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Ask an expert - general

164 questions

Q:  If I undertook training to be able to deliver ear acupuncture using the NADA protocol and then obtained NADA membership, would I be covered by my membership if anything went wrong?

A:This would depend entirely on the insurance arrangements in place. We have been searching the net for information about NADA-UK, but for reasons we do not quite understand their public website seems to have disappeared. We seem to recall that membership was only a matter of continuing competence and certification, and accountability together with an element of promotion, and did not include insurance.

Normally we would say that insurance is relatively straightforward. Most individual practitioners seem to get their insurance through the brokers Balens in Malvern who act for a master policy under Zurich. This is one of two main complementary medical insurers, the other being Royal Sun Alliance through whom we are insured. RSA don't deal with individuals as far as we know, and won't cover acupuncturists who do not belong to the BAcC. 

The confounding factor, though, on which you would have to seek advice is whether they would offer cover within the NHS. We suspect the answer may be 'yes' given the relatively safe nature of the intervention, but we would be a little cautious before saying this was certain. RSA, for example, won't cover any of our members who are practising GPs or working solely within the NHS. This has everything to do with the way that hospitals and surgeries deal with their own insurance and the fact that professional insurers might be an easier target than a health trust for what could be a very much wider range of potential claims. If Zurich won't pick up cover, be very careful of other offers. The cheaper the policy (and someone will always write cover) the greater the chance that the small print will apply.

If all else fails you would probably need to approach your practice heads or trust managers to get approval to offer your service within their overall offer. If, though, you are working independently of the NHS and can demonstrate this then it's probable that Zurich will pick up cover.

We are sure that NADA must have been asked this question thousands of times and almost certainly have a ready answer. 

 

A:  The abbreviations all relate to physiotherapy, as far as we can tell.  We assume that you mean MCSP rather than MCPS, this being Membership of the Chartered Society of Physiotherapy. MAACP means that the person is a member of the special interest group, the Acupuncture Association of Chartered Physiotherapists. SRP usually means  state registered paramedic, but we think in this instance it refers to state registered physiotherapist.

Q:  I have had 4 treatments with acupuncture over the last 6 weeks for menopause symptoms.   My last period was two years ago but I have two small bleeds over the last week and I am concerned. Could acupuncture have triggerd this off?

A:  It is always possible that acupuncture treatment may cause the body's systems, especially hormonal, to re-activate to a degree. This is why we always take great care when treating people with a stable thyroid or Type-2 diabetic medication routine, in case the treatment triggers any residual function and destabilises the regimen.

In cases like yours this is always possible, and even without treatment it is possible to have occasional small bleeds around the menopause, often at long and unpredictable intervals. The occurrence of a bleed now could, indeed, be entirely coincidental. However, if you are at all concerned, you should visit your GP. It is a part of our training to encourage patients to visit their GP for any unexplained or unusual bleeding.

This is quite often a difficult message to get across without being alarmist, as you might imagine. In the vast majority of cases it proves to be completely unexceptional. However, in the rare event that there is something more significant going on, it is better to find out and address it immediately rather than take a 'wait and see' approach.

You might also want to have a chat with your practitioner to see if there is anything in your case history or treatment to date which suggests that this is or has been likely. Some treatments are quite expulsive by nature, and can often cause a kind of cleansing effect on the system. A great deal would depend on the nature and quality of the bleed.

We think, though, that a routine check with your GP would probably be the first and best option. 

A:  This is quite a difficult question to answer without knowing a little more about the swelling. There are all sorts of reasons why a thyroid gland can swell, from a benign cyst which can be drained through to the goitres one would associate with Hashimoto's Disease or Graves Disease. If we are talking about the latter, where the swelling is a part of a larger pattern of pathological changes in the body, then acupuncture may be more relevant but the advice less specific.

If this is a pattern of thyroid enlargement causing hyperthyroidism (over-active thyroid) then the evidence from research for the use of acupuncture is not that encouraging or plentiful. Our factsheet

http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/thyroid-disease.html

cites three studies which address some of the more common manifestations of hyperthyroidism, but while the results are quite positive the samples are too small to generalise.  there are some Chinese studies of the treatment of benign thyroid nodules, and these again, while encouraging, are quite small.

However, one of the great dangers in trading in symptoms from a conventional medical perspective is that it does not do justice to Chinese medicine theory which has developed over 2500 years. Thyroid problems are not new, and although the ancient Chinese would not have understood hormone levels and thyroid function as we know it, they would certainly have made sense of all of the symptoms associated with thyroid hyperactivity, and would have been able to address them within the system of medicine. That does not mean that they would always be able to treat them successfully, and we have to be very careful not to let our maxim of 'treating the person, not the disease' lead people to believe that anything is possible. However, it does mean that there is a chance of bringing the symptoms under control.

However, without more specific information we would struggle to say more. It may simply be a benign swelling, in which case there may be more cause for optimism about what treatment can achieve. What we always say, though, is that if you are on medication for thyroid malfunction we always tread with great care. It can take a long time to achieve a good working balance from a diseased thyroid, and treatment can affect a good balance which has taken months of establish. We tend to work as closely as we can with a patient's medical team to ensure that everything is managed to maintain a good and stable pattern.

The best advice we can give is that you pop along to see one of our members local to you. This will give you the best chance to describe in greater detail what is going on and to be able to get from them a better idea of what may be possible. 

Q: I catch too many viral illnesses/flu like illnesses, about 6 or 7 a year. I am fit and well in between and not chronically ill, I am a 60 year old lady and my only other problem is asthma which is well controlled with inhalers. Could acupuncture help?

A:  You have probably heard people talk about a weakened immune system; in fact, it is a rather over-used term in modern times. However, it does sound as though this really is the case for you, especially if you are relatively fit and healthy the rest of the time.

From a Chinese medicine perspective the point of greatest interest is that you have asthma. Although it may be well-controlled it does show that there is probably some weakness in the Lung energy. We cannot be absolutely certain from the name alone; there is no direct correspondence between symptoms and disturbance in the function of an Organ (capitalised to denote the Chinese understanding of an Organ), and quite often a named condition can have its root elsewhere. However, in the majority of cases the Lung energy is involved, and this is of particular interest because the Lung is closely associated with what is called in Chinese the Wei Qi, the defensive energy of the body. If the Lung is weakened or weaker, then it is less able to circulate the defensive energy, and in theory the body is then less well protected from what the Chinese call external invasion.

Of course, being a 2500 year old tradition there is always room for plenty of disagreement about where Wei Qi develops or is generated, but most writers seem to agree that the Lung is primarily involved in its effective circulation. Boosting this energy may have an impact on improving your defences. We would be more cautious about making any claims about your asthma. The evidence is not as strong as for some named conditions which we treat, and we find that many doctors strongly advise patients against interfering with patterns of treatment which maintain good control over the condition.

How does one's defensive energy become weakened? Well, there are many ways in which one can interpret the balances of energies in the body, and in many diagnostic systems there is not necessarily a correspondence between where a symptom turns up and its originating cause. A skilled practitioner should be able to make sense of the overall pattern, but may well find out that there is a hereditary element to the problems. Our health is determined to a very large extent by the energy of our parents who create us and also by their health at the time of our conception. If this has been at all compromised on either front, then it may leave a legacy of under-performance which might make someone more vulnerable as time goes by to opportunistic viral infections. This is something which we believe can be helped by treatment.

All of this, of course, is speculation based on very little information! The best advice we can offer, given that we think there may be some benefit from treatment, is to visit a BAcC member local to you for an informal chat about whether acupuncture is likely to help. Most members are happy to give up a little time without charge, and face to face it will be far easier to offer an individualised opinion about the possible benefits.

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