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Ask an expert - general

161 questions

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.

Q:  Who are the people who access more acupuncture treatments? Educated or non-educated people?

A:We have no data on which we can base any comment.

It used to be something of a piece of 'received wisdom' that traditional acupuncture was a middle class preserve for financial reasons. Indeed some of the more innovative ways of providing acupuncture, such as community clinics and mutli-bed clinics, have their origins in the United States where a very forceful group argued that acupuncture would be beyond the means of working people without initiatives such as these.

However, in our view this may not be the case at all. Although the cost of treatment has risen over the years it is no longer beyond the means of an ordinary working person. Nor is there a direct correlation between class and educational background as there may have been thirty or forty years ago, leaving aside what 'educated' might mean.

Essentially, the message of traditional Chinese medicine is not one which requires a great deal of intellectual capacity or the ability to understand esoteric concepts. The very direct way in which it describes and addresses the sorts of problems which everyone has makes its message easily accessible, and it is always very reassuring when giving talks to audiences of all kinds to see the recognition which greets some of the descriptions of the ways in which disharmony and imbalance can affect the body, mind and spirit.

Q: I have had 4 strokes and I have diabetes, high blood pressure and high cholesterol. I have been falling a lot lately, tripping over my own feet. This happens a lot more when I am tired. My neurologist says that my falling is multi-factorial - the diabetes he feels has caused some neuropathy in my feet and the strokes have messed up my center for balance in my brain. I am at my wits end trying to avoid falling. Do you think that acupuncture could help my condition(s)?

A:  There is certainly no likelihood of any hard from trying acupuncture treatment; it remains one of the safest medical interventions, with very few adverse effects, most of which are transient.

We have been asked about diabetic neuropathy on a number of occasions. Our factsheet on neuropathic pain tends to address neuralgias more than neuropathy itself, and our answer to our last enquirer, slightly more specific than your question, was:

Q: My husband has diabetic lumbosacral radiculoplexus neuropathy. Please advise if he should find an acupuncturist specializing in this condition. .We live in west wales and would be grateful if you could recommend a practitioner.

A:The first thing we have to say is that you are unlikely to find an acupuncturist who specialises in treating this condition, but that is in the nature of Chinese medicine which is inherently generalist. In fact, in ancient China the specialist was regarded with disdain because they were restricted to treating a small number of conditions, whereas the generalist could treat all. Chinese medicine treats the person, not the condition from which they suffer. It would not be unusual for twenty patients with the same presenting conventional named condition, say migraine, to be treated in twenty entirely different ways.

Symptoms, what the patient experiences, are the same whatever system of medicine one practises, however, and it is the sense which a practitioner can make of them which determines whether treatment is possible. The normal symptoms of this form of diabetic neuropathy - pain, weakness in the limbs, muscle wasting and so on - would be seen by a Chinese medicine practitioner in the context of the Chinese medicine system which is premised on an understanding of the body as a flow of energy, called 'qi'. How qi flows. The balance and rhythms of this flow determine whether someone is healthy or not, and unsurprisingly where the flow is blocked or out of balance, pain and loss of function will result.

This is a rather long-winded introduction to saying that the Chinese medicine practitioner will be less interested in the name given to the condition than in how it presents, and will try to make sense of that both as a local disturbance and as a manifestation of the balance of the whole system. This can mean on occasion that acupuncture treatment can achieve changes where people thought change was impossible, but this has more to do with the fact that the causal relationships on which conventional medicine relies can be misinterpreted. Nearly everyone over the age of 60 has some degeneration of the lower spine visible on X-ray but that doesn't mean that every backache is caused by it.

In the case of diabetic lumbosacral radiculoplexus neuropathy, however, the diagnosis tends to be more precise and what we can say is that there is a limited amount of evidence for the use of acupuncture in the treatment of neuropathy and considerably more evidence for the treatment of chronic pain wtih acupuncture to suggest that acupuncture treatment may be able to take the edge off your husband's pain. Working at this remove, though, and without being able to see exactly how it manifests we are somewhat limited in what we can say. The best advice we can give is that you go to see a BAcC member local to you for an informal face to face assessment of whether acupuncture treatment may be of benefit. A skilled practitioner should very quickly be able to tell you based on what they can observe whether they think that treatment applied locally may help, or indeed whether balancing the whole system may help the body's own mechanism's to function better and take charge of its own recovery.

As far as finding a practitioner is concerned, there is a 'find a practitioner' feature on our home page www.acupuncture.org.uk which should be able to provide you with a list of names of working in or near your postcode area. We always recommend using postcodes; the search engines are very specific and if you name a county you may find that someone works just over a county border who is far closer than the practitioners operating in your own town or county.

We think there is enough overlap here to answer some of your question, but we would probably place greater emphasis for you on the fact that acupuncture treats the person, not the disease itself. Given that you have a number of quite serious health problems, it is sometimes more advantageous coming at them from a different perspective to avoid taking on symptom after symptom, one at a time. We see many patients taking bucketloads of medicine as a consequence of this approach, and while we are not at all opposed to the use of medication, we are always concerned that this overloads the body with the complex interactions between the medicines and generally addes a few more symptoms.

The traditional acupuncture practitioner will try to make sense of the patterns which have developed in such a way that they can apply the minimum amount of treatment to the most needy areas to encourage the person's own healing process. While it is possible to use acupuncture treatment in a more targeted way, we believe that taking a holistic approach offers the best way not just to help the patient to get better but to stay well. In ancient times the traditional doctor was paid to keep someone well, not to get someone better after they had become ill. This was, said the Chinese, like 'digging a well when you are already thirsty, or forging a spear after the battle had started.'

The best advice, as we said in our earlier reply, is to visit a BAcC member local to you and seek a brief face to face assessment of whether acupuncture treatment may be of benefit to you.

Q:  I am a doctor  (MD degree)but am not registered in the UK. I have also obtained 'Master in Traditional Medicine (Acupuncture, Herbology, Laser, Electrobiomagnet), Samra University of Oriental Medicine, LA, CA, USAFor'. I would like to get some experience (training and working)in the UK and was wondering if you could provide me with some advice on how I can get registration with the British Accupuncture Council.

A:There are very few restrictions to the practice of acupuncture in the UK. In the absence of statutory regulation the only primary legislation by which practitioners are governed is generic skin piercing legislation mainly concerned with health and safety. This can differ depending on where you want to work. As we wrote to someone else from the States earlier this week:

There are very few restrictions on the practice of acupuncture in the UK, and there is what is described as a common law right to practise freely. In the absence of statutory regulation or state registration the only legal requirements are for registration or licensing by local authorities. This is primarily concerned with the standards of hygiene and safety for acupuncture as a skin piercing activity, although in more recent times many local authorities have become much more assiduous in checking that practitioners are properly trained and insured. Your training and registration in the US far more than meets the basic requirements for suitable training.

In the Greater London area the London Local Authorities Act 1991 applies, which means that you would have to obtain an annual licence at about £200 - £400 to practise. If you belong to an exempt body such as the BAcC, you do not have to pay, although you have to notify the authority of your presence and they will probably inspect the premises.

Outside London the Local Government Miscellaneous Provisions Act 1982 applies. This means that you have to be registered for every practice in which you work. Registration is a one-off process, costing again £250-£500. Only doctors and dentists are exempt from this Act.

In Scotland an annual licensing scheme exists similar to that used in London, but the only exemptions allowed are for those healthcare professionals like physios and nurses who are already state registered. BAcC members have to pay. This has been a bone of contention for many years, but we remain hopeful that we can negotiate exemption.

Your registration in California is one of the tougher ones in the States, but unfortunately there is no reciprocal recognition of qualifications as yet, so application to professional associations will almost certainly be through the individual 'external applicant' route, details of which you can find on our website. There are a number of other professional bodies whom you would be qualified to join, but we believe that we are the main and most respected regulator of Traditional Acupuncture in the UK and would hope that you would join us if you re-locate to the UK.

Registration with the BAcC would be through our 'external applicant' route, the details of which you can obtain by contacting Robert Moore, our Admissions Manager on 0208-735-1210 or by e-mailing This email address is being protected from spambots. You need JavaScript enabled to view it..

Q:  GBS Guillian Barre syndrome -  I  have had two rounds of VIG treatment and again my weakness is increasing.  Can accupuncture help me?
How do  find an accupuncturist who would know about trating guillean barre syndrome?  Is accupuncture treatment given under the NHS?

A:As you might imagine, we have been asked about many conditions already, and the last response we gave to a question about Guillain Barre syndrome was:

Q: I suffered with guillian barre syndrome, I have foot drop in my left foot and tight calves. Would acupuncture offer any relief?

A: Many of the symptoms which persist after an episode of Guillain Barre syndrome spontaneously remit within a year, so it is unusual and unfortunate to be troubled by residual effects.

There is not a great deal of research evidence of the treatment of Guillain Barre syndrome, although a group of Chinese researchers have posted a protocol for a review about to take place

http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD007797/pdf

which might produce a better picture once they have searched the databases for information.

To answer your question really means to look at what traditional Chinese acupuncture attempts to do, and that is to reinstate and maintain the flow of energy, 'qi' as it is called, in the body to ensure that everything functions as it should. Conditions like Guillain Barre which interfere with the normal flow in the muscles and tendons are seen in Chinese medical thought to be causes of blockage and deficiency, and at a very simplistic level the treatment is aimed at reinstating a blocked or missing flow. Of course, in practice things are a little more sophisticated than that, because the practitioner will want to know what happened to the system as a whole to let these particular symptoms appear where they did, and to decide whether it is really a local problem or one which requires a more subtle and systemic approach. Any condition involving a change in muscle tone or function may be benefited by acupuncture, though, and even the western medical acupuncture tradition sees this as a worthwhile intervention.

However, one important factor to bear in mind is that in a small percentage of cases residual symptoms not only persist for a great deal longer, but are sometimes intractable to treatment. If you did decide to give treatment a go and contacted a BAcC member local to you, it would be very important to establish very clear outcomes in order to assess whether the treatment is having an impact and a very clear sense of how many sessions to have before reviewing whether there has been progress and whether it is sustainable. It is in everyone's interests to ensure that, in Dr Johnson's famous words, continued treatment is not the triumph of hope over experience.

Our advice remains substantially the same. We have heard anecdotal evidence of successful treatment and also anecdotal evidence of prolonged treatment which has had no benefit at all. Chinese medicine works on an entirely different theoretical basis, however, and a western-named disease or condition could be diagnosed in many different ways. This will obviously have a direct bearing on how successful treatment may be. The best advice will always be to see a BAcC member local to you for a face to face assessment of what might be possible.

From our perspective, all of our practitioners are equally well qualified to treat all conditions. Chinese medicine treats the person, not the disease, and so there are relatively few areas where we recognise the importance of specialist training (paediatrics and obstetrics are two that we are researching). This means that you can be confident that anyone you identify near to you will be equipped to handle your problems.

As for getting acupuncture on the NHS, this is more of a problem. Most NHS personnel who offer acupuncture, generally doctors and physios, are limited to treating conditions for which there is good evidence and which fall within their scope of practice. You might just find that if you are offered physiotherapy that your practitioner mighy use acupuncture as a part of the package, but the chances are that they will not be using Chinese acupuncture, or at least, not Chinese acupuncture as we understand it. Many healthcare professionals now use Chinese points but often do so in a very formulaic cookbook way, and this will never be as effective as these points used within the framework of Chinese medicine itself.

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