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A: The short, and somewhat trite, answer is that they make sure that they are properly trained to begin with. Training in the UK, at least for entry to registering bodies such as the BAcC, requires a three year degree equivalent course which ensures not only that the basic knowledge is wired in but also that the bestg possible clinical practice is inculcated in the students. Knowledge without wisdom and good practice is irrelevant, and the crucial element in training is not being able to generate lists of symptoms and syndromes but to be able to respond to the unique problems which each patient brings to the clinic. This requires a great deal of supervised practice, in our view, to give practitioners the confidence to be able to adjust and refine their work to the patient's best advantage, and also to deal with situations where things don't go as well as they hoped. Knowing what to do is important, but knowing what to do when something goes wrong is the sign of true skill and mastery.
Making sure that someone follows best practice is an individual responsibility, but regulatory bodies such as the BAcC have the responsibility for checking that practitioners registered with it maintain their skills and develop as practitioners. As well as offering our own advice and support, with a great deal of valuable material being available on our website and through our professional journals we also have a mandatory requirement for members to undertake what is called CPD, Continuing Professional Development, which is aimed at making practitioners develop their skills after they have qualifed and for as long as they practise.
That, of course, is the carrot. The stick is that we have some very well defined rules of behaviour, skill and conduct to which we expect our members to adhere, and we are always ready to take sanctions against someone who does not continue to meet or adhere to our standards. Expelling members is a rare event, but we do have occasion to ask members to up their game in terms of basics like good record keeping or respecting boundaries. The BAcC is a particularly well-behaved professional body, and disciplinary cases are rare. Above us, however, sits the Professional Standards Authority, a government agency with whom we are accredited, and its task is to ensure that professional associations such as ours continue to demonstrate that we are protecting the public by making sure our members are properly trained and accountable, and that members of the public have access to advice, support and pathways to complain if they are unhappy with any aspect of the treatment which they receive.
Q: My 23 year old daughter has always suffered with colds/bad throats throughout her childhood. Unfortunately it has carried on into adulthood and this last year she has had one after the other. Would acupuncture help her, she also has at times suffers with hair loss, leading to bald patches.
A: The evidence for the treatments of cold and flu, as you can see from our factsheet
does exist but is a little less than convincing. This does not come as a great surprise to us, though. The kinds of trials favoured in the west for proof of efficacy, the so-called randomised double blind control trial borrowed from drug testing, does not particularly suit acupuncture treatment in general, and colds and flu in particular. The aim of RCTs is to reduce the number of variables to measure a specific outcome, but from our perspective the biggest variables are patients whose unique energy balances we work with, the from any perspective deciding what counts as 'identical' in two colds to make testing possible is well nigh impossible.
Chinese medicine has a very rich understanding of the conditions which from its perspective create the symptoms which we describe as colds, and most are related to the climate and changes within it. The Chinese were essentially an agrarian race, and factors such as exposure to wind and cold, or damp and heat, were seen as inherently threatening to a system unprepared for them. The fact that we are not exposed to similar conditions does not change the fact that the symptoms as they appear in modern times are amenable to the same treatments.
However, while there are agreed protocols for treating what we call colds, the situation with a cold which continues without really clearing, or which renders the person susceptible to cold after cold is slightly different, being seen by the Chinese as a weakness in the immune system, although this was not a word they used; in Chinese medicine the defensive energy of the body would be said to be weakened to the point where it cannot throw off the 'invasion' of the factor which generates symptoms. While the treatment of a relatively fresh cold is often aimed at clearing a pathogen, the treatment of a long-term weakness often involves building the whole system up. In modern times the advent of conditions grouped under names such as ME, or Post-Viral syndrome or Chronic Fatigue syndrome often display clinical features which are similar to defensive energy weakness.
This does not mean that they are automatically treatable. As you know, many people are crippled with ME and it can take years for someone to recover, so we would not even begin to estimate whether your daughter can be helped by acupuncture treatment. Our best advice is for her to visit a local BAcC member and to ask in person what, based on her signs and symptoms he or she may be able to achieve. This is likely to be far more helpful than bland positivity from us.
As far as hair loss is concerned, we have been asked questions about this before and we repeat our most recent advice below. There is a cautionary overtone to our response as you can see, because we have found that the fact that sufferers are highly self-conscious about their appearance can, if you are not careful, be mis-used in running up a large treatment bill. We are not suggesting that this is what the practitioner here is/was doing, but it is something which has to be borne in mind.
It may well be, though, that the weakness in the immune system is a contributory factor, so it may be worth seeing, if you decide to pursue acupuncture treatment, whether straightforward constitutional treatment helps to reduce the problem.
Q: Are there any acupuncturists specifically trained in non-surgical "face-lifts" who are members of BAcC and if so, are there any in Oxfordshire?
A: We find ourselves a little bit conflicted when we receive questions like this. There are a number of areas where are developing standards of expert practice. This in turn might lead to qualifications which would enable us to recommend specific groups of practitioners. However, at the moment the focus is on paediatrics and obstetrics, so although we are aware of a number of courses which offer postgraduate training in facial or cosmetic acupuncture, we have not yet agreed the standards against which they should be measured.
However, it is widely recognised by many of the trainers in this area that using facial acupuncture techniques without also attending to the underlying patterns of energy is not as effective. We always recommend, therefore, that if someone is conducting their own search for a practitioner they should ensure that the person is a fully trained professional acupuncturist, not someone who has learned a few specific techniques as an adjunct to beauty therapy. There are also some safety concerns about being treated by someone who is not a professional acupuncturist. There is no difference in health and safety terms between someone who uses ten needles a year and someone who uses ten thousand. The same scrupulous attention to hygienic practice is essential. We have some reservations about very short coirses which offer the technique and all of the safe practice essentials in a very time.
If you undertake a google search under 'facial acupuncture oxford' you will find a number of BAcC members whose standards you can trust and who have undertaken additional training in this area of work
Q: Would acupuncture help with a chronic nerve pain which I have in my shoulder which refers down to my forearm?
A: A great deal depends on whether the pain is caused by impingement of a nerve, either in the shoulder itself or higher up in the neck, which can also produce similar sensations. If there is a structural problem, then while acupuncture treatment may help to reduce any inflammation which results from the trapped nerve, the problem will recur until the structure is fixed. While acupuncture treatment aims to restore natural function, and may eventually encourage the structure to right itself, the quickest way to deal with a problem such as this may be to visit an osteopath. They will be able to tell you whether there is a problem, and perhaps re-refer you to an acupuncturist after they have corrected it. We find this kind of cross-referral often works well; once the structure is settled it is important to get the muscles and tendons to re-assume their correct positions and tension. Acupuncture treatment seems to help well with this.
However, this is to take a very Western view of what is going on, and there are many occasions when the sensation which someone describes can be explained, understood and treated in Chinese medicine by using a different way of looking at the body. From a Chinese medicine perspective, which is premised on a good flow of energy (called 'qi') in the body, pain arises from deficiencies, excesses or blockages in the flow. The exact nature of the pain will inform the practitioner about the exact nature of the blockage. It is perfectly possible that working in this way the pain can be treated.
The best advice we can give, though, is to visit a BAcC member local to you for a brief face to face assessment of whether they can help with the problem. It is very difficult to tell at one remove what the best course of action is, and a visual inspection would help to determine whether or not an onward referral to an osteopath is more appropriate.
Q: My farther has had his leg amputated 4 years ago and still has very painful phantom pains, can this be treated with acupuncture?
A: Phantom limb pain can be a very distressing phenomenon.
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:
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.
The best advice we can give, especially when there is so little case evidence to point to, is to visit a BAcC member local to your father for advice on his specific circumstances. There may be a number of initial soundings which he or she could make to determine whether treatment may be of benefit.
The problem with conditions like this is that there are case studies which offer encouragement, but nobody publishes the results of case studies where things don't work, so for the small number which have been successful there may be ten times as many where treatment was tried and failed. It is best not to over-excited by the fact that some treatments work. Everything works for someone, but that doesn't mean that somehing works for everyone.