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Sandy Williams

Sandy Williams

Monday, 01 December 2014 00:00

Acupuncture recent study on osteoarthritis

Ease your joints -  acupuncture provides sustained benefits after 10 treatments

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.

A:  We have to be a little cautious about how we respond to questions like. If you undertake database researches for all forms of prolapse there is very little evidence for the effective use of acupuncture as a treatment. There are many reasons for this. There are some studies, but these are mainly Chinese, have often not been translated, and usually fail to meet the standards of methodological rigour adopted in the West. It is also quite difficult to assemble a trial group; there are many different reasons why prolapse can occur, and for research purposes there has to be complete consistency across all elements of a trial.

That said, Chinese medicine operates from an entirely different theoretical basis involving an understanding of the body as a system of energy, called 'qi', and its flow and balance. The Organs of trhe body (we always capitalise them when we talk about them in the Chinese medicine context) are seen as a group of fucntions which overlap with some of the functions which we recognise in the West but are far more wide in their definition. One of the Organs, the Spleen, is in Chinese thought responsible for the internal gravity of the body, making sure that everything is held up. Not surprisingly, when this is weakened, things start to descend, and prolapses are a well-established consequence in Chinese medicine of weakness of Spleen energy.

Where symptoms appear, though, and what might be causing them are two entirely different issues. The system of energy is one of complex interrelationships, and the fact that a symptom is caused by a weakness does not mean that this is where the weakness originated. The great strength of Chinese medcine is that it seeks to establish which part of the system is the underlying cause. Otherwise, just treatment the symptom, even from a Chinese perspective, will not hold.

The best advice that we can give you is to visit a BAcC member local to you for a brief face to face assessment. This should very quickly establish whether this part of the system is weakened, but also give a better idea of the context in which the symptom is occurring. You may find that the practitioner may recommend that you look at other options to accompany acupuncture treatment. We find that women can often set out to do pelvic floor exercises on a regular basis, but all of us tend to be better at following routines where we are accountable to others, and we find that many patients find Pilates classes very effective as a way of reinforcing improvements gained through treatment.

A:  When someone has a serious neurological disorder like MND it is quite common for nearly every new symptom in the body to be ascribed to this. We have the same experience treating people with MS or Parkinsons. In the vast majority of cases the symptoms will be to do with the primary condition but there are a few occasions where there is no necessary connection between the symptom and the headline condition, and for these acupuncture treatment may be of value.

Certainly the symptom as you describe it could be explained within the system of Chinese medicine. You may or may not know that the theory is based on an understanding of the body as a system of energy, called qi (pronounced 'chee') , whose flow and balance are essential to good health. Qi is said to provide nourishment and warmth to all parts of the body, so if the flow is impaired this can cause areas to become weak, cold and generally less healthy.

An experienced practitioner will be able to assess very quickly from a brief face to face assessment how likely this is to be the case, and if they believe it is something that is amenable to treatment they will be give you a good estimate of how much treatment may be necessary. We believe that with problems like this there is often quite a rapid response or none at all, and two or three sessions should give a clear indication of whether the treatment will work. What we try to avoid is the victory of hope over experience, with people committing to long courses of treatment where there is clearly nothing happening.

Most BAcC members are more than happy to give up a few moments without charge to deal with these kinds of enquiries face to face, and there is almost certain to be someone working close to where your friend lives. The postcode search facility on our home page is very good for identifying the closest member.

Q: Good to have this blog to post questions.  My question is we have consulted a physio for neck pain and the physio instructed that it's due to trapezius muscle knot and he has given me acupuncture treatment. The neck pain has reduced but have the  trapezius muscle pain. I am worrying if its due to acupuncture treatment? What are the side effects for trapezius muscle acupuncture?

A:If we understand you correctly, the treatment for the neck involved releasing the trapezius muscle and now that the neck pain has reduced the trapezius is painful instead.

A great deal depends on how long it is since the treatment was given. Many physiotherapists use forms of what is known as 'trigger point' acupuncture. This is a western acupuncture approach which involves locating and treating tight spots in the muscle fibres which cause pain where they are and also cause muscle contraction which can then cause pain further down the line. Trigger point treatment often involves using longer and thicker needles than we would use in traditional acupuncture, and the treatment itself can sometimes leave a painful area for a few days. There is sometimes a little internal bruising after this technique, and this can also take a short while to go. You could normally expect this kind of pain to go after 48-72 hours, although if the treatment has been epecially vigorous this may be as long as a week.

If the pain persists after this the first person you should speak to is the physion himself; he will be in the best position to assess what is happening because he will know exactly what he has done, and may be able to apply further treatment and exercises to help to resolve the problem. If this does not do the trick then the next port of call is your GP. However, we strongly suspect that the problem will have gone long before you reach this stage.

The other possibility to consider is that sometimes a severe pain can overshadow another pain in the same area, and when the primary pain goes, the second one becomes more noticeable. This is very common in feedback when people have multiple problems. Here again the physio is the best person to speak to. If he has managed to reduce the neck pain, then he can probably release the trapezius pain too.

There shouldn't be any especially noticeable side effects from this treatment. Clearly if the treatment is vigorous you may feel a little bruised in the area for up to 48 hours, but if the physio recognises from your first session that you are quite sensitive to the needling he may well reduce the intensity of the treatment to make the after-effects a little less noticeable.

We hope that this reassures you.

Wednesday, 12 November 2014 13:09

Can acupuncture help with addiction to alcohol

A:  We drew up a review paper some years ago

http://www.acupuncture.org.uk/arrc/public-review-papers/substance-abuse-and-acupuncture-the-evidence-for-effectiveness.html

which summarises the use of acupuncture treatment for a number of substance abuse problems, and as you can see in the paper, the evidence for the use of acupuncture is relatively positive, although the trials undertaken are often methodologically flawed and rather small to be used as a basis for definitive statements. The most recent systematic review in 2009 reached this conclusion, and nothing significant has been published more recently to change this view.

However, although mainstream acupuncture treatment is used to deal with the problems of alcoholism, there are a great many projects which use a more limited form of acupuncture, ear acupuncture or auricular acupuncture as it is often known. There are two very large national groups, NADA-UK (http://www.nadauk.com/) and SMART-UK (http://www.smart-uk.com) whose members offer the five-point protocol and other formula treatments for helping people to deal with the problems of alcohol, and details of where practitioners can be found are on both websites. A great deal of their work is done in drop-in facilities, and some provide additional support and counselling as a part of the service.

There are also a substantial number of practitioners who belong to the Microsystems Acupuncture Regulatory Working Group which is registered with the PSA-accredited Complementary and Natural Healthcare Council. This group includes a number of organisations whose members offer more sophisticated auricular treatment than simple protocols, and their details can be found here (http://www.macrwg.org/).

This does not mean that the ordinary BAcC member does not treat people with alcohol problems, and many do to great effect. Our experience, however, is that the group setting of the detox projects often adds considerable value to the treatment through the peer pressure and encouragement which abounds. It may still be worthwhile seeking the advice of a local BAcC member, however. There are huge variations in the experience of alcoholism, from falling down drunk to a simple realisation that the end of work day drink is becoming a necessity rather than a treat, and our members may well be able to provide exactly what someone needs.

Wednesday, 12 November 2014 13:02

Can acupuncture help with chronic pain in my leg?

 Q:  I have nerve damage following a spinal surgery, which sadly has complications. I now have chronic pain in my right foot and acute pain in my right lower leg. Would accupunture help?

A:  A great deal depends on whether the nerve damage has been shown to be directly responsible for the pains in your right foot and lower leg, or whether they have simply arisen at the same time as a consequence of the operation.

The reason we make this distinction is that traditional acupuncture is based on an understanding of a flow of energy, called qi, in the body whose balance and rhythms are responsible for everything functioning as it is supposed to. When the flow is disturbed by surgery or injury, this can have considerable consequences, often local to begin with and then becoming systemic as the flow to deeper structures starts to become impaired.

The reason for pointing this out is that is the nerves have been physically damaged by the operation, something which a neurologist should have established very clearly, then we would be dishonest if we did not say that there is not a great deal that treatment with acupuncture can do. There is a small amount of evidence from animal experiments, dismissed by many of our colleagues as 'ratpuncture', that acupuncture treatment may help nerve to regenerate, but whether one can take results from rats and extrapolate this to human beings is completely unclear. We tend to take the view that in the absence of any hard evidence to the contrary, when nerves are physically damaged there is not much to be done.

However, the flow of energy in the body is organised in what are called channels, and major surgery is often very disruptive of the flow of these. If you look on the internet you will see diagrams of channels, two in particular, which run down the centre of the back and then continue down the back of the legs to the feet. If there has been a blockage caused by the surgery, this might create long term pain because of the diminished flow.

It is difficult to give you a definitive view at a distance, however, and your best bet will be to visit a BAcC member local to you for an informal, and hopefully without charge, face to face assessment of whether treatment may be of benefit. There is no doubt that acupuncture can provide relief from pain; this has been one of the most heavily researched and documented areas of effect. The question is always how much relief and how sustainable, and balancing this against a long term continuing expense. A well-trained practitioner, though, should be able to make a relatively rapid assessment of whether the treatment may be able to achieve more than this based on a simple inspection of which areas are affected and how these relate to the flow of channels in the body.

 

Wednesday, 12 November 2014 12:59

Acupuncture and sarcoidosis

Q:  have sarcoidosis and get accupuncture once a week at the hospital.  Lately the nurse has put needles near all the way in( i get them in my hands near the thumb and one in each foot).  I have had accupuncture before which was great but after my last couple of sessions I have lot of pain in my hands an don't feel well for a few days.  Is this normal?

A:It is not unusual to feel slightly different for a couple of days after treatment, even sometimes a little worse than before, and usually the effects are transient and wear off. If they continue for more than two to three days it suggests that the treatment is too strong or that there has been some internal bruising which will continue to cause discomfort until it clears. This may take a week or two.

The points you describe suggest that the nurse is using a treatment with which we are familiar which is often used to reduce pain and also used as a general calming treatment for the whole body. If so, unless the nurse is using very short needles there is a possibility that the very deep insertion is causing excessive stimulation, and the simple answer to that is to insert needles to a lesser depth and to do less with them by way of tweaking and twisting when they are in place. Generally speaking we do not favour putting needles in up to the hilt. We always recommend that practitioner use longer needles inserted half way than short needles to their fullest extent.

The best thing, though, is to describe what has happened to the practitioner and ask if he or she can reduce the strength of the treatment a little. Most responsible practitioners are very much guided by the feedback from patients, and there are patients who are particularly sensitive to acupuncture, whether this be traditional acupuncture or western acupuncture.

We are pleased, though, to hear that it has been of benefit and hope that once you have ironed out this slight problem you will experience the same levels of benefit.

Wednesday, 12 November 2014 12:51

Do we work with the NHS?

]Q:   Do you work with the NHS can any of your associates  work through the NHS System?

A:  A small number of our members work within the NHS, but this is very much to do with local resources and personal negotiation. It is a stark reality that there is not a great deal of speare funding within the system at the moment, and very few Commissioning Groups are looking to import services which will add to their budgetary concerns. We do not anticipate any national agreements within the foreseeable future

There is a certain amount of acupuncture provisions within the NHS from doctors and physios who incorporate it within their work in specific areas such as back pain, but it is not usually possible to seek out an NHS acupuncturist as such.

Most people look for NHS provision of acupuncture treatment because of the cost, and it is important to point out that most BAcC members are prepared to reduce fees if someone faces genuine hardship in trying to meet the standard rate. There are also a number of facilities called multibed clinics which have been set up with the express inention of making acupuncture more widely available to a wider target group. Details of these can be found at www.acmac.net.

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.

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