillow is too high, too hard, too low, etc., excessive head deflection, so that the neck muscles are pulled for a long time, in a state of tension and static injury, manifested as spasm of the cervical muscles or some fiber bundles of the tear, or caused by the distribution of the parasympathetic nerves in sternocleidomastoid muscle, trapezius muscle traction injuries, prolonged tension or muscle spasm will sometimes cause the light joints of the cervical joints. Prolonged stretching or muscle spasm may cause mild dislocation of the cervical articular synchondrosis and the corresponding clinical manifestations. Clinical manifestations and diagnosis The disease starts suddenly, mostly after waking up in the morning, the pain and discomfort in the back of the neck and the upper back, mostly on one side, or on both sides, or on one side, or one side is heavy, one side is light, and the pain may radiate to the back of the shoulder. Accompanied by limited neck movement, the head can not freely rotate the back of the head, often with the upper body when turning the head to rotate the waist to compensate for the rotational movement of the neck. In severe cases, the flexion and extension movements of the neck are also limited, the neck is toned, and the head is tilted to the affected side. On examination, the cervical muscles are spasmodic, palpable as strips, with extensive tenderness, and pressure points are often palpable in the mastoid process, the inner-superior angle of the scapula, the supraspinatus fossa, and the infraspinatus fossa. The course of the disease is relatively short, mostly within a week, X-ray examination often has no characteristic image, part of the performance of the cervical spine physiological curvature straightening. The falling pillow needs to be differentiated from cervical spondylosis. Treatment For those with qi stagnation and blood stasis, the treatment is to activate blood circulation, remove blood stasis and open the channels, and the formula is to add subtractions to Body Pain and Blood Stasis Soup. For wind-cold invasion, the treatment is to dispel wind and cold, activate blood circulation and relieve pain, and the formula is to add subtractions to Fangfengxionggui Tang. For deficiency of liver and kidney, the treatment should benefit the liver and kidney, replenish qi and blood, and dispel wind-dampness, and the formula is Duhuo Shengsheng Tang with additions and subtractions. Acupuncture and moxibustion should be applied to the acupoints of Da Lian, Jing Bone, Kun Lun, Shoulder Outer Yu, Hou Xi and Feng Chi. External treatment is based on the principle of dispelling wind and dispersing cold, and relieving pain by relaxing the tendons and activating the collaterals, which can be treated with corresponding traditional Chinese medicines such as ointment, application and hot compress. Anti-inflammatory and analgesic drugs, such as anti-inflammatory pain tablets and Futalin tablets, can be used as appropriate. At the same time, physiotherapy, massage and massage can be used. Prevention and management Prevent neck trauma, use suitable pillows, maintain correct sleeping posture, and pay attention to preventing cold and keeping warm. Prognosis and regression The disease is self-healing and can be cured after one week. After active treatment can shorten the course of the disease. Frequent occurrences, often the neck muscles strain, cervical vertebrae degenerative changes, prone to cervical spondylosis, repeated pillow fall is often a precursor of cervical spondylosis.