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Q: I had accupuncture in my left foot after which my right leg felt very cold and tingling -  is this normal?

A:This is not a normal response to treatment, and although we could provide a possible explanation we would be very surprised if the treatment and this sensation are connected.

Essentially, traditional acupuncture treats the system as a whole, whatever the symptoms or conditions which the patients comes in with. Because it is an enclosed system in which all the pathways interconnect there is always a possibility that dealing with blockages or even simply improving the overall flow will cause an increase in the energy supply to areas which could deal with a weaker flow but not with something stronger. This can be diagnostically very significant, and a practitioner can often uncover other
areas of blockage as the system starts to work better.

Generally, though, cold and tingling sensations arise where the energy is lacking, and it would be most unusual for this to be the case after a treatment. However, without knowing exactly what the practitioner did and why it is difficult to comment. What we can say with certainty is that the practitioner, if there are a BAcC member, will not only be the best person to offer advice but will be delighted to discuss with you what may have happened.

The other thing to bear in mind is that the symptom may have nothing to do with the acupuncture treatment and may have arisen for some other reason. This is not a sneaky way of avoiding responsibility, but a genuine concern. We have sometimes seen situations develop where the argument kicks in about whether the treatment caused the problem or not while the problem itself goes untreated. What you are experiencing is not a normal state of affairs, and if it persists for more than 48 hours after treatment you can say with some certainty that it has not been caused by it. In this case we would always recommend that a patient visits their GP to start to establish what is happening.

In all cases, however, the practitioner is usually the best resource at your disposal, and nearly all of our members are very happy to guide patients through the options for other forms of care and attention if a problem arises which they are not able to treat or consider would be better treated by other forms of conventional or complementary medicine.

Q:. I have separated my spine at T12/L1 causing irreparable damage to the spinal cord and leaving me paralysed from the waist down. Due to the damage to the spinal cord I now suffer from chronic nerve pain in my right leg. I was wondering if acupuncture would be suitable to try and lessen  the pain?  Would I locate someone
in South Wales with the correct neuropathic knowledge to try treat it?

A:  This is a very difficult question to answer. Our first thought on reading your question was that it reminded us of phantom limb pain, the sort of problem which people have after an amputation where they can still feel often unbearable pain in a non-existent limb. Oddly enough, there has been some very interesting research in this area, and in answer to a question we were asked some time ago we said:

There have been a number of studies over the years which describe the use of acupuncture in individual cases, and if you google 'acupuncture phantom limb
pain' you will find examples such as:

http://www.ncbi.nlm.nih.gov/pubmed/6972207

We are also aware of a paper published in the Journal of another acupuncture association which cites the following papers about phantom limb sensation:

Bradbrook D (2004) Acupuncture in Medicine Acupuncture Treatment Of Phantom Limb Pain And Phantom Limb Sensation in Amputees. 22; 2; 93-97

Hecker
H. -U et al (2008) Color Atlas of Acupuncture 2nd Ed. Thieme, Stuttgart

Hill
A (1999) Journal of Pain and Symptom Management Phantom Limb Pain: A review of the Literature on Attributes and Potential Mechanisms. 17; 2; 125-142

Johnson
M.I. et al (1992) Pain Clinic Treatment of Resistant Phantom Limb Pain by Acupuncture: A Case Report. 5; 2; 105-112

Liaw
M.-Y et al (1994) American Journal of Acupuncture Therapeutic Trial of Acupuncutre in Phantom Limb Pain of Amputees. 22; 3; 205-213

Monga
T.N et al (1981) Archives of Physical Medicine in Rehabilitation Acupuncture in Phantom Limb Pain. 62; 5; 229-2321

The mechanism by which the treatment works is not at all clear from a Western medical point of view. From a Chinese medicine perspective it is perhaps easier to make sense of the appearance of the pain from the fact that the channels which run through the affected area spread out across the body, and even in 'conventional' Chinese medicine treatment it is not unknown to treat a problem in the lower left limb by using points in the upper right limb. The fact that the opposite limb is missing would not necessarily render the treatment useless.

However, in your case it may be more complex. The fact that you are paralysed from the waist down does not necessarily mean that the sensory as well as the motor
nerve pathways have been blocked or severed. We would be interested to know if you have lost all sensation in the lower limbs, because some of what you feel
may be a genuine pain caused where you think it is rather than an illusion created by severed nerve endings.

In any event, it may well be worth trying acupuncture treatment on the basis that it cannot do any harm and may possibly do some good. The only thing we would say is that the experience of the researchers was that where treatment seemed to work it responded fairly quickly. If you did decide to go ahead, we would advise you to set a finite limit of sessions to avoid getting locked into a cycle of treatment which extends beyond any useful point with no result.

Your best bet is to contact a BAcC member local to you for advice, and perhaps arrange a brief visit to let them have a first hand look at the problem and give a more realistic assessment of what may be possible. There are no specialists in this area of which we are aware, mainly because Chinese medicine is generalist by its very nature, and all of our members are equally well-qualified to deal with the vast majority of problems which come their way.

Q: I have a condition called anosmia which is loss of my sense of smell which happened for no known reason 2 years ago. Scans have shown nothing abnormal and steroid
treatment did not work. Would acupuncture help me?

A:   Google is a massively powerful search facility, and if you google 'acupuncture anosmia' it looks as though there are a number of studies which give cause for hope. If you look carefully, however, you will see that there is but one study

http://aim.bmj.com/content/21/4/153.long

which is frequently quoted, generating a number of secondary references. This study, what we call an n=1 case study because it is the report of a single case, is important because it suggests that there may be something worth looking at in the use of acupuncture treatment. The weakness of n=1 studies, of course, is that they are not designed to test acupuncture, and the positive outcome could have arisen for any number of reasons, especially since the case study can provide no evidence for the sudden onset of the problem.

That is not to say that acupuncture treatment is not worth trying. The use of Traditional Chinese medicine involves a great deal of questioning and examination to determine the state and flow of the energies of the body, called 'qi', and the state of the organs which are responsible for all of the functional aspects of the body. Even where there is no obvious cause from a conventional medical point of view, it is rare for a symptom to stand alone in Chinese medicine other than where it derives from a blockage. In this
case, if the blockage is removed, the function is restored. We strongly suspect that this is what happened in the case study, and blockages of this kind can sometimes occur for no obvious reason. Generally speaking, though, a pattern of disharmony will generate a number of symptoms or changes in function, not all of which are clinically significant from a conventional perspective, and these may point t specific imbalances affecting Organic function. Note that we capitalise the word 'Organ' - what we understand by this in Chinese medicine is a great deal more than a physical unit in the body. The Chinese understanding of an Organ embraced functions on all levels, body mind and spirit, and whenpractised properly Chinese medicine can legitimately claim to be holistic.

The best advice we can give is that you visit a BAcC member local to you for advice on whether they think that acupuncture treatment may be of benefit, and to discuss briefly with you the other aspects of your health which may indicate wider patterns which in turn may link to your problem. That is not to say that there may not be as simple a treatment as the one described in the paper, and one of the points used has the Chinese name 'Welcome Fragrance' suggesting that it may have a direct bearing on the sense of smell. You would certainly not do any harm. However, we would be more likely to look at this as a functional disturbance and be looking at other factors in the
system which might point to a treatable pattern.

Q:  I had acupuncture for a neck muscular problem 2 days ago and had a wave of panic during the session. I have had awful panic attacks since and haven't slept
properly for 2 nights. Whilst I do suffer with general anxiety I don't get panic attacks that often or at least not as severe or as long as this.  Do these feelings go away and if so, how long before you get back to normal. I feel as though I'm going to be like this forever!

A:  This is a rather strange consequence of treatment, and we rarely see anything on this scale. The first and most important thing to say, though, is that most adverse effects of acupuncture treatment are transient, lasting 24 to 48 hours at most. In fact, we strongly suspect that by the time that we have got this reply to you, the Bank Holiday having intervened, the episodes will have grown less frequent and perhaps stopped altogether. The only slight concern would be that they become self-sustaining - worrying about whether a panic attack will happen can sometimes convert a more manageable general anxiety into something a bit more troublesome.

As to what has caused this, a great deal depends on the kind of treatment which you were given. It would be most unlikely that there has been a physical cause. We can't think of any physical structure which could generate panic attacks if it were to be touched by a needle. The only thing we can surmise is that for some reason the muscular tension in the neck is a reflection of a somatisation of the anxiety which you have been experiencing at a lower level, and releasing the muscles has generated a small surge of the kinds of feelings which are 'contained' there. This is much more common an experience in deep tissue massage where colleagues often report that working on
deep structure can often release some very powerful emotional responses in people who would not have suspected that this lurked within. As we say, this is unusual but not unknown with acupuncture treatment, and if this is the case then the effect is likely to be short lived.

The best person to speak to about this is the practitioner who treated you. Knowing exactly what they did will make it far easier for them to make sense of what has happened, and they will almost certainly be able to treat you for the panic attacks in order to break any cycle which sustains the feeling. Chinese medicine works on many different levels simultaneously, and although someone may use points which affect the physical structure of the neck, these can impact on accompanying issues in the mind and emotions, and the practitioner may well be able to make sense of exactly what has happened.

As we said, however, we strongly suspect that the attacks will be subsiding even as we pen this response.

A:  Surprisingly there are very few studies of the use of acupuncture treatment of polymyalgia. We suspect that the principal reason is that the condition can present in so many different forms and that the diagnosis itself is not always 100% accurate (it could be a number of other problems) that it is difficult to identify clear enough trial and control groups to set up the kinds of trials which are favoured in the West, the so-called randomised double blind control trials.

However, the symptoms which people experience are not a modern phenomenon, and Chinese medicine has been confronted by, and dealt with, similar presentations for over two thousand years, and has ways of interpreting what is happening within an entirely different conceptual framework. Chinese medicine, as we are sure you already know, is based on an understanding of the body as a flow of energy, called 'qi', whose flow and balance in the body determines someone's overall health and well-being. Any excesses, deficiencies or blockages cause pain, and the skill of the practitioner lies in determining how best to restore correct function and flow in the whole system.

Clearly from this perspective each patient is unique and different, and when dealing with a problem like PMR this is a positive strength, since it takes seriously the individual presentation which the patient reports rather than shoe-horning all cases into a generic formula treatment. From a Chinese medicine perspective the emergence of PMR pointsto both local and systemic disturbance, and the underlying question is why these symptoms have arisen in this person. This means that ten people presenting with the same symptoms may have ten different treatments, based on the different nature of the problems which have generated the same symptom.

PMR is such a wide-ranging problem that we would be reluctant to offer any kind of prognosis here. Some cases are very straightforward; but in our experience the majority aren't. The best advice we can give is that you visit a BAcC member local to you for an informal chat about what acupuncture treatment may be able to offer you.

As far as electro-acupuncture is concerned we are not really able to offer a view. Although many of our members use EA alongside traditional treatments, there is an equally large number of practitioners out there who use it on the basis of a western medical diagnosis and on a much more local treatment basis. There is not a great deal of evidence for the effectiveness of EA on PMR in David Mayor's definitive textbook and online resource, but that is not to say that it does not work. The same considerations apply as to the remarks above about research; it is difficult to assemble a trial with a condition with such wide variations of presentation. The best that we can say
is that if the EA is applied according to traditional Chinese medicine principles, we would believe it had the same likelihood of dealing with the imbalances in the energy as ordinary needles.

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