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Ask an expert - body - skin conditions

49 questions

Q:  I have had  PHN for over more than ten years, it is affecting my left leg..the pains is still ongoing... I wonder if acupuncture can help?

A:  As you might imagine we have been asked about this many times over the years; shingles can be a terribly distressing condition whose after-effects can persist for months or even years. The treatment of post herpetic pain is an area which has been heavily researched in China, as our factsheet

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

says, but the quality of trials is not that great. There is a comprehensive systematic review of all available trials, but this was only announced last year and has not yet been published. We ourselves have treated many cases of shingles, and we have to be honest and say that there has been a significant number of cases where it has been very difficult indeed to reduce the pain, which as we are sure you know can be excruciating.

However, there is no point in being unduly pessimistic. There have been cases of post-herpetic pain where the acupuncture treatment has made significant inroads into the symptoms from a mixture of constitutional treatment to bring balance back to the system as a whole and local treatment to reduce some of the irritation and inflammation. Generally speaking, it is better to start treatment as soon as possible after an attack, just as the use of conventional anti-viral medicines is favoured as early as possible. However, the reality is that most patients present with post-herpetic pain long after they attack and usually because the side-effects of the long-term medication are becoming a problem, so we are used to adopting a slightly different approach from that used in China, where needling often commences with days of an attack starting.

The best advice that we can give is that you visit a BAcC member local to you for a brief face to face assessment. The one caution we always voice in these cases is that if you decide to go ahead with treatment you set review dates for assessing progress and also try to set specific outcome measures, objective evidence that the condition is improving. This can be quite difficult with chronic conditions like this which can still have acute episodes, but it is really important to try to find a marker which can show that there has been progress. We would feel confident, though, that acupuncture treatment might offer some benefit in pain relief and recovery. The only question to resolve is how much and how sustainable the relief is, which is why we are always cautious in setting clear outcomes measures and review periods.

The great strength of Chinese medicine, though, is that each patient is unique and different, even though their symptoms be the same. This means that a skilled practitioner, and all of our members are, would be able to make links that we cannot do at this distance, and may be able to recommend other things that may help alongside acupuncture treatment. We would strongly recommend that you visit a local BAcC member for advice, and hope that it puts you on a path to finding some relief.

The one confounding factor about your problem is that it has now persisted for ten years. There is a kind of received wisdom that treatment becomes more difficult the longer a problem persists, and there used to be a line that treatment of a problem took as many months as the years it had persisted. Most of us don't take this too seriously, though; we have seen thirty year problems sometimes vanish within weeks. The key issue will be to determine what is happening in energetic terms. This may give some very useful pointers to what has caused the problem to persist and similarly pointers to what might make things improve.

 

Q:  I have colitis, hayfever and dust allergies, psoriasis and recently some new pain and swelling in my thumb and toes. I am aware that auto immune diseases can cluster in this way in individuals and now with the new symptoms am wondering if acupuncture could help me and if there is an NHS practitioner in my area of Gloucestershire? 

A:  You are right to think that the approach inherent in traditional Chinese medicine may offer possibilities for the treatment of some of the problems which you have. We don't want to quote great numbers of studies at you because you have clearly done your research, but if you want further details then you need look no further than our website where you will find under the 'research' tab a further button for fact sheets which cover many of the problems which you mention. Indeed, if you use the 'site search' facility on the home page you will find dozens of answers which we have given over the years about many of the problems which you have.

 The great strength of Chinese medicine is that the practitioner is trying to make sense of all aspects of a person's health and well-being by using a theoretical framework which draws on 2500 years of understanding of the whole body, mind and spirit as an energy system. This means that interconnections are very naturally a part of this understanding, whereas conventional medicine tends to address each aspect separately and in isolation. This is often not quite so pronounced as some of our colleagues argue; we know of many GPs who are proud of their genuine holistic approach to health. The system itself, however, does not lend itself to this kind of approach.

 We think, however, that you may find it very difficult to identify any traditional acupuncture provision in your area. What acupuncture treatment there is can most often be provided by doctors and physios within their normal scope of practice, and usually only on conditions for which there is a substantial and persuasive evidence base in western terms. This does not extend to many of the problems you have.

 On the assumption that you want to find treatment free at the point of delivery, it might well be worth asking a BAcC member local to you (whom you can find using the postcode search facility on our home page) if they are aware of anything local to you in NHS provision. We know of one member who was heavily involved in NHS work but we think it may have been in another field of medicine. If this doesn't turn anyone up you may well be pointed to someone who is prepared to treat you at highly reduced fees. Many of our members are as concerned with helping people than making a mint, and are usually prepared to help people find what they need.

 There is also a growing number of multibed clinics trying to provide acupuncture at reduced rates for work in group settings. A list of these can be found at this website http://www.acmac.net/, and this may offer possibilities.

Q:  I have alodinya feels like permanent sunburnt but also results in pain in different areas. I have had an MRI scan and the  results they don't think are anything to do with spine damage. They think it is difficult to associate it with sensory symptoms.  Would acupuncture help?

A:  We are very sorry to hear that you have this problem; it can be very disheartening to have something for which no clear-cut cause can be found.

We have searched the literature for any evidence of acupuncture being used to treat this, but weren't at all surprised to find nothing of significance. The condition usually presents itself as a feature or symptom of something which is already named and classified, and treatment usually focuses on that specific problem.

However, the great strength of Chinese medicine is that it has a 2500 year history of treating problems not by name but by how things appear, and understanding them within a system which is based on energy flow. This has evolved to use a great many classifications based on observation and lived experience, like feelings of heat and cold in the body, and also a complex understanding of the inter-connectedness of parts of the system. Once one steps aside from the disease label and asks more specific questions about where the sensations are, how they feel, and what makes them change this can often point to a series of possible causes, many of which are treatable.

It has long been received wisdom in the acupuncture and Chinese medicine world that skin problems are often best treated with a combination of acupuncture and Chinese herbal medicine. Since most of the practitioners on the Register of Chinese Herbal Medicine are also BAcC members too this may be the best option to pursue. However, herbs are to everyone's taste, and we are pretty confident that acupuncture alone could be just as effective.

The best advice that we can give, and often do give, is that seeing a problem face to face is always the best way to establish whether something is treatable. Most BAcC members are more than happy to give up a few minutes without charge to have a look at the problem and give more specific advice, and this also gives you a chance to meet them and see where they work before committing to treatment.

 

Q:  I am in the 5th week of shingles on my neck, scalp, ear, shoulder and upper chest Scabs all gone but I am left with acute skin sensitivity and itching - the latter mainly at night. I received anti vial medication and am now on Amytriptilyne and take paracetomol.  Do you think it is too early to consider acupuncture?

A:  Quite the reverse!

As with a great many conditions viewed from a Chinese medicine perspective the earlier treatment commences the better. The logic is somewhat similar to the use of antivirals like acyclovir in conventional medicine - get in early before the problem takes root.

Our factsheet on herpes zoster quotes some quite positive research study material

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

and although the studies are not large enough or methodologically acceptable for advertising purposes, they are suggestive of the usefulness of giving acupuncture a go.

From a Chinese medicine perspective, shingles is a combination of Wind and Heat, but note the capital letters! We are talking about categories within an entirely different diagnostic system which describes opportunistic infections as 'invasions' and which sees the expulsion of them as the primary task. The earlier this is done the better. What happens of the condition is left untreated too long is that it becomes what the Chinese call a 'lingering pathogenic factor' with different characteristics. To some extent the body gets used to this being a part of its make-up, and removing it can be more of a challenge. This may sound rather odd, but all conditions eventually become a part of who we are or believe ourselves to be, and there can be quite a great deal of 'habit' energy involved in a presentation which can be a problem to dispel.

Five weeks is still relatively early, though, so it would be well worth your while to visit a BAcC member local to you for an informal chat about what acupuncture treatment may be able to offer. Shingles is a horrible condition whose effect far outweighs its apparent simplicity of appearance, so we wish you well in limiting its nastiness.

Q:  Can acupuncture treat lump tissue under the skin? I have a lump about 2 inch diameter on my  back, I have been told I can have it surgically removed but it will leave a cavity but it is not cancerous. 

A:  It depends what the lump is. The first thought when asked these questions is that someone may have something like a lipoma, the fatty lumps which sometimes appear for no reason and in no specific places. However, removing these does not leave a cavity once the lipoma has been removed, only a small post-operative scar, and the fact that you have been told that there will be a cavity indicates that there may have been some changes to the tissues immediately beneath the skin.

From a Chinese medicine perspective, anything which manifests in this way is simply seen as a change in the energetic flow of the body, and in theory anything which manifests because of energetic blockage should be able to be dispersed by using needles to get the energy flowing. A very common presentation in clinic is Dupuytrens contracture where a fibrous lump gathers on the tendons of the palm of the hand causing the fingers  to be permanently hooked, and there are many case studies of people having successfully used acupuncture to treat this. The treatment is usually quite local rather than systemic, and very often more 'aggressive' than we would normally perform. However, you only ever read case studies which work, and we suspect a far greater number have failed. Everything works for some people, but it is rare for something to work for everyone.

We suspect that the best and only advice we can give is to visit a BAcC member local to you for a more informed view of what may be possible. The fact that the removal will leave a cavity suggests that there has been permanent change to some of the adjacent tissue, and there are limits to what any form of therapy can achieve. However, at very worst you would get to chat to a helpful acupuncturist  for a short while, and have a much clearer idea of not only what they can offer, but what else they may recommend based on what they can see. We often network with fellow professionals to ensure that patients find the most appropriate care and interventions for their problems

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