A staged framework integrates dry needling, Fascial Manipulation, and Yijinjing for chronic cervical myofascial painNew framework proposes staged approach for neck pain

Chronic cervical myofascial pain is a common and disabling musculoskeletal pain condition, yet its persistence is unlikely to be explained by a single local lesion. Current evidence points to a multilevel process involving hypersensitive nodal sites, impaired fascial gliding, imbalance across continuous tension chains, sensorimotor disturbance, and mechanisms that maintain pain chronicity. Alongside advances in fascial science and mechanobiology, traditional meridian sinew theory offers a clinically useful language for pathway-based pain, tension-chain imbalance, remote–local interaction, and functional restriction. This narrative review with expert synthesis examines possible correspondences between meridian sinew theory and the modern fascial continuum and considers the layer-specific roles of Yijinjing, meridian sinew therapy, dry needling, and Fascial Manipulation in chronic cervical myofascial pain. These correspondences are framed as clinical heuristics and phenomenological analogies, not as anatomical equivalences or proven mechanistic homologies. We propose a hypothesis-driven staged framework in which dry needling may assist local desensitization, Fascial Manipulation and meridian sinew therapy may support chain correction, and Yijinjing may contribute to active remodeling and long-term self-management. The framework is intended to guide research and clinical reasoning, not to serve as a validated treatment algorithm. We also discuss transferability to primary care and non-TCM systems, safety and contraindications, evidence certainty, intervention standardization, objective mechanistic measures, and priorities for future studies, including staged trials, health-economic evaluation, patient-reported experience measures, and wearable sensor-based monitoring.