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Ask an expert - general

160 questions

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.

Q:  I have been diagnosed with Mal de Debarquement disorder with going on 2 1/2 months of balance issues. Have tried physical therapy, chiropractic, and now acupuncture. My acupuncturist has dealt with dizziness, but no one with this disorder. Any advice to share? We have worked on the sinus, ears, etc. 

A:  MdDS is quite a rare condition, although the overlap with a number of better documented problems such as Meniere's Disease or vertigo could mean that it is under-reported. As is always the case with relatively rare conditions there is hardly any research, even in conventional medical literature.

We searched for whatever we could find, and there are certainly a number of anecdotal accounts from people with this condition who have found acupuncture in combination with some fairly low level medications has done the trick. This sample is self-selecting, though; there is less chance that someone who hasn't found it useful will post the bad news.

For problems like this we have to say that the way that Chinese medicine works, interpreting the symptoms against a completely different theoretical framework and supplementing what is reported with findings from, for example, looking at the tongue, taking the pulse at the wrist and other clinical observations, can sometimes generate solutions where conventional medicine cannot. Chinese medicine is based on an understanding of energy, called 'qi', and its flow, rhythm and balance in the body. The flow is affected both functionally by weaknesses in the Organs of the body which sustain it, and also positionally because of local blockage and disturbance. It is probable that a practitioner may find evidence of changes or blockages in the flow, and by re-aligning these start to reduce the symptoms. This is certainly the case with other balance problems, where the evidence for the effectiveness of acupuncture treatment, while not conclusive, is certainly encouraging enough to suggest that treatment is worth a try.

The best advice we can give is that you visit a BAcC member local to you and seek a brief face to face assessment. We are confident that in person they will be able to offer a much better view of what may be possible. The only caution we have is that conditions can become more difficult to treat the longer they have been entrenched, and a fifteen year history suggests that improvements may take a while. However, life is full of surprises, and we have seen longstanding problems vanish almost overnight, so the best idea is probably to have no expectations either way.

We have checked the databases to see what else might have been published since we wrote this in 2014, but apart from a 2013 study which uses a form of magnetic therapy

http://www.ncbi.nlm.nih.gov/pubmed/23202153

we have not found anything else which would affect what we have said either way.

The only addition we would make to this answer is to mention that there are one or two other forms of treatment, notably cranial osteopathy, which might also offer some relief and improvement. Although the evidence for acupuncture and MdDS is a bit thin, there is a considerable amount of good quality research on vertigo and other balance problems like Menieres and labyrinthitis. From a Chinese medicine perspective, the disease labels of western medicine are less interesting to us than the functional disturbances which a patient reports. We have ways of interpreting these within the conceptual grid of Chinese medicine which makes direct equivalences hard to establish - some presentations with different western names are the same as far as we are concerned, and twenty people with the same named presentation may be treated twenty different ways.

Hopefully a practitioner will find something which makes sense of your problem and can give you a much clearer idea than we can here of the potential for treatment with acupuncture.

We publish a fact sheet on menopause

http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/menopausal-symptoms.html

which is refreshingly candid about the chances of treating menopausal symptoms, and refers to a number of papers which seem to provide encouraging results. One of the main reasons which bedevils the results of research is that the treatment is often compared to a 'sham' treatment, and both generate better results than the control group. As a consequence the treatment is said to be 'no better than sham' and all down to a placebo effect. We, however, would say that there is no such thing as 'sham' acupuncture; sticking needles anywhere will generate a result, and it's the difference between good and better treatment. As one of our medical colleagues said, if sham treatment is better than conventional treatment, who cares how it works, just use it!

In  essence, though, we have to say that traditional Chinese medicine has been addressing the problems of the menopause for over 2000 years, and over that time has looked in enormous detail at the kind of energetic changes which occur at this time of life. Interpreting these against the backdrop of the patient's constitutional energy is where the skill of the practitioner lies. This is more than just deciding out of the five causes for a symptom which specific treatment will work best. Chinese medicine treats the person, not the condition, and simply picking off the symptom while leaving the overall balance untreated will in many cases mean that the symptom returns. This is why we are quite concerned about people learning formula treatment for named conditions; sometimes they work, sometimes they don't, and when they don't people wrongly conclude that acupuncture treatment does not work.

The best advice we can offer is that you visit a BAcC member local to you for a brief face to face assessment of what may be possible. Most members do not charge for a short interview, and face to face they can give you a much better idea than we can at a distance of what may be possible. A postcode search facility on our home page will identify the practitioners nearest to where you live and work.

Q:  I understand you can have acupuncture on the face, to slow down/ help with the ageing process!! Is this correct please? 

A: There has been something of a boom in recent years in the use of acupuncture treatment to reduce the appearance of ageing. There is little or no research to validate claims for success, but this is really no surprise. It is difficult to imagine how one could design a meaningful trial with objective outcome measures. However, when something is popular and enduring, which this appears to be, then there is usually something in it. You can fool some of the people some of the time.......!

There are literally thousands of practitioners operating in this field, not all of them professional acupuncturists with a full degree level training. We have said for many years that local interventions like this will only have enduring effect if they are underpinned by constitutional treatment. The face does reflect very well the overall balance of the person, and it would be unrealistic to expect to improve one part of the system when the rest of it is showing signs of overall imbalance and disruption. The best that one might hope for is a short term fix requiring further treatment a few weeks down the line. While this falls within the normal pattern of beauty treatment, we rather hope that our members that use facial/cosmetic acupuncture are aiming for something a little better.

There are a number of things you should check. First, is the practitioner properly trained? There are a number of

reasonably reputable courses around, and these are a minimum requirement, in our view. Some of the needle techniques are not within mainstream treatment, and the face is not a place for amateurish treatment. Second, is the person properly insured and registered for what they do? Many beauty practitioners take short courses without any information about safety, waste disposal, registration for skin piercing and proper insurance. This could have serious implications if something goes wrong.

Because we have yet to agree standards for this specific practice we have no way of telling which BAcC members offer this type of treatment. However, if you use our home page postcode search facility and retrieve a list of names, it should be fairly easy to search on google to see who offers this. Those who do tend to use it in their PR. If not, most practitioners know which of their colleagues to refer people to for speciality treatment, and it should take you very little time to find someone who can offer facial treatment alongside traditional treatment aimed at restoring balance overall.

IAs this expert knows only too well from personal experience, persistent hiccups/hiccoughs can be a very distressing experience, not the increasingly funny experience which many observers seem to find it.

There is a little bit of evidence for the use of acupuncture, mostly in the form of what are called case studies about single instances where treatment has helped, or sometimes where treatment has been offered to a specific target group where hiccups often present and where there is a need to deal with them quickly, as in post myocardial infarctions. Below are a few examples of these kinds of studies

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3035062/

http://www.ncbi.nlm.nih.gov/pubmed/15813167

http://www.ncbi.nlm.nih.gov/pubmed/11908864

Most practitioners during their training learn a number of what we call 'first aid points' which are known to have an effect on specific conditions. There are certainly two or three which are commonly used to stop hiccups, and one additional one which appears to be effective for treating children with persistent hiccups. Overall, though, there isn't a great weight of evidence, and we would be a little remiss to suggest that acupuncture definitely provided a solution.

However, that said, we are practising a system of medicine where hiccups, a symptom like any other, is not always seen as the problem itself but is usually a manifestation of other imbalances and blockages in the system. As you may have read, Chinese medicine is premised on the understanding of the body as a system of energy in flow, and the skill of the practitioner lies in making sense of symptoms within the general background context against which they appear. This is why the same symptom can often be treated in a dozen different ways in a dozen different patients depending on what internal causes are allowing it to develop.

The short answer to your question is that you may have to visit a BAcC member local to you for them to be able to see what is going on and try to make sense in Chinese medicine terms of what is happening. This is the only way that you will get a clear idea of how treatable the problem is. What we can say, though, is that with conditions like this we tend to take the view that if they are going to respond they will do so quite quickly, and as such we would caution a prospective patient about getting engaged in a long run of treatment with no obvious improvement. We would suggest three or perhaps four treatments would be the maximum we ourselves would offer before reviewing the case in depth and deciding whether there is any point in carrying on.

This all sounds rather negative, especially when many of us have stuck a needle in with almost immediate effect like a party trick. However, everything works for someone, but something doesn't necessarily work for everyone, so we would advise caution.

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