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Q:  A nerve in my lower back does not seem to function resulting in a pronounced limp ( but no pain ).  I cannot get up onto my toes in the left foot. Can accupuncture help in this instance?

A: The crucial question here is what might have caused the nerve to function, and of course how precisely this has been diagnosed. We are assuming that you will have been seen by a neurologist, but if not it is very important that you see your GP and arrange an appointment to see one shortly. Any loss of sensation or muscular action needs to be investigated, not necessarily urgently (we don't want to sound alarmist) but certainly with reasonable haste to ensure that if there is any temporary impingement of a nerve the damage does not become more permanent through failure to get the appropriate treatment quickly.

On the assumption that the condition has been assessed by a specialist, the best we can say is that acupuncture treatment may help to restore some of the function, but there is very little evidence of research which would enable us to give even a partly qualified recommendation. If the nerve has been damaged in some way, then we have to be honest and say that acupuncture treatment will probably have no impact at all. The regeneration of nerve tissue in this part of the body is not as much as people might hope after injury, and once damage has occurred that is usually that.

That said, Chinese medicine is premised on an entirely different understanding of the body mind and emotions as a system of energy, called 'qi', in movement, and symptoms are understood in this context to be a result of some changes in the nature of the flow which affect the rhythm or balance of the energy. From this perspective, a weakness in a specific muscle set or loss of sensation would usually be seen as a deficiency of flow or a blockage, and the practitioner's skill would lie in working out how to reinstate the flow.

In some cases, such as the treatment of post-stroke patients, there is a growing body of evidence that the paralysis and muscle flaccidity which accompanies a stroke is significantly improved by acupuncture treatment, and in China patients are often given an intensive course of acupuncture treatment starting as soon as possible after the event. The point that we are making here is that from a conventional perspective this does not make sense, but clearly patients benefit, and the argument is that from the Chinese medicine perspective and understanding of strokes, something can be done. 

The same can be said of sciatica and other problems, such as osteoarthritis, which are diagnosed as being the result of changes in the lower spine causing impingement of nerves and pain. We have treated enough patients over the years whose X-rays show degenerative change but whose pain has been reduced to know that the causation accepted as 100% by conventional medicine need not be so clear, and that a percentage of these cases are amenable to acupuncture treatment because the pain arises from a different cause which ca be understood in Chinese medicine terms.

Our best advice is to visit a BAcC member local to you and ask if they can give you a better assessment based on a brief face to face interview about whether in their view acupuncture treatment may be of benefit. It is highly unlikely that this is the only symptom linked to a major physiological change, and they will also be able to assess using Chinese medicine techniques whether there is other evidence of energetic disturbance which may explain what is happening.

However, as we said, a great deal depends on whether your condition has been thoroughly investigated within conventional medicine, and what if any reasons were given as to why the problem occurred in the first place. Practitioners of all systems of medicine will ask the same generic questions - when did it start, was the onset gradual or sudden, what treatments and investigations have you had, what was happening at the time of the symptom appearing or shortly before, and so on - to make sense of what is happening. If you have the answers to these from your existing health practitioners it will inform what an acupuncture practitioner can advise you.     

Q: I have suffered with back pain since I was 14 years old.  I'm now 27 and still suffer greatly. I was diagnosed with scoliosis in my lumbar region and was seen by a physio. I've made several visits to my GP but they keep supplying pain relief. Last year I paid to see a chiropractor- most of my spine was out of line and he helped. Then pain carried on and I then tried accupunture and deep tissue massage. This eased the pain a little. Because both practises mentioned a lot wrong with my spine, sciatica and whip lash symptoms I revisited my GP hoping for a scan to get some answers. Instead they referred me to back2health- an NHS back clinic. I have been having accupunture and chiropractor there and my pain is getting worse- and I'm finding daily activities demanding. I am now having to take constant pain relief. Is the treatment they are giving me a cause for the worsened pain do you think? As the acupunture is extremely painful there- unlike when I received it at a Chinese clinic. I just want some answers to my pain and find a way of managing it

A:We are very sorry to hear of your experience. It must be very disappointing to have been getting somewhere with treatment only, like in a game of snakes and ladders, to find yourself going downhill again.

In our experience, any disturbances which people experience after acupuncture treatment are usually short-term and transient, lasting 24-48 hours at most. We are aware from patients who visit chiropractors and osteopaths that much the same applies, two or three days of mild to moderate discomfort followed by a gradual improvement. Our view is that often when the body is severely out of alignment, any attempt to correct posture means bringing into play muscles which have been working out of position for a long time and which are resistant to change, even positive change.

If things are getting worse rather than better, then we always recommend that patients stop having treatment. It may be that the getting worse has nothing to do with the acupuncture and chiropractic, and we are used on occasion to be taken to task because we happen to be treating at the same time as a problem is deteriorating for other reasons. However, if there is any doubt we recommend that someone stops treatment for two or three weeks to see what is really happening.

Your mention of the different between the needling at a Chinese clinic and the needling at the Pain Clinic does make us wonder what kind of acupuncture you are receiving. In our experience, many of the western medical professionals who use acupuncture use thicker needles inserted in a slightly different way, and this can often feel quite rough after a more traditional Chinese approach. However, the really big difference is the theory underlying the different types of acupuncture. Whereas western acupuncture is largely based on trying to release trigger points in muscles and achieving a neurophysiological effect to jam out local pain signals, Chinese medicine is based on an entirely different view of the body as a system of energy, called 'qi', whose balance, rhythm and flow needs to be optimal for the body to function properly. If everything functions as it should, then the structure of the body follows. This is the opposite direction to osteopathy and chiropractic which both work on the premise that correct structure allows and encourages normal function. This is why the two types of treatment can dovetail well.

Whether the current treatment is causing your problems to be exacerbated we can't say. In our experience it would have to be serious mis-treatment to make things worse, and we don't believe this is likely. Much more probable is that the treatment you were having before was successful in maintaining a level of balance where the pain was manageable, and if it is within your means to do so we would recommend that you go back to what was working for you. There used to be an old maxim in the profession, whether true or not it is difficult to say, that it often took as many months as the years a patient had suffered with a problem to help to remove it. This may just have been to make us more realistic about how quickly we could help people to get better, but in any event it made us remember that long-standing problems would not simply vanish but would require perseverance and patience. Having had your problems for nearly 14 years it may take a while for the full benefits of treatment to work their way through.

We are assuming that you were happy with the treatment you received from the Chinese clinic, and if so, you would be well advised to go to them again. If not, we are sure that there will be a BAcC member local to you who will be more than happy to see you for a brief chat without charge to give you the benefit of a face to face assessment of what acupuncture treatment as they do it may be able to offer.

Q:  I have a chronic medical infection. I am receiving treatment to combat it but I have been ill for so long that a number of body systems are now locked into "be ill" mode and I need to do something to unlock them.
 There are lots of things doing the rounds at the moment including sticking a stent into the jugular vein and expanding it on the nerve cluster in the neck where I know there are a number of acupuncture points.
 Rife and Fenzian technology is also being used with some success but is massively expensive. I am interested in establishing if it might be possible to do something with electroacupuncture as there seems to be a lot of cross over between a lot of these therapies.

A:  The problem you mention, one of the body being locked into a 'be ill' mode, is a very familiar one to us and a great many other complementary and conventional medical practitioners. A person can be ill for so long it becomes their reality, and attempts to change it can often be thwarted by kind of 'habit' energy which resists even beneficial change.
 
We were going to say that without knowing more about the precise nature of the infection were were limited in what we could say, but of course Chinese medicine is about treating people, not conditions. Although the last twenty years has seen a considerable increase in the 'acupuncture treats x, y and z' articles, we must never forget that Chinese medicine is based on an entirely different theoretical system in which the overall balance of the energies of the body is seen as critical to all aspects of a person's health and ability to recover from ill health.
 
However, your question is a very specific one. As far as we can judge RIFE therapy and Fenzian treatment are very cutting edge interventions which are still the subject of vigorous debate in both conventional and complelentary medical circles. The results of some of the limited trials are, if replicable on a larger scale, very ground-breaking, and the logic of their effects seems compelling. We think that there probably could be overlaps with some of the more experimental forms of electroacupuncture around, but the 'mainstream' traditions of EA equally have overlaps with TENS machines and ultrasound, which are as far from cutting edge as you can get, so the spectrum of possibilities is very wide.
 
We do not keep separate lists of practitioners who use EA, and are not really able to advise you on who you might be able to see to discuss whether EA might prove a close enough approximation to RIFE and Fenzian approaches to warrant a few sessions. One of our members has written the definitive UK textbook on EA, and if you contact him (he is easy to track down by internet searches but our house rules forbid naming him) he may be able to comment more specifically than we can about the latest EA developments. We have to be cautious in what we publish, however; EA is within our wider scope of practice but is not a core element of traditional acupuncture. 
 
We are duty bound to say that good old-fashioned acupuncture practised according to 2000-year old principles has often been effective in our experience in breaking these self-sustaining cycles of illness, and the concept of qi which underpins Chinese medicine theory has a great deal in common with some of the more cutting edge fields of quantum physics and field theory, so it does not necessarily mean that someone has to be using cutting edge equipment to be generating effects at this kind of level.
 
Our advice, as always, is to visit a BAcC member local to you so that they can offer you more precisely targeted opinion based on a face to face assessment than we can at this remove. 
 

Q:   Can acupuncture help with infertility, endometriosis, fibroid and severe abdominal pain. I live in Ghana, how do I find a specialist in this field?

A:We have to say that we are finding it very difficult to locate a reputable practitioner in Ghana. We don't mean that there aren't any, but we have no way of checking from this distance whether someone is a bona fide practitioner or not. There are a number of companies which appear to advertise themselves as having outlets all over Ghana, but the ones that we can find are mainly based in Accra. If you can locate one of these they may be able to help you to find professional colleagues elsewhere in the country. The other option is to ask your Department of Health. Acupuncture is quite often regulated by the state, and this means that there may be a nationwide listing.

As far as the conditions which you mention are concerned. we have a number of factsheets which can tell you how successful is in treating these conditions, The main ones are:

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/endometriosis.html

We have been asked a number of questions about these problems over the years, and one answer which may be of use to you was:

I have 3, 4cm Fibroids. I am also trying for a baby. Does accupuncture help to reduce the size of these fibroids and improve fertility?

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.

It is also worth using the search facility on our home page to see what other answers we have given over the years, many of which may be relevant to you.

What we have to say, though, is that the evidence for the use of acupuncture treatment of endometriosis and fibroids is not great, but that is mainly a reflection of the fact that there isn't a great deal of it in the West, and the studies from China, of which there are hundreds, are often methodologically flawed. Anecdotally we can say that we have had some success with all aspects which you touch on but we would have to be honest and say that fibroids and endometriosis, particularly the latter, can be very treatment resistant, and if they are becoming a source of secondary problems, such as infertility, there may be no other resort than surgical options.

As you can see from the embedded answer, the treatment of fertility problems has become something of a growth area in the last decade, and with it have come entrepreneurs on the fringes of the complementary health world happy to cash in on what is a highly emotionally charged situation. We would advise you to take special care if you do find people who promise results at a price. A bona fide professional will see fertility problems as just another manifestation of problems in someone's energies, and will treat the person exactly as they would if the presenting symptom were headaches or IBS.

That said, we are on the point of recognising expert practice in this field in the UK, and practitioners who have undertaken significant postgraduate training in working with this group will be able to lay claim to recognition as expert practitioners.

We wish you well in your search for a good practitioner.

Q:  What exactly do the needles do to effect a cure. Do they touch nerves for instance?  Is there some sort of chain reaction?  I would like to understand this technique before using it. In the past I did have acupuncture for migraine but do not understand how it works.

A:Many of our patients believe that acupuncture works by touching nerves, and indeed one of the main theories of western medical acupuncture is based on the neurophysiological consequences of putting needles into tissue with significant amount of nerves.
 
However, Chinese medicine has an entirely different understanding of the body, mind and spirit. In Chinese thought, everything is regarded as a manifestation of energy, which the Chinese call 'qi', and the human body in all its complexity is understood as a flow of qi which has distinct patterns and rhythms. These patterns can be disrupted by external causes like climate and food, but also internal causes like strong emotions or mental strains. Because everything is interlinked, blockages or disruptions in the flow of energy can have effects on all sorts of levels - a physical pain will often be accompanied by a corresponding mental or emotional state which may not appear to be related at first sight to the primary problem- and also a problem in one area can ramify to create problems in other areas. This is why traditional Chinese medicine practice does not place all of its reliance on symptoms; these may simply be secondary problems where the main problem lies elsewhere and may not even be generating symptoms itself.
 
This world view is not unique to China. The Japanese have the concept of 'ki' and Indian culture has a concept of 'prana', both of which fulfil the same sorts of function in understanding how the body, and indeed the world, can be understood and treated. This is vastly different from mainstream western thought which has rejected this kind of theory, sometimes called 'monism' which rests on a belief in a single universal substance from which everything is made. Instead in the West the dualism which has held sway since Descartes is very much predicated on a material substance in the world which can be understood in purely mechanical ways, and something of a different order on mind and soul which is not reducible to a physical state.
 
That said, at the cutting edge of scientific thought in quantum physics, some interesting parallels are starting to emerge, and it is highly possible that the next hundred years will see ancient Chinese medicine theory being better understood within mainstream science as these state of the art understandings start to permeate more popularly understood science.
 
The use of acupuncture needles, therefore, is to influence the flow of energy and to make good areas of the body where the flow of qi has been compromised. With a 2000 year history acupuncture has a wealth of sophisticated means of diagnosing and treating imbalance, and while the basics are relatively easy to learn, by contrast to the highly complex training in Western medicine, the application of these principles can involve a lifetime's endeavour. The saying used to be that Western medicine was hard to learn but once learned easy to practice, whereas Eastern medicine was easy to learn but very hard to practice. So much depends of the observational and sensory skills of the practitioner, and requires a level of development beyond day to day experience. This is why we sometimes describe our work as mastery of an art rather than technical knowledge of a skill.
 
In the end, though, there will always be patients for whom taking this on board is a step too far, and all we can say to them is that we are happy to be judged by our results.