Sandy Williams

Sandy Williams

Tuesday, 19 July 2016 15:52

Would acupuncture help kyphosis?

Q: My son has kyphosis. He is due to see surgeons regarding  an op on his back, the pain he is in is terrible. He also suffers terrible pain in his ribs.  I am wondering if this is because he "stoops" over. He finds it difficult to work, although he has a part time job. He stays in most of the time because of the pain. Would  acupuncture help him either to get to his appointment or instead of surgery?

A: We are sorry to hear of your son's problems.

It would interesting to know whether the kyphosis was a congenital problem or whether something has happened throughout his life to make the problem develop, and where the main areas of 'bend' are. This would to some extent condition the advice we can offer.

Generally speaking, traditional acupuncture treatment is as much about treating the person as treating individual conditions on the simple but effective premise that a system in balance will maximise function across the body and help the body to repair itself. This is why we successfully treat a great many people with back and neck problems, not through manipulating the physical structure but through encouraging better and more correct function in the muscles which in turn pull the body back into shape. It may well be possible that treatment of this kind might benefit your son. There are also a great many ways of treating specific changes in structure by directly supporting the channels of energy which hold things in place, making good weaknesses which allow the shape to 'slip.'

There is also some hope that acupuncture might be able to address continuing pain. We invariably say that it is not a question of whether acupuncture treatment can treat pain as much as how much relief the treatment can give and how sustainable the relief is. This can sometimes, unfortunately, come down to finances. If treatment can buy a fortnight's relief and someone has deep pockets this might be a viable long term arrangement. Most of us are not so fortunate. After Nixon's visit to China in the 1970s made people in the West aware of the use of acupuncture for pain relief and anaesthesia there was a great deal of research which showed that treatment could have a tremendous effect, which is why some many pain clinics routinely offer acupuncture as a primary option.

We think that the best advice that we can give is to encourage your son to visit a BAcC member local to him for a brief face to face assessment of what might be possible. This will be a great deal more precise than anything we can offer here. He might also usefully consider cranial osteopathy as an alternative. This is a very gentle form of treatment which may be able to offer similar benefits.

Q:  I m trying to be  convinced , but my period stopped from three months.  My doctor says I m passing through the premonopouse.  I am 37 years old.  Should I get pregnant ? What should I do to get  my period back?

A:  We are sorry to hear of your problems. Early menopause can be a terrible blow when someone decides to have a child at what should be a perfectly normal age to conceive.

As our factsheets show

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

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

the treatment of fertility and menopausal problems has been an area of great focus within the last decade, and a significant proportion of BAcC members undertake postgraduate training in treating fertility issues. We are actually on the verge of agreeing standards which allow someone properly qualified to claim to be an expert provider. Speaking to someone with this kind of training background who may be based near to you would be an extremely useful thing to do. We cannot tell, for example, whether your doctor's view that you are peri-menopausal or menopausal is based on blood tests of hormone levels or just an assumption based on the fact that your periods have stopped and you are in the right age group. There may also be family history which would give some insight into what is happening. If there is a history of early menopause in your family that could make a significant difference to what you could expect from treatment.

Once someone is armed with this background information it is possible to offer a much better idea of what may be possible. As this rather dense and heavy study shows

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3962314/

there have been interesting and often successful studies of almost all aspects of women's reproductive health, so there is every reason to believe that if you have not fully entered the menopause treatment may be able to enhance the remaining functions of your body.

Our advice, as always, is to visit a BAcC member local to you who can tailor the advice to your specific circumstances. The one thing they will need to know is whether your doctor has checked your hormone levels and if they show that you are truly in the menopause. This will have a huge impact on the advice they can offer you.

Q:  Is it possible for acupuncture to increase the length of your menstrual cycle? My cycle has always been 30-32 days but since starting acupuncture I have had 2 cycles that have been 42 and 40 days long. My periods have never been this delayed and this only happened following my first acupuncture treatment. I'm undertaking acupuncture treatment for unexplained infertility and so the uncertainty over my periods is causing quite a bit of stress as I'm worried the treatment is taking me in the wrong direction and it's making it difficult to predict when i am ovulating. 

 

A:  It is difficult to imagine that acupuncture treatment could have caused your cycle to have 'stretched' permanently. The underlying premise of that treatment is that there is a 'normal' pattern of bodily functions to which the body will return once it is in balance. We can remember our own teacher being extremely dogmatic about the cycle being 28 days, and giving us a hard time if we accepted any variation from this as OK.

It is possible that when someone first has treatment the whole system can become a little unpredictable. Although a great deal of treatment is described as 'treatment for x' or 'treatment for y' the reality is that true traditional acupuncture treats the person, not the condition. This offers the best chance of sorting something out and keeping it sorted. When you begin a course of treatment it can disturb patterns which have been in place for a long time, and rather like dropping a stone in a pond it can take a while for a steady picture to emerge.

The person best equipped to offer you advice on this is your practitioner, especially if their specialist field is the treatment of fertility problems, in which many practitioners undertake postgraduate training these days. They will almost certainly have come across similar problems before, and most belong to specialist networks through which they can share information and seek advice.

We can understand, though, how frustrating it must be when there is such an emphasis on exact timing and the various treatments which are used to enhance the chances of becoming pregnant. Hopefully, though, things will settle down from now on and enable you to have a better chance of making a baby.

Q: I had acupuncture yesterday afternoon, and it's the night of the next day, and my stomach is still twitching?  I read that muscle spasms are normal after acupuncture, but I was wondering if they really last this long? I had acupuncture for my chronic tension headaches. I had 6 needles; one on each of my upper forearms, one on each of the areas below my knees, and one each between my big toe and second toe. Is it normal to still have these muscle twitches?

A:  The short answer is 'no'.

While muscles in the area which has been needled can twitch slightly when the needle is inserted and may continue to do so for a while, it would be unusual, but not impossible, for a muscle somewhere entirely different to react in this way. You can never rule out the extremely unexpected because acupuncture treatment treats the whole person, so in theory a needle could start a chain reaction which could lead to a palpable change somewhere else. However, changes are more usually functional than structural, i.e. a needle in the foot might make a headache go away but would be less likely to cause an unintended structural event.

That said, we don't think there is anything particularly worrying in what you describe, and we strongly suspect that by the time you get this response it will have stopped happening. If by some chance it does continue, then you should discuss the matter with your practitioner in order to see if they can understand what is going on. If this is a mystery to them it may be worth popping along to your doctor to see if there is something else going on. We say this because most unusual consequences of treatment disappear within 24-48 hours, and something which goes on beyond that may have coincidentally happened at the same time as treatment but not be related to it. In these circumstances it is important to find out what has happened rather than spend time trying to find out what caused it. The process of establishing what it is usually does that anyway.

Q:  I have been diagnosed with ocular myasthenia and have been reading up about possible benefits of acupuncture treatment.  I was wondering if I can get contact details about a good acupuncturists based in Edinburgh.

A:  There is, as you might expect, not a great deal of evidence for the treatment of ocular myasthenia with acupuncture. We managed to find half a dozen case studies, mainly in Chinese and not translated, which showed some encouraging signs, but the reality is that small case studies only get published because they are the ones where treatment worked. As such, they are not reliable, because in single cases there are many other factors which might have had an impact. However, there was one study of more cases which seemed a great deal more positive, which you can read here:

http://www.sciencedirect.com/science/article/pii/S100352571360032X

We were asked a little while ago about myasthenia gravis, and what we said there is just as applicable to your problem which is one presentation of the wider condition.

There is a small amount of evidence that acupuncture may be beneficial for treating myasthenia gravis, but the studies, like this one


http://www.ncbi.nlm.nih.gov/pubmed/18271233


are small in size and while suggestive of benefit a very long way from being conclusive evidence.

The trite answer we could give is that acupuncture treats the person, not the disease, and to the extent that all acupuncture treatment is geared to helping the body mind and spirit to normal function, then all conditions should, in theory, benefit from treatment. However, one has to be very careful with statements like this because it gives a false impression that all conditions are curable, which is clearly not the case. There are many debilitating diseases which are chronic and degenerative, for which the best one can say, as one patient famously did, is that they were 'very pleased because they were getting worse slower.'

The one advantage of Chinese medicine, however, is that it looks at the symptoms which patients experience through an entirely different diagnostic framework, one which can sometimes make sense of conditions in a way that conventional medicine cannot. Very few diseases are new, and Chinese doctors were probably treating this two thousand years ago without any concept of auto-immune disorders. they would simply have made sense of the presentation of the condition based on the understanding of the physiology in Chinese medicine and the pathologies which could arise when internal or external factors disturbed the flow of energy, or 'qi' as it is called, and led to organic malfunction.

Weakness and flaccidity of the muscles could be understood as a local or systemic problem, and the skill and art of the Chinese medicine practitioner lies in determining the most elegant and effective way to restore balance and good flow. It may be worthwhile asking a BAcC member local to you whether there is something obviously out of kilter in your system which might be contributing to the problems you have. 

On balance, though, we have to be realistic and say that even anecdotal evidence is not that great, and what acupuncture may do, more than remove or reduce symptoms themselves, is to help you withthe secondary stresses and anxieties which the condition can engender. Many patients report this as an outcome which in itself makes treatment valuable.

We think that asking a local BAcC member for a view remains sound advice, and is probably a more realistic way of approaching the problem than by reference to a named condition occurring in different patients with different baseline constitutions. How your problem presents will be something which can inform a professional view far better than we can do here at this remove.

A: As far as the condition itself is concerned, as our factsheet shows:

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

there is a small amount of fully researched evidence that acupuncture can provide short-term relief for the problem. The criteria for quotable research set the bar very high by employing research requirements more suitable for drug testing, the randomised double blind control trial. In daily practice tennis elbow is one of the more frequent named conditions for which people seek help from acupuncturists. Our usual recommendation to patients is to have two, three or four sessions along with trying as much as possible not to have to do the sorts of things which brought the condition on. 

We tend to look for regular reviews after four or five sessions and measurable outcomes - range of movement, weight bearing etc - to ensure that a pattern does not develop of ten or more sessions without any result. This tends to make unhappy patients, so we are very clear about drawing a line if there is no discernible change after the first few sessions.

On balance we think that the best advice we can give you is to visit a BAcC member local to you to see what they make of the problem that you have and by virtue of a face to face assessment offer you a very clear idea of what may be possible for you. 

A:  The abbreviations all relate to physiotherapy, as far as we can tell.  We assume that you mean MCSP rather than MCPS, this being Membership of the Chartered Society of Physiotherapy. MAACP means that the person is a member of the special interest group, the Acupuncture Association of Chartered Physiotherapists. SRP usually means  state registered paramedic, but we think in this instance it refers to state registered physiotherapist.

A:  We are often asked about specialists in treating certain kinds of problem, and the answer is always the same - from a traditional Chinese medicine perspective we are all generalists because we treat the person, not the condition. Indeed, in ancient times the specialist was looked down on as a rather unworthy being because they only treated a small range of problems! In reality, there are a number of areas like paediatrics, obstetrics and mental health where we are investigating how to accredit expert practice because we do recognise that in each area there is supplementary knowledge and experience which is not a part on undergraduate training, but this does not mean that only these people can treat these groups. The difference is between good and better.

The nature of Chinese medicine is that the symptom or presenting condition has to be seen in the context of the person's overall health or balance. This explains why twenty people with the same named condition might be treated in twenty different ways. In reality, though, there is quite great deal of research using slightly more formulaic points which can help the problem of chemo-induced neuropathy. Western research tends to eliminate variables, so treatment protocols tend to be repetitive, unlike most practice which is evolutionary and developmental.

There is a systematic review found here

 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3741953/

which looks at all of the studies which have been conducted, and tends to be a little bit negative, although conceding that there are studies which look promising. Part of the reason lies in the fact that many Chinese studies, of which there are thousands, tend to be more concerned with what works better than with whether acupuncture works, and these tend to be dismissed as methodologically weak, hence the almost universal request for 'more robust' studies. The reality is that the gold standard of research in conventional medicine, the randomised double blind control trial, is not best suited to testing a therapy with many variables, so results are always going to be strange. The more the treatment fits the conventional structure of testing, the less it looks like what we do.

Anyway, enough carping about research! Most of us have had successes quelling the worst aspects of neuropathy, but we have also had our failures. It is very important to review treatment to avoid a subtle accumulation of many treatments, and equally important to try to find measurable outcomes to test whether there really has been progress. On this basis a course of acupuncture treatment will certainly not do any harm, and will probably do some good. The question is really how much good and how sustainable.

To find a practitioner geographically closest the best thing to do is to use the postcode search facility on the BAcC home page. We have just  tried it and generated thirteen hits on SO22 and SO23, so we are sure that you will find a suitable practitioner close to where you live. Most of our colleagues are happy to invite people in for a chat before committing to treatment, and this is often the best way to establish whether someone is the practitioner for you.

Q:  My GP is referring me to have acupuncture treatment for my neck.  I have a partial fear of needles and a low pain threshold . I am suffering with bad headaches and my GP  thinks it's coming from my neck.

A:  The GP may well be correct; a considerable number of headaches arise from problems in the neck, often to do with gradual changes in the vertebrae which can impinge nerves and affect blood flow. There is quite a great deal that acupuncture for both problems, as our factsheets show:

http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/4076-neck-pain.html

http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/1581-headache.html

Obviously we have to qualify these kinds of sheet with the statement that traditional acupuncture treats the person, not the condition, so we treat a person with a headache, not just a headache. This can make a profound difference to the treatment. Twenty different patients with the same presenting symptom might be treated in twenty entirely different ways as the practitioner sought to balance their own specific patterns of energy. This is one reason why we believe that acupuncture can be more successful than some conventional treatment because it is tailored to the unique needs of the patient.

As far as needles are concerned, there is no reason to fear them. The majority of members use needles which are 0.18mm ot 0.25mm and usually only an inch long, of which the top 3mm-5mm is actually inserted. The use of guide tubes helps even more, the pressure of the tube deadening most of the sensation in the area. Most of us have treated people who are needle phobic, and the simple expedient of showing someone what is going on, perhaps on an area where they can see what's happening, and talking through the process is usually more than effective. There are very few cases where the needling itself has stopped people having treatment, and most of us know how to start as gently as possible in order to keep people happy! The best thing to do is to visit a local BAcC member for a pre-commitment chat to be reassured about them, where they work and what needles look like. You will also get the benefit of a straightforward assessment of how well acupuncture may be able to help you.

Thursday, 14 July 2016 11:02

Will acupuncture help with bad headaches?

Q:  My GP is referring me for acupuncture for my neck.  I have a partial fear of needles and a low pain threshold . I am suffering with bad headaches and my gp thinks it's coming from my neck.

A: The GP may well be correct; a considerable number of headaches arise from problems in the neck, often to do with gradual changes in the vertebrae which can impinge nerves and affect blood flow. There is quite a great deal that acupuncture for both problems, as our factsheets show:

http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/4076-neck-pain.html

http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/1581-headache.html

Obviously we have to qualify these kinds of sheet with the statement that traditional acupuncture treats the person, not the condition, so we treat a person with a headache, not just a headache. This can make a profound difference to the treatment. Twenty different patients with the same presenting symptom might be treated in twenty entirely different ways as the practitioner sought to balance their own specific patterns of energy. This is one reason why we believe that acupuncture can be more successful than some conventional treatment because it is tailored to the unique needs of the patient.

As far as needles are concerned, there is no reason to fear them. The majority of members use needles which are 0.18mm ot 0.25mm and usually only an inch long, of which the top 3mm-5mm is actually inserted. The use of guide tubes helps even more, the pressure of the tube deadening most of the sensation in the area. Most of us have treated people who are needle phobic, and the simple expedient of showing someone what is going on, perhaps on an area where they can see what's happening, and talking through the process is usually more than effective. There are very few cases where the needling itself has stopped people having treatment, and most of us know how to start as gently as possible in order to keep people happy!

The best thing to do is to visit a local BAcC member for a pre-commitment chat to be reassured about them, where they work and what needles look like. You will also get the benefit of a straightforward assessment of how well acupuncture may be able to help you.

 

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