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Q: Can acupunture be used for cardiac rhythm disorders such as frequent ventriluar ectopics and non-sustained ventricular tachycardia? Is there any acupunture expert who specialises in treatments of these disorders?

A:One has to be very careful answering questions such as these. Taking the pulse a the wrist is one of the key diagnostic techniques in Chinese medicine, along with looking at the tongue and a number of other evaluations. The rapid pulse and the irregular pulse both have clinical significance in the tradition, and point to specific disorders of organic function as understood within this paradigm of medicine. However, these may not all involve the heart - in fact, most of them don't - and any suggestion that this is treating the heart as it is understood in the west needs to be set aside.

From a conventional medicine point of view, there is not a great deal of evidence that acupuncture can treat these problems, although what little there is does tend to be very positive, although not always methodologically sound enough to use as the basis for a recommendation. A good example of a systematic review is:

http://www.ncbi.nlm.nih.gov/pubmed/18992625

Some of the published research also involves animal experiments, sometimes called 'ratpuncture in the trade, and although the results here may be promising it is quite a large assumption to believe that human physiology will respond in the same way.

We think that it would certainly be worthwhile talking to a BAcC member local to you about what these two conditions may be telling them about the way your system as a whole is functioning. From our perspective all of our members are equally well-qualified to deal with the vast majority of patients who present at their clinics, and it is obvious from what we have said earlier that there are no specialists in heart problems per se - Chinese medicine primarily treats the person, not the condition which someone has.

Q: I have suffered from peripheral neuropathy for 16 yrs which is a nerve damage problem. I walk with the aid of crutches. Would acupuncture help this problem?

A:We have been asked several times about the treatment of peripheral neuropathy, and one answer which still seems to sum up our position says:

Q: Is there any evidence that acupuncture can help with peripheral neuropathy and if so is there a distinction between chinese and western acupuncture?

A: There is some evidence that acupuncture may be helpful in the treatment of neuropathy, as our factsheet

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

but this is not yet compelling enough for us make a firm recommendation. If you google for results from the US National Centre for Biotechnology Information, a very useful research resource, as 'ncbi acupuncture peripheral neuropathy' you will find references to a number of studies, some of which seem to show very positive results, others less so. Treating nerve damage with acupuncture, however, suffers from the same limitations as any other therapy. If the damage is already considerable there is less chance of reducing the pain and loss of sensation.

Western and Chinese acupuncture operate from entirely different conceptual bases, although in practice many of the acupuncture points they use will be in the same places. Most western acupuncture is based on a neurophysiological understanding of acupuncture, that its effects are caused by stimulation of local and distal nerves. There are other variations on this theme, but in essence the practitioner works with a western medical diagnosis and very often uses needles in and around the affected area. Chinese acupuncture is based on a theory of energy, called 'qi', and its flow and balance in the body. This can often mean that the needles used in conditions like peripheral neuropathy are often local to the problem and seen as a blockage in the flow of qi, but Chinese medicine has an elaborate understanding of the functional nature of the internal organs, understood entirely differently from in the West, and will often look at how the problem may also be a manifestation of a wider functional disturbance in the system. Then, of course, you have the underlying premise of the original Chinese medical systems which were largely asymptomatic, regarding the achievement of overall balance as the primary aim in the belief that this would deal with symptoms wherever they manifested.

The important element in treating peripheral neuropathy is understanding the physiological basis for its appearance in western terms and being realistic about what may be achieved. If this amounts to maintaining the status quo, or even as one very wise patient expressed it 'getting worse slower', then as long as this is the agreed basis for treatment, that is fine. Our members are trained to avoid raising unreal and unreasonable expectations in people with degenerative conditions or permanent physical damage. Talking to a BAcC member local to you face to face may be the best advice if you are considering treatment. They should be able to assess relatively quickly whether acupuncture was a worthwhile option for you.

We are mindful of the fact that you have suffered for 16 years and have been forced to use crutches to move around. This suggests perhaps a greater level of damage than that about which we are often asked, and perhaps the expectation from treatment has to be geared down. However, we are always careful to remind ourselves that we are talking about an entirely different way of looking at the body and how it functions, and there are occasions when making good a blockage or imbalance which has lain untreated for many years can have extraordinary effects.

As we said in the earlier reply, though, the best advice is to visit a BAcC member local to you and let them make a face to face assessment. This is likely to be far more informative than we are here, and may well generate other treatment options for your specific problem.

Q: I have suffered from peripheral neuropathy for 16 yrs which is a nerve damage problem. I walk with the aid of crutches. Would acupuncture help this problem?

A:We have been asked several times about the treatment of peripheral neuropathy, and one answer which still seems to sum up our position says:

Q: Is there any evidence that acupuncture can help with peripheral neuropathy and if so is there a distinction between chinese and western acupuncture?

A: There is some evidence that acupuncture may be helpful in the treatment of neuropathy, as our factsheet

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

but this is not yet compelling enough for us make a firm recommendation. If you google for results from the US National Centre for Biotechnology Information, a very useful research resource, as 'ncbi acupuncture peripheral neuropathy' you will find references to a number of studies, some of which seem to show very positive results, others less so. Treating nerve damage with acupuncture, however, suffers from the same limitations as any other therapy. If the damage is already considerable there is less chance of reducing the pain and loss of sensation.

Western and Chinese acupuncture operate from entirely different conceptual bases, although in practice many of the acupuncture points they use will be in the same places. Most western acupuncture is based on a neurophysiological understanding of acupuncture, that its effects are caused by stimulation of local and distal nerves. There are other variations on this theme, but in essence the practitioner works with a western medical diagnosis and very often uses needles in and around the affected area. Chinese acupuncture is based on a theory of energy, called 'qi', and its flow and balance in the body. This can often mean that the needles used in conditions like peripheral neuropathy are often local to the problem and seen as a blockage in the flow of qi, but Chinese medicine has an elaborate understanding of the functional nature of the internal organs, understood entirely differently from in the West, and will often look at how the problem may also be a manifestation of a wider functional disturbance in the system. Then, of course, you have the underlying premise of the original Chinese medical systems which were largely asymptomatic, regarding the achievement of overall balance as the primary aim in the belief that this would deal with symptoms wherever they manifested.

The important element in treating peripheral neuropathy is understanding the physiological basis for its appearance in western terms and being realistic about what may be achieved. If this amounts to maintaining the status quo, or even as one very wise patient expressed it 'getting worse slower', then as long as this is the agreed basis for treatment, that is fine. Our members are trained to avoid raising unreal and unreasonable expectations in people with degenerative conditions or permanent physical damage. Talking to a BAcC member local to you face to face may be the best advice if you are considering treatment. They should be able to assess relatively quickly whether acupuncture was a worthwhile option for you.

We are mindful of the fact that you have suffered for 16 years and have been forced to use crutches to move around. This suggests perhaps a greater level of damage than that about which we are often asked, and perhaps the expectation from treatment has to be geared down. However, we are always careful to remind ourselves that we are talking about an entirely different way of looking at the body and how it functions, and there are occasions when making good a blockage or imbalance which has lain untreated for many years can have extraordinary effects.

As we said in the earlier reply, though, the best advice is to visit a BAcC member local to you and let them make a face to face assessment. This is likely to be far more informative than we are here, and may well generate other treatment options for your specific problem.

A:There is no evidence that we can find, at least not in English, that acupuncture has been successfully used to treat bunion pain. There may well be papers amongst the many thousands published in Chinese each year, but none have as yet been translated. Working on the premise that important papers often make it into English you could probably assume that this means that there are no landmark studies.

From a western perspective once a bunion, always a bunion, unless you have an operation. The thickened skin and additional bone growth are not likely to be dealt with by anything short of surgery, and the best that is usually offered is anti-inflammatory medication to reduce the secondary inflammation and management advice - wider shoes, forms of cushioning.

There is a long and well-researched tradition in Chinese medicine of the use of acupuncture to deal with chronic pain, and the question in this case is simply how much pain relief treatment may provide and how sustainable it is. If treatment offered relief for a week or so, then it may be a worthwhile continuing programme, but it would not be realistic to look for anything beyond temporary relief alongside conservative management strategies like better footwear and padding.

There may be some merit in talking to a BAcC member local to you who can give you advice on the unique presentation of your problem, but as a general rule we would have to say that the chances of radical change in an area which it is difficult not to irritate in daily life are relatively small.

Q  My daughter, while on holiday, had treatment for a torn shoulder muscle. The acupuncture was Tung Style acupuncture and very successful.(one session).  Since returning home she has tried to locate one in our area, without success. Could you please tell me if we have a Tung Style Acupuncturist in West or North Yorkshire ?

A:We are pleased to hear about the success of your daughter's treatment using this style of acupuncture, but we are afraid to say that we do not record the individual styles which our members practise. There are simply too many variations within a complex tradition to provide a simple key to any list. We have checked the website of the association which claims to be the primary one for the training and accreditation in this style

http://worldtaa.org/website/membership/

and the only UK practitioners also happen to be BAcC members. We have located another member who has trained in this style, but our searches did not get us any further, and the practitioners are all based in the South East.

The best that we can suggest is that she contact one of them to see if they know of any colleagues in the UK who have also trained alongside them - the informal network is usually pretty strong. Other than that we would have to say that just as there are many styles of practice, there are many ways to travel to the same destination and it is probable that practitioners working in other styles will be as effective. Chinese medicine is predicated on the same shared structures, and the difference in styles does not have as much impact on the outcomes as people may assume from a cursory look.

If she cannot locate a Tung style practitioner near you it may still be well worth her while speaking to a BAcC member local to her about what they believe they may be able to offer.