Sandy Williams

Sandy Williams

Q:  I have symptoms of arrhythmia.I do have an ICD to keep my heart in check in case of a runaway tachycardia episode .I take mexiletine and sotalol to prevent that from happening. .The drugs themselves are enough to kill me.  Would acupuncture be a viable alternative to all these medications,and to better my overall health? I am more than ready for a change! (Sick and tired of being sick and tired) I am only 61 yrs old with a lot of living yet to do.  I'm in good health otherwise.Just can't do the things I used to do......frustrating!!!

A:  We have to say that acupuncture is not viable as an alternative to your current medications.

This is a problem which we confront quite often with medications, and especially those prescribed for asthma. The medications are prescribed as a preventative, and if someone's condition is stable then it is extremely unlikely that a GP will consider stopping or reducing the dose. This is not a surprise. There is evidence to suggest that if long term medications for asthma are removed there is a slightly increased risk of a serious or fatal attack, and faced with this possibility for any preventive medicine it is likely to mean a lifetime regime. Better than the alternative, as they say.

However, we do treat many people with lifetime medication regimes and there is no doubt in our minds that acupuncture can sometimes make the side effects of the medication less unpleasant, and may also start to address the underlying problem for which someone is taking the meds. There are obviously no trials to validate this statement - they'd never get ethical approval - but from a Chinese medicine perspective the drugs themselves are a toxin which will have an impact on the body's energies beyond the positive effects they have on the specific problem, and it is always possible to reduce the discomfort that these cause. A classic example for us is the use of acupuncture for the nausea caused by chemotherapy. There is a great deal of research which shows that the anti-emetic effect is strong without compromising the effect the drug has on cancer cells.

The best advice that we can give is that you visit a BAcC member local to you for a brief consultation about what benefits acupuncture may be able to offer. Your condition will have some sort of history, and even a brief narrative account may well offer some useful insights into what the problem is from a Chinese medicine perspective, what the underlying causes may be, and also what effects the medications are having on the system. This may encourage a practitioner to feel that there is a good chance of reducing the impact that these medications are having. 

A:  We find it quite difficult to answer questions about very specific problems like this. There is little or no research into problems like this, and where this is it tends to be in the form of case studies. These are interesting but offer far too many confounding factors to be able to draw any conclusions or recommendations. In modern times the advertising rules are now far too prescriptive to make claim without proper evidence (although we often argue with the ASA about what counts as 'proper'!)

However, symptoms are the same the world over, and in its 2500 year history there is a rich vein of addressing the pains and discomfort which people feel from problems like this by looking at their structure and appearance from within the framework of traditional Chinese medicine. This is an entirely different paradigm of medicine with patterns and syndromes which sound utterly alien to the untutored ear,  but it has stood the test of time. If we drop disease labels out of the picture and focus on what someone experiences as a change in the balance and flow of energy, called 'qi', on which the system is based we often find local blockages and systemic weaknesses, the correction of which can make a significant difference.

Essentially Chinese medicine treats the person, not the condition, and the practitioner will want to understand why this particular symptom developed in this person. In this sense traditional acupuncture can help in the treatment of most named conditions, but we have to be careful because 'treat' implies 'cure', and this is often not the case. All that we can do is to maximise the balance of the individual and then let nature take its course. Sometimes the results are very good, on other occasions there are many hereditary and lifestyle issues which limit what is possible.

The best advice that we can give is that you visit a BAcC member local to you for an informal chat about the possible benefits of acupuncture. You will be able to let them know a great deal more about what exactly is happening, and this will offer the chance of a much better and more precise view than we can offer here. Most do not charge to have a quick look at a problem, and of course you get to meet them and see where they work before committing yourself to treatment.


Wednesday, 18 May 2016 15:01

Acupuncture and tendonitis

Q:  Can acupuncture make tendonitis worse, I have had 2 sessions now the first session was fine, but after my second session I was sore, which was 5 days ago & I am having trouble moving my neck, lying down & stabbing pain in my shoulder with swelling, also a slight bruise has come up on the inside of my arm. 

A:  The short answer to your question is 'yes.'

With all forms of musculo-skeletal treatment we warn patients of the potential for symptoms to become a little more pronounced after the first session or sessions. This is very often the case for back and neck problems. There is no definitive reason for why this happens. Most of us take the view that although we treat function rather than structure, when we get the balance of the body's energies more as it should be the structure of the body will start to adjust. This means that tendons and muscles which have adapted to an imperfect structure will have to tighten or loosen, and this will always involve a certain amount of discomfort. Some colleagues also talk about the restoration of energy flow being somewhat akin to putting cold feet in front of a fire after a long walk - immediate relief followed by pain as the circulation improves.

However, the fact that you have such a large range of problems suggests that the treatment may just be a little too powerful for you. Generally speaking if someone is quite sensitive to treatment, as many are, the effects may be a little too dramatic and we tend to scale back our endeavours with no loss of outcome - less really can be more. The fact that you have a small bruise, which probably comes from needling, may be indicative of this.

The most important person to discuss this with, though, is your practitioner. He or she will know exactly what they have done, and also how much they have done, and can provide you with the necessary reassurance. They can also adjust the treatment if indeed it is the strength of what they have been doing which is causing you concerns.

What we do often find, though, is that this sort of effect only happens with the first couple of treatments. After that there just tends to be steady progress, and the main concern is then how much progress and how sustainable it is.

 

A:  'Tried and tested' treatments for atrial fibrillation, and with them a 'best practice treatment' don't really sit well with the concepts of Chinese medicine.

We have been asked about AF on a number of occasions, and a composite response earlier this year said:

There are some early indications that acupuncture may have an anti-arrhythmic effect in patients with atrial fibrillation. A study published earlier this year

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3312232/

concluded that there appeared to be benefits and that further large scale trials would be valuable to test the hypothesis more carefully.

However, it is only fair to say that needling a single point such as Neiguan repeatedly is not a fair representation of what a traditional acupuncturist does in practice. Although there is considerable overlap between eastern and western systems the arrhythmia typical of AF could be classified in several different ways within Chinese medicine, and the practitioner would be guided by evidence other than simply a reading of the rate of the pulse. That in turn would mean that ten people with AF might receive ten different treatments. To that extent, it is not that straightforward to extrapolate from research studies like this and conclude that 'acupuncture works'. 

The skill of the practitioner lies in making sense of the symptom of AF within an entirely different theoretical framework, and understanding each presentation in each individual patient as unique. The best advice we can give any prospective patient is to contact a BAcC member local to them to seek a short face to face consultation at which they can be given a better assessment of whether acupuncture might benefit them.

The one caution with AF is that most patients are taking some form of medication to control the problem, and the cessation of medication can quickly provoke a return of the symptoms. For people involved in highly technical or responsible work this might represent a serious risk. We would always recommend that any member contemplating treating someone with a condition like AF should talk to the patient's GP to ensure that nothing they do will undermine the current treatment regime. 

We have undertaken some further searches of the literature and these two articles

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4321072/

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4673375/

say much the same as the earlier articles and indeed cite them frequently.

Most of us have treated AF cases, and they do represent something of a challenge because of the management of the case alongside western treatment and medication. Even where we manage to bring the episodes under control to a greater degree than the medication most medical practitioners are reluctant to stop the meds in case the patient has a serious recurrence when they are doing something which could have dangerous consequences (driving a car, etc etc). However, good dialogue can address these kinds of problems, and a patient with their symptoms under control is likely to be happy to facilitate good communication anyway.

The other slight issue is with the setting of outcome measures. AF can come and go, and a problem-free period can happen anyway, so a practitioner has to be careful to discuss with the patient what would count as evidence from the patient's perspective that there had been some progress.

As you can see from the responses there is a strong commitment to the idea that Chinese medicine treats the individual, not the condition itself. It may have been a strategic error for us as a profession to spend so much time talking about named conditions because it has started to develop a public perception that we are doing the same as doctors  but using needles instead. The reality is that although the symptom may be the same from a Chinese medicine perspective a dozen people with AF may be treated in a dozen different ways if the practitioner discerns a different root pattern in each system which needs to be treated to restore proper flow and balance.

Adding to what has been said above, we tend to tread cautiously with patients diagnosed with AF. Sometimes the treatments offered can have their own substantial side effects, and these need to be factored into any treatment plan. However, we tend to want to work in close contact with a patient's orthodox healthcare professionals to ensure that the condition can be brought under better control without risk to the patient.

Q: After neuro tests I have nerve damage to my left knee. This is causing difficulty in walking and knee pain ,there is also muscle wastage.

A:  A great deal depends on what caused the nerve damage. If this is as a result of an accident or illness which caused the initial problem then there may be rather more difficulty in restoring full function. However, the sort of muscle wastage you are experiencing is something which happens even to top flight athletes. It is not unusual for a footballer with a knee injury to be out of action for several weeks because the quads lose their tone really quickly and can take longer than the knee itself to become match fit.

The theories of Chinese medicine are all based on theories about energy, called 'qi', which is the basic constituent of all living structures. When this energy, which flows in well-established patterns and rhythms, is disrupted pain and weakness follow. The art and skill of the practitioner lies in determining the extent to which the poor flow is a local problem or a local problem which has persisted or failed to improve because of a greater underlying weakness or problem in the overall system. This marks the difference between traditional acupuncture and the more medically based versions used by conventional physicians. Sometimes if the problem is local, then it matters not what system to choose, and both will work. However, our experience is that very often there are good reasons from the Chinese medicine perspective why something is not improving as it should, and using systemic treatment alongside the local treatments can make a great deal of difference.

There is also the issue of how long after the initial problem the treatment is given. There is an interesting parallel with the treatment of muscle flaccidity or paralysis after stroke. In China this is treated almost immediately to ensure that proper flow is restored as soon as possible. The longer the disruption has been in place the more the body starts to accept this as 'normal' and the more entrenched the weakness becomes. This does not mean that improvement is impossible, just that iot may take a little longer.

We are assuming that you have been offered physiotherapy or exercise routines to help with your recovery. We would always advise someone to arrange to visit a BAcC member local to them for an informal assessment of what may be possible. It should be fairly straightforward to find at least one near to you who specialises in treating sports injuries, and they will be without doubt a valuable resource in putting together a package which will help you back to better mobility without pain.

 

A:  We are not quite sure whether your question relates to the age of the patient or to the problem she has.

Let us be clear straight away that age itself is not a factor in treatment. We have seen treatments given to new born babies and to 100 year olds, and there is always something which can be done to improve the balance of the system and the flow of energy within it. The only factor which may change is the ability to respond to treatment and even here there are no set rules. This 'expert' used to treat a lady in her 90s whose energy responded better than most to very simple treatments.

As far as migraines are concerned, these are one of the more frequent problems with which we have to deal on a regular basis. As our factsheet shows in a rather matter of fact way

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


there is a gathering body of evidence which shows that acupuncture is at least as good at conventional treatments with the added advantage that the body does not have to deal with the relatively strong medications which are routinely prescribed for the problem.  Of course, all migraines are different, and one of the great strengths of Chinese medicine is its concern to establish why this person gets this migraine, which means understanding not only what the whole picture of the system presents but also what counts as a migraine. This is a very flexible definition, and although there are family resemblances between all migraines, not everyone experiences every feature.

The best treatment patterns, in our experience, often involve a number of weekly sessions followed by a series of subsequent visits at longer intervals. Getting migraines under control is not the same as getting rid of them altogether, and the risk of stopping treatment too soon when they appear to have stopped is that when they return people conclude that the acupuncture did not work.

The best advice that we can give, however, is to visit a local BAcC member for an informal chat and face to face assessment of what may be possible. This is likely to give a much better idea of what benefits there may be and will also offer someone a chance to meet the practitioner and see where they work before committing to treatment.

Q:  My partner is an acupuncture student and was practicing on me in an effort to relieve a headache of mine. He inserted one of the needles in the space next to my pinky knuckle and I experienced a small explosive sensation, as if an elastic band had snapped on the surface of my knuckle, along with some sharp pain. It faded for a couple days and since the pain has returned and become a chronic soreness, that is acute when I grasp and turn things with my hand. This has continued for a week now, and I am concerned that I have permanent nerve damage and accompanying pain. Do you have any insight you can offer into what happened and where I can go from here. If it is nerve damage is there hope for recovery?

A:  We think that it is highly unlikely that you have suffered permanent nerve damage. The most likely cause of your pain, if the point is the one which we suspect it is, is that there has been a small bruise caused by the insertion of the needle and which lies hard up against a nerve or tendon passing through the area. Whenever you grip something or move a little, this is going to press on the surrounding tissue and cause discomfort. Generally speaking these sorts of problems resolve themselves within a couple of weeks. 

It is unlikely, given the needling techniques taught to students, that there has been anything forceful enough to cause physical damage. However, without knowing exactly what was done and what gauge, depth and angle of needle insertion we are a little bit limited in what we can say. We are, though, just a little bit concerned that you experienced a snapping sensation. If a nerve is hit this is usually experienced as an electric shock feeling, and often causes involuntary movement in the affected area. If the problems persist for more than another week we would be very inclined to recommend that you see your GP and get the area checked. It would be particularly important to see whether this has affected your range of movement of grip.

That said, in all likelihood it will have resolved by the time you read this. We are bound to say, though, that it does highlight a small problem about receiving treatment from someone who is not qualified. Many training courses take a very dim view of students practising without permission, and although some have what is called pre-qualifying practice where the student has insurance and a permit to work unsupervised away from the course, the majority only insure someone working inside the course premises and working in properly established conditions. If something very much more damaging had occurred there would be no insurance cover and the only redress would be a civil action, which is not renowned for cementing good relationships. It also means that a student would be limited in what they could ask, given that they could get thrown off a course for practising pre-qualification. 

Sorry to have to mention this, but we often tell our members that treating friends and family at any time except in emergencies is fraught with problems. People think that being  a friend means that someone will not complain or sue - they are wrong!

Tuesday, 17 May 2016 13:51

Can acupuncture help with paralysis?

Q: My father suffered cerebral haemorrhage and left side paralysis due high B.P.  Accordingly he was treated without operation. All is normal now except left side paralysis. Since last 4 days he is being treated with electro acupuncture. Will this help in his recovery and if so, then to what extent? 

 

A:  We are glad to hear that your father has made a good recovery apart from the left side paralysis.

There is no doubt that acupuncture can be used to help in stroke recovery. In a review paper which we have on our website which is probably far too complex for your immediate needs 

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

we take a good look at the evidence, and there is no doubt that research has shown that there is a benefit. Indeed, in China acupuncture is often used as a frontline treatment against the immediate effects of a stroke. It is not uncommon for someone to begin a course of treatment on the day of admission to hospital, the logic being that restoring the flow of energy as soon as possible can stop the body becoming 'set.'

If someone starts treatment a little later it appears to reduce the effectiveness a little, and our experience is that change may take longer to achieve. We have to remind people, though, that we treat people, not conditions, and our aim is to restore balance in all of the system. This might mean, for example, having an impact as well on the high BP, as well as helping the patient to feel more focused and positive about their recovery.

It is impossible to predict any outcome with accuracy, though. So much will depend on the amount of damage caused by the stroke and by the person's state of health before it happened. That there will be a benefit we have no doubt. Whether it is worth the investment in time and money is a judgement call, and we would expect a reputable practitioner to be as alert to this as a patient - none of us likes to treat someone when there is limited improvement, and we would often consider what might work better as an alternative.

We hope that you do see some positive changes soo 



A:  We always find these sorts of questions intriguing!

We are assuming that you have already consulted your doctor about this problem. If not, it is worth checking in because there are a small number of named circulatory disorders which can cause this as a symptom and you need to rule them out.

From a Chinese medicine perspective, the body is a field of energy called 'qi' which warms, nourishes and moistens the body tissues, so any symptom like coldness in a part of the body immediately alerts the practitioner to the possibility of a weakness of flow in one of the channels or flows of energy, or sometimes to a functional failure in a part of the system as a whole. Sometimes it is possible to trace specific lines of coldness which match specific channels, and on other occasions there will be a number of other issues, not necessarily seen as symptoms by a patient, which will point to a functional disturbance in one of the Organs (not that we put a capital letter in frony - the Chinese concept of an Organ is very different from the western concept.)

The practitioner will almost certainly ask a great many questions about the problem itself, trying to establish whethere the legs feel cold to touch or just feel cold on the inside, checking whether there are specific times when it feels better or worse, asking whether there are things which make them improve, like having a bath or eating, all to get a sense of what is going on. They will almost certainly them ask you about many other aspects of your health to get an overall sense of what is going on. This is the great strength of Chinese medicine practised properly, not just sticking needles where the problems are but seeing them within the overall context of someone's health.

We always advise potential patients to visit a BAcC member local to them for advice and a chance for someone to cast a professional eye over the problem. This will give you a much better sense of what might be achieved, and will also give you a chance to meet them and see where they work before committing yourself.


A:  As you can read from our factsheet

http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/1138-sciatica.html

there has been a significant amount of research into the treatment of sciatica with acupuncture, and the results have been increasingly positive. The threshold for being able to make a definite claim is based on a research process for which very little acupuncture treatment except non-traditional formula work will work, but there have been dozens of Chinese studies aimed at finding what works better which seem to show that sciatica responds well to treatment. Certainly this 'expert's' experience is that sciatica seems to respond well to treatment in most cases.

There is no doubt that formula treatment will work to an extent, and there are many medical acupuncturists and 'cookbook' practitioners who will use the same 'sciatica' patients on every patient. The real strength of traditional acupuncture, though, is that it addresses the problem of why sciatica occurs in this particular patient, or more properly why the system does not put right and recover from the injuries which normally cause it. Twenty different people may have the same named condition but be treated in twenty entirely different ways. What this does is not just put the problem right but try to make sure that it does not recur.

There are no special treatments for sciatica, and no specialists, so any well-trained traditional acupuncturist should be able to help you. The best advice, though, since there are one or two cases which would not make us feel so optimistic, is to pop in to see a BAcC member local to you for a chat and to get a short face to face assessment of what is going on. This will not only give you more precise information but also give you a chance to meet a practitioner and see where they work before committing to treatment.



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