Gavin Erickson

Gavin Erickson

FORGET Botox. The latest way to turn back the years and banish telltale lines is with acupuncture.

According to those in the know, stars such as Madonna and Gwyneth Paltrow have regular ‘acupuncture facelifts’ to ward off wrinkles.

 

 

ITV weather girl Clare Nasir believes acupuncture helped her conceive after|battling fertility problems. She talks to Gabrielle Fagan about her difficult pregnancy and her new life as a mum.

Wednesday, 29 February 2012 00:00

Neuropathic pain

 

Neuropathic pain results from damage to, or dysfunction of, the system that normally signals pain. The International Association for the Study of Pain (IASP 2007) defines neuropathic pain as follows: ‘Pain initiated or caused by a primary lesion or dysfunction in the nervous system. Peripheral neuropathic pain occurs when the lesion or dysfunction affects the peripheral nervous system. Central pain may be retained as the term for when the lesion or dysfunction affects the central nervous system’. A review of the epidemiology of chronic pain found that there is still no accurate estimate available for the population prevalence of neuropathic pain.(Smith and Torrance 2010)

Neuropathic pain is often chronic, and can be severe and difficult to treat.(NICE 2010) The origin of neuropathic pain can be metabolic, inflammatory, infective or neoplastic, or can be due to an injury, compression or infiltration (e.g. by tumour) of peripheral nerves. Various conditions can cause neuropathic pain include diabetic neuropathy, postherpetic neuralgia and trigeminal neuralgia, pain following chemotherapy and HIV infection.

Neuropathic pain is commonly described as burning, stabbing, stinging, shooting, aching or electric shock-like in quality.(Sykes 1997; Galer 1995) The pain may superficial or deep, intermittent or constant, and can be spontaneous or be triggered by various stimuli.

Conventional management often involves the combined use of a range of pharmacological (e.g. amitriptyline, gabapentin, opioids, NSAIDs, topical treatments such as capsaicin and lidocaine) and non-drug approaches, (e.g. transcutaneous electrical nerve stimulation, psychological treatments, and specialist procedures to stimulate, block or destroy discrete areas of the nervous system.(Sykes 1997)

References

Galer BS. Neuropathic pain of peripheral origin: advances in pharmacologic treatment. Neurology 1995; 45 (suppl 9): S17-25.

International Association for the Study of Pain (2007). IASP Pain terminology [online]. Available: www.iasp-pain.org/AM/Template.cfm?Section=Home&Template=/CM/HTMLDisplay.cfm&ContentID=3058#Neuropathic

National Institute for Health and Clinical Excellence, 2010. CG96 Neuropathic pain - pharmacological management: full guideline [online]. Available: http://guidance.nice.org.uk/CG96/Guidance

Smith BH, Torrance N (2010) Neuropathic pain. In: Croft PR, editor. Chronic pain epidemiology: from aetiology to public health. Oxford: Oxford University Press, in press (ISBN 9780199235766)

Sykes J et al. Difficult pain problems. BMJ 1997; 315: 867-9.

 

How acupuncture can help

This Factsheet focuses on the evidence for acupuncture in trigeminal neuralgia, chemical-induced neuropathy and neuropathy due to HIV infection. Diabetic neuropathy is discussed in the Type 2 diabetes mellitus Factsheet. There are also Factsheets on Sciatica and Cancer. Carpal tunnel syndrome and postherpetic neuralgia will be discussed in future Factsheets.

One systematic review of randomised controlled trials comparing acupuncture with carbamazepine for trigeminal neuralgia found acupuncture to be as effective as drug treatment, but to cause fewer unwanted effects.(Liu 2010) In single randomised controlled trials, electroacupuncture was found not to be effective for chronic painful neuropathy in general (Penza 2011); acupuncture was found to be more effective than cobamamide for peripheral neuropathy due to chemotherapy (Xu 2010); acupuncture plus acupoint injection was found to be more effective than carbamazepine for greater occipital neuralgia (Pan 2008); and neither acupuncture nor amitriptyline were found to be more effective than placebo for peripheral neuropathy due to HIV infection, but acupuncture was associated with reduced attrition and mortality rates(Shlay 1998; Shiflett 2011). Other non-randomised studies have found encouraging results with acupuncture for chemotherapy-induced neuropathy, HIV/AIDs-induced neuropathy, trigeminal neuralgia and peripheral neuropathy of undefined aetiology.(Donald 2011; Schrader 2007; Phillips 2004; Galantino 1999; Spacek 1998).

In summary, acupuncture seems to be at least as beneficial as the drugs it has been tested against, though in some circumstances neither may be very effective. As yet, there is insufficient research to indicate which patient groups it may be most helpful for. Acupuncture may offer additional benefits, from better sleep to reduced mortality, and probably has fewer side effects than pharmaceutical treatment.

In general, acupuncture is believed to stimulate the nervous system and cause the release of neurochemical messenger molecules. The resulting biochemical changes influence the body's homeostatic mechanisms, thus promoting physical and emotional well-being.

Research has shown that acupuncture treatment may specifically help to relieve neuropathic pain by:

  • Reducing hypersensitivity induced by spinal nerve ligation, an effect dependent on the opioid system (Cidral-Filho 2011);
  • Inhibiting paclitaxel-induced allodynia/hyperalgesia through spinal opioid receptors (Meng 2011);
  • Influencing the neurotrophic factor signalling system, which is important in neuropathic pain (Dong 2006).
  • Acting on areas of the brain known to reduce sensitivity to pain and stress, as well as promoting relaxation and deactivating the ‘analytical’ brain, which is responsible for anxiety and worry (Hui 2010; Hui 2009);
  • Increasing the release of adenosine, which has antinociceptive properties (Goldman 2010);
  • Improving muscle stiffness and joint mobility by increasing local microcirculation (Komori 2009), which aids dispersal of swelling;
  • Reducing inflammation, by promoting release of vascular and immunomodulatory factors (Kavoussi 2007);

About the British Acupuncture Council

With over 3000 members, the British Acupuncture Council (BAcC) is the UK’s largest professional body for traditional acupuncturists. Membership of the BAcC guarantees excellence in training, safe practice and professional conduct. To find a qualified traditional acupuncturist, contact the BAcC on 020 8735 0400 or visit www.acupuncture.org.uk

 

Research

Conclusion

Systematic reviews

Liu H et al. A systematic review on acupuncture for trigeminal neuralgia. Altern Ther Health Med 2010; 16: 30-5.

 

 

A systematic review that assessed the efficacy of acupuncture treatment for trigeminal neuralgia. Twelve randomised controlled studies involving a total of 920 people were included that compared acupuncture with carbamazepine. Four trials reported that acupuncture was superior to carbamazepine, and the remaining eight studies showed no difference between the treatment and control groups. Adverse effects with acupuncture, which were reported in three studies, were mild. The reviewers concluded that the evidence suggests that acupuncture is of a similar efficacy to carbamazepine, but results in fewer adverse effects in treatment of trigeminal neuralgia.

Randomised controlled trials

Penza P et al. Electroacupuncture Is Not Effective in Chronic Painful Neuropathies.Pain Med. 2011 Sep 14. doi: 10.1111/j.1526-4637.2011.01230.x.

A double-blind randomised placebo-controlled trial that investigated the analgesic efficacy of electroacupuncture (EA) in 16 patients with chronic painful neuropathy. EA was compared to pseudo-EA (placebo). Only one patient per group (EA and pseudo-EA) reported 50% of pain relief at the end of each treatment compared with pain intensity at baseline. Pain intensity did not differ between EA and pseudo-EA. The researchers concluded that their results do not support the use of EA in this population of painful neuropathy patients.

Xu WR et al. Clinical randomized controlled study on acupuncture for treatment of peripheral neuropathy induced by chemotherapeutic drugs. [Article in Chinese] Zhongguo Zhen Jiu 2010; 30: 457-60.

 

 

A randomised controlled trial that looked at effective treatments for peripheral neuropathy induced by chemotherapeutic drugs. A total of 64 patients with peripheral neuropathy induced by paclitaxel or oxaliplatin were randomly allocated to acupuncture or intramuscular injection of cobamamide. The neurotoxicity of two groups was compared using a questionnaire before and after treatment. The total effective rate for sensory nerve disorder in the acupuncture group was 66.7% compared to 40.0% in medication group (p< 0.05). The researchers concluded that acupuncture is more effective than cobamamide for treatment of peripheral neuropathy induced by chemotherapeutic drugs.

Pan C, Tan G. Forty-two cases of greater occipital neuralgia treated by acupuncture plus acupoint-injection. J Tradit Chin Med 2008; 28: 175-7.

A randomised controlled study that assessed the therapeutic effects of acupuncture plus acupoint-injection on greater occipital neuralgia in 84 patients. Acupuncture plus acupoint-injection was compared with oral carbamazepine. The total effective rate was 92.8% in the treatment group and 71.4% in the control group. The difference in the total effective rate was significant (p<0.05) between the two groups. The researchers concluded that acupuncture plus acupoint-injection is effective for greater occipital neuralgia and better than the carbamazepine.

Shlay JC et al. Acupuncture and amitriptyline for pain due to HIV-related peripheral neuropathy: a randomized controlled trial. Terry Beirn Community Programs for Clinical Research on AIDS. JAMA 1998; 280: 1590-5.

 

 

 

 

Shiflett SC, Schwartz GE. Effects of acupuncture in reducing attrition and mortality in HIV-Infected men with peripheral neuropathy. Explore (NY). 2011; 7: 148-54.

 

A randomised controlled trial that evaluated the efficacy of a standardised acupuncture regimen (SAR) and amitriptyline hydrochloride for the relief of pain due to HIV-related peripheral neuropathy in 250 patients. All treatment groups showed a reduction in mean pain scores at 6 and 14 weeks compared with baseline values, but there was no significant difference between the placebo, acupuncture or amitriptyline groups. The researchers concluded that neither acupuncture nor amitriptyline was more effective than placebo in relieving pain caused by HIV-related peripheral neuropathy.

A reassessment of research assessing acupuncture versus amitriptyline for peripheral neuropathy in 114 HIV-infected patients study. The results were inconclusive for pain measures, but acupuncture had a strong and positive effect on attrition and mortality. Overall, acupuncture was associated with lower attrition rate (27.6% vs. 44.6%, p=0.058), and a zero mortality rate (0% vs. 12.5%, p=0.047) than amitriptyline. This protective effect of acupuncture was most pronounced among patients with poorest physical functioning at the beginning of the study (0% vs. 23.8%, p=0.047). The researchers concluded that acupuncture was clearly effective in reducing attrition and mortality in men with HIV and peripheral neuropathy, but that results for pain relief were mixed.

Other clinical studies

Donald GK et al. Evaluation of acupuncture in the management of chemotherapy-induced peripheral neuropathy. Acupunct Med. 2011; 29: 230-3.

 

 

 

An observation study that clinically evaluated the effectiveness of acupuncture in the management of 18 patients with chemotherapy-induced peripheral neuropathy (PN). In all, 82% (n=14) of patients reported an improvement in symptoms following their course of acupuncture; one patient with advanced disease died during the 6 weeks. Some patients derived additional benefits from the treatment, including a reduction in analgesic use and improved sleeping patterns. The researchers concluded that, although these results are encouraging, they are uncontrolled.

SchrÃder S et al. Acupuncture treatment improves nerve conduction in peripheral neuropathy. Eur J Neurol 2007; 14: 276-81.

 

A pilot study to evaluate the therapeutic effect of acupuncture on peripheral neuropathy as measured by changes in nerve conduction and assessment of subjective symptoms. Forty seven patients with neuropathy of undefined aetiology were enrolled: 21 were treated with acupuncture therapy according to classical Chinese Medicine, while26 received best medical care but no specific treatment for neuropathy. Sixteen patients (76%) in the acupuncture group improved symptomatically and objectively, while only four patients in the control group (15%) did so. Three patients in the acupuncture group (14%) showed no change and two patients an aggravation (10%), whereas in the control group seven showed no change (27%) and 15 an aggravation (58%). The researchers concluded that their results suggest there is a positive effect of acupuncture on peripheral neuropathy of undefined aetiology as measured by objective parameters.

Phillips KD et al. Effect of acupuncture administered in a group setting on pain and subjective peripheral neuropathy in persons with human immunodeficiency virus disease. J Altern Complement Med 2004; 10: 449-55.

 

 

 

A study that assessed acupuncture treatment for pain and symptoms of peripheral neuropathy in 21 patients with HIV infection. Comparison of the pretreatment and post-treatment Pain Rating Scale results indicated a significant reduction in present pain (p=0.0002), least and most pain in the last 24 hours (p<0.0001 and p=0.0004, respectively) and the total pain summary score (p<0.0001). Scores for pain/aching/burning, pins and needles, and numbness in the hands and feet were reduced (p=0.0065), as well as the total summary score (p=0.0001). The researchers concluded that subjective pain and symptoms of peripheral neuropathy were reduced during the period of individual acupuncture therapy.

Galantino ML et al. Use of noninvasive electroacupuncture for the treatment of HIV-related peripheral neuropathy: a pilot study. J Altern Complement Med 1999; 5: 135-42.

 

A prospective study that tested the hypothesis that low-voltage non-invasive electroacupuncture will improve the condition of 11 patients with neuropathic HIV/AIDS. Complete data was obtained from only 7 patients, and there was improvement in the condition of all of them. They felt much better and reported feelings of increased physical strength and a significant overall improvement in functional activities (p=0.02). The researchers concluded that their results support the hypothesis that low-voltage electroacupuncture will improve the condition of the neuropathic HIV/AIDS patient.

Spacek A et al. Acupuncture and ganglionic local opioid analgesia in trigeminal neuralgia. [Article in German] Wien Med Wochenschr 1998; 148: 447-9.

 

 

A retrospective analysis of data from 39 patients with trigeminal neuralgia. In all, 17 patients had received carbamazepine and acupuncture therapy (group A), 11 had had carbamazepine and GLOA + acupuncture (group B), and 11 had received carbamazepine and GLOA without acupuncture (group C). All subjects had taken carbamazepine for at least 4 weeks. Of the groups who received acupuncture as an additive, 8 of the subjects in group A, and 5 of the subjects in group B were pain free, but only 2 of the subjects of group C (no acupuncture). The results for patients with marked pain reduction were similar. The researchers concluded that their results showed that the combined use of acupuncture and carbamazepine with or without GLOA achieves an additional therapeutic effect in the treatment of trigeminal neuralgia, and that the addition of acupuncture seems to have a superior effect to the addition of GLOA.

Possible mechanisms of acupuncture

Cidral-Filho FJ et al. Manual acupuncture inhibits mechanical hypersensitivity induced by spinal nerve ligation in rats. Neuroscience 2011; 193: 370-6.

 

 

A study in rats that found acupuncture stimulation was able to reduce mechanical hypersensitivity with treatment beginning in both acute and sub-chronic phases of SNL-induced neuropathy. The effect was blocked by naloxone, and was similar to the effect with gabapentin. The researchers concluded that their results demonstrated that manual acupuncture reduces hypersensitivity induced by the spinal nerve ligation, and the effect is dependent on the opioid system and comparable with the one obtained with gabapentin.

Meng X et al. The effects of opioid receptor antagonists on electroacupuncture-produced anti-allodynia/hyperalgesia in rats with paclitaxel-evoked peripheral neuropathy. Brain Res. 2011 Sep 26;1414:58-65.

A study using rats that found electroacupuncture (EA) to significantly inhibit paclitaxel-induced allodynia/hyperalgesia through spinal opioid receptors. The researchers concluded that EA may be a useful complementary treatment for neuropathic pain patients.

Goldman N et al. Adenosine A1 receptors mediate local anti-nociceptive effects of acupuncture. Nat Neurosci 2010; May 30.

 

 

A study showing that the neuromodulator adenosine, which has anti-nociceptive properties, was released during acupuncture in mice, and that its anti-nociceptive actions required adenosine A1 receptor expression. Direct injection of an adenosine A1 receptor agonist replicated the analgesic effect of acupuncture. Inhibition of enzymes involved in adenosine degradation potentiated the acupuncture-elicited increase in adenosine, as well as its anti-nociceptive effect. The researchers concluded that their observations indicate that adenosine mediates the effects of acupuncture and that interfering with adenosine metabolism may prolong the clinical benefit of acupuncture.

Hui KK et al. Acupuncture, the limbic system, and the anticorrelated networks of the brain. Auton Neurosci 2010; 157: 81-90.

 

Studies have shown that acupuncture stimulation, when associated with sensations comprising deqi, evokes deactivation of a limbic-paralimbic-neocortical network, as well as activation of somatosensory brain regions. These networks closely match the default mode network and the anti-correlated task-positive network. The effect of acupuncture on the brain is integrated at multiple levels, down to the brainstem and cerebellum and appears to go beyond either simple placebo or somatosensory needling effects. Needling needs to be done carefully, as very strong or painful sensations can attenuate or even reverse the desired effects. Their results suggest that acupuncture mobilises the functionally anti-correlated networks of the brain to mediate its actions, and that the effect is dependent on the psychophysical response. They discuss potential clinical application to disease states including chronic pain, major depression, schizophrenia, autism, and Alzheimer's disease.

Hui K.K.-S. The salient characteristics of the central effects of acupuncture needling: limbic-paralimbic-neocortical network modulation. Human Brain Mapping 2009; 30: 1196-206.

 

 

This study assessed the results of fMRI on 10 healthy adults during manual acupuncture at 3 acupuncture points and a sham point on the dorsum of the foot. Although certain differences were seen between real and sham points, the hemodynamic and psychophysical responses were generally similar for all 4 points. Acupuncture produced extensive deactivation of the limbic-paralimbic-neocortical system. Clusters of deactivated regions were seen in the medial prefrontal cortex, the temporal lobe and the posterior medial cortex. The sensorimotor cortices, thalamus and occasional paralimbic structures such as the insula and anterior middle cingulate cortex showed activation. The researchers concluded that their results provided additional evidence that acupuncture modulates the limbic-paralimbic-neocortical network. They hypothesised that acupuncture may mediate its analgesic, anti-anxiety, and other therapeutic effects via this intrinsic neural circuit that plays a central role in the affective and cognitive dimensions of pain.

Komori M et al. Microcirculatory responses to acupuncture stimulation and phototherapy. Anesth Analg 2009; 108: 635-40.

Experimental study on rabbits in which acupuncture stimulation was directly observed to increase diameter and blood flow velocity of peripheral arterioles, enhancing local microcirculation.

Kavoussi B, Ross BE. The neuroimmune basis of anti-inflammatory acupuncture. Integr Cancer Ther 2007; 6: 251-7.

Review article that suggests the anti-inflammatory actions of traditional and electro-acupuncture are mediated by efferent vagus nerve activation and inflammatory macrophage deactivation.

Dong Z-Q et al. Down-regulation of GFRalpha-1 expression by antisense oligodeoxynucleotide attenuates electroacupuncture analgesia on heat hyperalgesia in a rat model of neuropathic pain. Brain Research Bulletin 2006; 69: 30-6.

An animal study that found the endogenous glial cell line-derived neurotrophic factor signalling system (important in neuropathic pain) is involved in the effects of electroacupuncture analgesia on neuropathic pain in rats.

Wednesday, 29 February 2012 17:55

bad circulation with cold toes.

Q. Dear Sir, would you please be so kind to help me.

My mum has problems with her feet. She had oedema around ankle joint and around feet, which become more and more painful when she walks but also when she rests. She has a bad circulation with cold toes. All lab results are within normal ranges. Doctors excluded any cardiological cause. She was exemined by rheumatologists, but no conclusion.Would she benefit with acupuncture?

Many thanks

 

A. This is not an uncommon situation for an acupuncturist, where someone comes to them who has exhausted all of the usual tests with nothing unusual found and yet the pains and discomfort from which they suffer continuing to blight their lives.

 

Traditional Chinese acupuncture is based on an entirely different way of looking at the body and its workings. The symptoms which people have are understood within a different framework and often make sense from an oriental medicine perspective where in the western view they are simply a number of different items. The underlying theory of Chinese medicine is also based on very simple premises of balance and good flow of qi, the word used to described the body's energy. Even where a practitioner does not go directly after a symptom, there are strategies involving the whole system which are none the less effective in restoring good overall function and having an effect on symptoms wherever they appear.

 

The problems which your mother is experiencing - cold extremities, poor circulation, swelling - are all commonly found in specific syndromes described in Chinese medicine, and the skill of the practitioner is mainly deployed in making sense of these in conjunction with diagnostic signs unique to Chinese medicine - looking at the tongue and taking the pulse at the wrist. Your best course of action is to see if a BAcC member local to you is prepared to have a brief chat with you and your mother to assess whether treatment would be beneficial for your mother, and if so, what kind of timescale and frequency of treatment might be involved.

 

As a footnote, it is always good, when people have had a great many tests, to know that some of the problems which cause a great deal of worry have been ruled out. It may be cold comfort to someone still in pain, but ruling out heart disease and other blood-testable conditions is extremely reassuring.

From a western perspective the evidence for treating fibroids is not that good. In a major review undertaken two years ago

 

 

http://www.thecochranelibrary.com/userfiles/ccoch/file/Acupuncture_ancient_traditions/CD007221.pdf

 

the authors concluded that while acupuncture was heavily used in China to treat fibroids, there was not enough research conducted according to the best practice in the West to be able to draw firm conclusions. The same applies to acupuncture for the treatment of (in)fertility. As our own factsheet acknowledges such evidence as there is does not really provide a strong enough foundation to make sustainable claims.

 

However, one of the great strengths of Chinese medicine is that it operates with an entirely different understanding of pathology and physiology. There are ways in which conditions which are given western labels like 'fibroids' are understood which do not overlap or translate exactly with the western label. Fibroids, for example, are sometimes described as 'Blood stasis' or as manifestations of 'Dampness', and the treatment protocols are aimed at these as systemic problems which manifest in the local disturbance. If the diagnosis is one of 'blood stasis' or 'dampness' there may well be other symptoms and diagnostic signs which confirm this pattern.

 

As far as fertility is concerned, much the same reasoning applies. The Chinese took the simplistic, but effective, view that if everything was in balance, then natural processes should happen without problem. If a natural process like conception did not function, then it was simply a matter of correcting the overall balance and letting nature take its course. Even if there are specific symptoms which are implicated in the failure to conceive, these may still be best understood as part of an overall pattern and treated accordingly.

 

Our one word of caution is that the acupuncture treatment of fertility issues, especially related to assisted reproduction such as IVF and ICSI, has become a growth industry over the last few years, and alongside BAcC members many other individuals and clinics have set up which often charge extremely high fees for treatment which is no better than that offered by any BAcC member. While we do not recognise specialisms, there are many BAcC members who focus their work on fertility and pregnancy issues, and often have a wealth of additional background knowledge in these areas. For women undergoing IVF and ICSI this understanding can be a valuable addition to the work that a BAcC member does. The acupuncture treatment itself, however, is based on principles over 2000 years old which underpin the work of all BAcC members.

Q. I hav had accupunture done in January on my neck{i have cervical Spondilosis}and i'm also told ny an oestopath that I have a overstretched ligament.When the needle was put in it was really painfully I did tell the accupunturist and was told that how it will be but I feel he may have either gone into a muscal.Since then I have pain in my neck across my neck/back and in the top of my right arm although it is a little easier but still very stiff.I really want to know if this will ease in time or if having accupunture again will correct my pains.I would really appreicate your advise as to ease the pain I am rubbing in Biofreeze which eases it for about half an hour.Many Thanks

 

 

A. Although acupuncture is a very safe form of treatment, there are occasional adverse events. The vast majority are transient - someone might gets a small bruise, or feel a little lightheaded but it would be rare for these to persist for more than a day, two days at most.

 

In your case the fact that the symptom has persisted for over a month is a cause for some concern. In the first instance it is normally best to talk to the practitioner who gave you the treatment to seek their views, but if you feel a little reluctant to go back until you know what the cause is the next step is to see your GP and ask for his or her view. The chances are that there has been bruising fairly deep within the muscle which is taking a long time to heal but in the meantime is putting pressure on a nerve. However, given that you have spondylosis your GP may arrange further tests for you to rule out other possibilities.

 

The BAcC is very keen to gather information on adverse events arising from acupuncture. The last formal surveys, both published in the BMJ a decade ago, were very positive about the safety of treatment, but to remain up to date the BAcC has just launched a pilot scheme based on the GPs' Yellow Card Scheme to collect information on any adverse event brought on by treatment, including ones which are associated with improvement.

 

In the unlikely event that there has been a more substantial injury it is worth reminding everyone that BAcC members are covered by a 'gold standard' professional insurance from Royal Sun Alliance as a part of their membership package, and that the general public can be reassured that their interests are fully protected.

Q. I have a gential rash, apparantly an immune reaction to a cycle racing crash. I also have low abdominal pain and pain through my urethra, although passing urine is surpisingly OK. Minor injuries are not healing as well as normal. I am 53 and extremely fit.

I believe that my immune system is seriously disrupted due to the crash.

Can acupunture restore the immune system balance, ie not just relieve the symptoms?

Thanks

 

A. There is no doubt that the aim of traditional acupuncture is to restore balance to the whole system, not simply to remove symptoms. The practitioner will aim not only to get someone better but to keep them better. This is one of the many reasons why the BAcC is so adamant in arguing that extremely short courses in acupuncture are not fit for purpose; if someone has treatment aimed only at removing a symptom, the chances are the symptom will return and they will conclude that acupucture didn't work, when all they have established is that symptomatic acupuncture didn't work.

 

In your case, there are features of your symptoms as a group which may make sense from a Chinese medicine perspective. There is every likelihood that the physical shock of an accident could cause a lowering of the body's immune system as a whole, but there may well be more specific injuries which may fall within the scope of practice of Chinese medicine. One of its great strengths, aside from treating the person as opposed to the disease, is that it has an entirely different take on the pathology and physiology of the body, and can sometimes make sense of a seemingly unconnected symptoms within one recognised diagnostic pattern. It may well be that a local blockage or disruption caused by the accident is impacting on the overall balance, rather than the accident itself affecting the immune system.

 

It would be best to seek advice from a BAcC member local to you, and to ask if they feel that they can do something for your specific symptoms. Most practitioners are willing to give up a little time without charge to assess whether acupuncture is appropriate for potential patients before committing them to treatment.

Q. I have had a sports related injury since September 2011. During a football match I felt a tear in my upper leg / groin area.

I haven't noticed any information on your website regarding this area - so is it possible to treat using accupuncture?

I look forward to your response...

 

A. There is no doubt that acupuncture is used quite frequently by traditional acupuncturists, doctors and physiotherapists in direct treatment of muscle tears. The points which they use, where needles are inserted, are often the same, even though the theories on which the selection is based are often very different.

 

Heretical as this may sound to some of our members, where sports injuries are concerned it is often essential to be treated by someone who specialises in working with athletes or sportsmen because there are often additional exercises and manipulations which will aid recovery and advice about what to do and not do which will speed up healing. Many BAcC members do actually have some background in sports medicine, but there are also a significant number of physios who use acupuncture alongside conventional sports medicine to great effect.

 

Your best course of action is to start by finding out who local to you offers sports medicine, and then to ask who within that network uses acupuncture alongside conventional skills. We have no doubt that traditional acupuncture alone would be able to resolve the problem, but there will be a large component of recovery management in getting you back to full fitness, and this is an acquired skill.

Wednesday, 29 February 2012 17:33

What about Parkinson,s disease ?

From the perspective of research studies alone it would be difficult to give any firm recommendations for acupuncture as a treatment of Parkinson's Disease. There are a number of studies, some undertaken in the US but the vast majority in China, which show some positive signs, but not of sufficient change in a significant number of patients under study to draw any firm conclusions. You can see some of the studies if you google 'ncbi acupuncture parkinson's disease' - the National Centre for Biotechnical Information in the States is a convenient way to find many of the the more significant papers. There is also a Cochrane Review of a protocol for assessing the value of acupuncture, but as far as we are aware this has not been put into action yet.

 

 

With all chronic degenerative conditions the extent to which acupuncture can help has to be carefully explained. It is often, as one rather ironic patient said, a case of 'getting worse slower', and this is extremely difficult to quantify in a condition like Parkinson's where the disease progression is neither smooth nor predictable. Anecdotally there are many accounts of patients finding that treatment helps with some of the manifestations of the disease, such as the periods of rigidity and freezing, and a general sense of well-being, but these are not documented sufficiently well to be able to claim any undisputed levels of efficacy.

 

The best course of action is to see whether a BAcC member local to you will give you an honest assessment from an eastern perspective of what they might be able to achieve for your own unique patterns. There may be elements of how the condition manifests which they may feel that they can help.

Wednesday, 29 February 2012 17:16

i have had a slight (chronic) discomefort

Q. i have had a slight (chronic) discomefort in my bum whilstdriving for the past 3-4 years.started playing squash again after a couple of years off, first 5-6 games fine, last one agonising. pain in the bone i sit on. internet says ISCHIAL TUBEROSITY which is 99% correct.would accupuncture be any good?

 

 

A. The first thing a medical practitioner of any persuasion would have to do would be to establish exactly what was causing the pain you are experiencing. The fact that it has come on after a renewed burst of heavy exercise would normally point in the direction of some kind of muscular strain or tear, or inflammation of a tendon or ligament. Spending a long time sitting in a fixed position with the pressure of the ischial tuberosity on an inflamed area would certainly be capable of generating some fairly intense pain. However, pain can be referred in all sorts of ways, and the sciatic nerve might have been affected higher up in the lower back with the pain manifesting in the buttock.

 

A BAcC member will generally spend a good deal of time trying to elicit what type of pain it is, where it is felt, what makes it feel better or worse, and so on, both to get a sense of the western pathology which this most likely represents and to inform the treatment strategy which they will adopt from a Chinese medicine perspective. BAcC members are required to work closely with orthodox healthcare professionals and with other complementary therapists, and if in the practitioner's point of view there is something which needs to be investigated further by X-ray or something which manipulation may help to correct quickly, you may be referred to a doctor or osteopath. If not, the practitioner will give you an honest assessment of whether he or she thinks they can help you.

 

There is a growing body of evidence for the use of acupuncture for pain, for sciatic pain in particular and for musculo-skeletal conditions, although most of this research originates in China and is regarded as methodologically unsound at the moment. Our factsheets on the BAcC homepage under 'research' and 'factsheets' will give you a detailed breakdown of the current evidence and its index of reliability. In this particular case, if you decide to go ahead with treatment, it is probable that you may be asked to stop playing squash for a while to give the problem a chance to recover