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Ask an expert - general

166 questions

Q:  This question is not strictly related to acupuncture, but i couldn't find answers anywhere else so I'm hoping an expert here could help me. Last week I accidentally punctured the palm of my hand with a large thumb tack by putting my weight on the desk when standing,  not realising the was an upturned pin under where I put my hand. It was a shock to say the least but the pain subsided quickly after I pulled the pin out. There was very little blood but my ring finger did twitch and my forearm felt tingly. Now a week on I am still feeling uncomfortable sensations in my ring finger, like a tightness and slight pain. The pin went in about two inches below the base of my ring finger. I should mention also that about a year ago I accidentally sliced open my hand about 1 inch below my ring finger and pinky. At the time I had it glued with butterfly stitches. There was no remaining pain once the slight swelling etc had gone down.

A: We're sorry to hear what has happened to you.

As you say, it isn't an acupuncture-related injury, but if we did have a patient report of similar response to an acupuncture needle, we would probably say that the reason for the continuing pain is most likely to be from deep bruising which has caused a clot to form and which is pressing on the nerve, replicating the pains you felt when the accident first happened. If this is the case, then it will clear within a fortnight or so with a gradual reduction in the unpleasant sensations.

It is possible that there has been some damage to the nerve itself, or any one of several nerves which traverse the area, and the outcome here may be a little more difficult to predict. We have certainly come across one case where a direct hit on a nerve generated unpleasant sensations for a number of months. However, this would be very rare, and if the symptoms continue with the same level of intensity thrughout the next fortnight, or even become a bit worse, then you will need to see your GP to get a referral to a neurologist. There may be no harm in seeing your GP early anyway; waiting list medicine sometimes demands that people try to get themselves on the treadmill sooner rather than later. If your GP has on inspection any reason to suspect nerve damage, then an early referral is a good idea.

On the balance of probabilities, though, the symptoms should begin to subside during this week.

As an aside, there are a number of powerful acupuncture points on the palm of the hand, and you may have given yourself an unwitting treatment. Two of the major channels travel where you report symptoms, but the chances that they would resonate for this long are very small. Not the nicest way to have acupuncture treatment either!

There is absolutely no doubt that this has become a very popular and recent extension to traditional acupuncture practice; many BAcC members undertake postgraduate training in the techniques, some of which are not a part of mainstream acupuncture training, and openly advertise this as an extension of their work. 'Rejuvenation' is not an acceptable term any longer; you would need much more rigorous evidence to meet the current ASA standards for advertisers. Most people describe their work as 'cosmetic acupuncture' or simply 'facial acupuncture.'

Q:  Popularity brings challenges, and this field has also become something of a lucrative sideline within the beauty business. This has meant the entry into the business of people who have trained only in this aspect of the work, and we have two major reservations about this. First is that no-one can be properly and effectively trained in the safe and hygienic practice of acupuncture in the course of a weekend training programme. From our perspective it matters not whether the practitioner uses ten needles a year or ten thousand needles a year, the standards remain the same. Our concern, as always, is that an amateur in what is a professional field does something wrong, and we can guarantee that the headline will say 'acupuncturist does.....'. No point in us quibbling about levels of training, the damage will have been done. When you think that this technique may be used by people in the public eye, the possibilities for a PR disaster are considerable.

More importantly, though, there is ino separate field of 'facial acupuncture'. There are simply the techniques of traditional acupuncture applied to a specific area, and these techniques will only be effective to the extent that the practitioner takes into account the systemic problems against which the facial problems occur. The most irritating thing from our perspective is that acupuncture used without an understanding of the wider system will most often not work very well, and we believe that a porr experience, where acupuncture treatment seems not to work, will turn someone away from a system which properly applied could do a great deal not just for the face but for the rest of the person too.

Our advice is that if you are looking for someone to provide this form of treatment, be sure to go to someone who also uses traditional acupuncture as a main profession. That is your best chance, in our view, of optimising your investment in time and money. We would also advise you to shop around. In the view of this expert, this has become something of a 'cash cow' for some practitioners who price themselves according to the beauty market in which the treatment is offered. Whilst we would recognise the value of postgraduate training and experience, it is after only only traditional acupuncture applied in a specific area, and the gap between someone's ordinary charges and this form of treatment should not be too great.

Q:   My uncle has just completed treatment for bowel cancer and he's suffering really badly with burning hot feet. I asked a family friend, who is an acupuncturist, if she thought treatment would help. She seemed to know the symptoms I'd described and called it 'something' syndrome (I can't remember what the name of it was and now I'm not able to get back in touch with her to clarify). Is this something that you are familiar with and could you offer any advice - including if there are any specialists in this area in the north west of England?

A:  While we admire our colleague's diagnostic prowess (!), we'd have to say that the symptom has to be seen in the wider context of the patient's overall patterns of energy. While there may be one or two syndromes where this symptom is central to the diagnosis, it is always possible that it is a secondary reaction to a deeper underlying pattern which could only really be identified by looking very carefully at all aspects of someone's functioning.

We don't know exactly what treatment your uncle has had, although very often it involves surgery and chemotherapy, and occasionally radiotherapy, but we do know that it usually has significant effects on the whole system, and that includes body, mind and emotions. It is really important to be able to assess first hand what effects it has had. This is why in Chinese medicine the same symptom can be treated in dozens of different ways. Even in conventional medicine the great Canadian physician William Osler famously said 'it is more important to find out what patient has the disease than what disease the patient has.'

The best course of action for your uncle is to visit a BAcC member local to him to see if they can give him a brief face to face assessment of whether in their view he would benefit from treatment. The great majority are willing to do this without charge in order to give the patient as much information as possible before they commit to treatment. There are no specialists in this field, but this is not because of the field but because of the nature of Chinese medicine which treats the person, not the named condition. In reality, though, so common is cancer and its treatment in modern times it would be unusual to find a practitioner who has not had experience of treating someone who is recovering after cancer treatment.

Q: I'm planning to  study intensive acupuncture in Goa (India).   I would like to know if I will be able to work in the UK after that and if I could be registered with the British Acupuncture Council.

A:There is regulation of acupuncture by the state in the UK, so in theory anyone is free to practise. However, local authorities operate local laws which govern all skin piercing activities which means that a practitioner has to be registered or licensed to practise. The grant of a licence or registration depends on the practitioner showing that they meet all the requirements for safe practice and that their premises are also sutable. Many local authorities now check the standard of someone's training, and undertake basic checks of being properly insured. The only exceptions are in London where belonging to a professional body on the list of exempt organisations means that a practitioner does not have togold a licence, although they are still required to let the authority know they are there.
As far as intensive training courses are concerned, it is only fair to tell you that the BAcC had some quite difficult arguments with other UK acupuncture associations some years ago because of our insistence on a minimum of 3600 hours training over three years. We do not believe that you can train to be a sound and effective practitioner in less time than this, and we regard the clinical element of the training, where someone learns through supervised reflective practice as critical. It is perfectly possible to learn the basic theory in much less time than this, but in our view that is not in itself a good basis for practice.
We only give automatic eligibility to graduates of accredited colleges. However, we do have an entry route for practitioners who trained elsewhere which uses the same criteria and we have known of cases where people have taken a shorter training and then succesfully applied to us after they have used their skills in clinical practice for several years, but as the professional standards are being raised year after year, we do not expect to see many people being admitted to the BAcC with less than a three year training. This is, after all, the World Health Organisation's recommendation for a non-medical practitioner in independent practice. 

A: There are no specific points for raising body temperature. There are a number of reasons in Chinese medicine why the body as a whole might be cold or why specific parts of the body may be cold, but the nature of Chinese medicine is that the practitioner treats the person, not necessarily the symptom in itself. Although the practitioner might describe a patient as Yang Deficient, often manifesting in coldness, there are many different ways in which a Yang Deficiency can both manifest and be created. The choice of points would reflect the specific nature of the unique balance of the individual.

There are plentiful lists of 'cookbook' or formula acupuncture on the internet, and there are often generic points which might appear in many of the possible treatments for Yang Deficiency. We always have a concern, however, that used out of specific context these points may have no effect or no lasting effect, and although they are unlikely to cause any harm, our experience is that people tend to walk away from treatments which cause them transient adverse effects, and we believe that point recommendations without specific diagnosis are not to be trusted.

The best advice, if you are experiencing coldness, is to visit a BAcC member local to you and seek their advice from a brief face to face assessment. This will give you a much clearer idea of what may be possible than that which we can give you here.

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